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Sep
6
2006

by Dan Handel, M.D. and colleagues

An OHSU physician and reseracher, Dr. Handel has submitted an editorial from the Annals of Emergency Medicine for discussion.

It is the end of another busy afternoon in the emergency department (ED). As you finish up your dispositions, a 35-year-old patient with poorly controlled diabetes and hypertension comes in for a medication refill. Reviewing his medical records, you discover he presents often for medication refills. His demographics sheet is marked as “self-pay.”

“Sir, do you have a primary care physician?” you ask.

“No, I don’t have any insurance, and they all ask for the payment up front, which I can’t afford,” he replies.

You have heard this all before. You return to your desk to refill this patient’s prescriptions yet again, knowing that he will soon return to the ED when he runs out or, even worse, will present with an exacerbation of his medical conditions because of his inability to obtain medications.

Residency trains physicians to handle all medical emergencies that present to the ED’s door, but it does not necessarily train physicians to address the ED’s significant social issues. Physicians’ best acute clinical care may be undermined by the social factors that affect the way their patients receive follow-up care. Read the rest of the editorial (PDF).

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Join the dialogue here

Sep 24, 2006 3:10:25 PM
MARGARET ROTH says

I have been in this business a long time. I started almost 40 years ago as a medical assistant. We would hear the story of how patients always paid their doctor last. After the mortgage, the utilities, food, clothing, etc.. At that time I did not have health insurance but it was still possible to get a doctor and pay for the visits as you go along. I guess doctors just got tired of being left out. So,if people would make their and their family's preventive health as a priority we would all be better off.Pay the bill for the yearly physical,make sure your kids are vaccinated. And if you don't have insurance don't sky dive, ride ATV's, or drink and drive. The inability of people to take responsibility for themselves has hurt everyone.

Jun 1, 2011 4:13:36 AM
wholesale nfl jerseys says

if people would make their and their family's preventive health as a priority we would all be better off.Pay the bill for the yearly physical,make sure your kids are vaccinated. And if you don't have insurance don't sky dive, ride ATV's, or drink and drive

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