Wednesday, November 16, 2011

I don't like the answer, so it must be a conspiracy

I really don't get this mindset. First, the back-story.

On the bus this morning, I noticed a guy I see semi-regularly was using a crutch. I asked him what happened, little knowing the rant I was in for. It seems that 6 weeks or so ago, he was trying to push a car up an incline, it rolled back on him, and the fender clipped his leg, fracturing his fibula. Being a "manly man", he didn't do anything about it other than tape it up or something. He apparently doesn't like going to the doctor unless he's dying, because all they do is try to cheat him out of his money.

Well, fast forward a few weeks. His leg is swollen from the ankle to up above the knee, and he has pain in his groin area. "Hmmmm, that's not good", he said. And he still didn't go to the doctor. A few more weeks go by, and the swelling is worse. He finally goes in to the doctor, who sends him straight-away to the emergency room. They perform an imaging test on his leg (he said MRI, but I think it was more likely an ultrasound), and diagnose him with multiple DVTs. Naturally, due to the risk of the blot clots detaching and causing a pulmonary embolism, they immediately admit him to the hospital and put him on a blood thinner regimen.

He is, naturally, still on warfarin, and will be for at least 3 months.

Now to his complaints. First, he's complaining that he had to be admitted to the hospital. As he put it, "I still have the blood clots, the blood thinner doesn't dissolve the clots. So why did they have to admit me, but now it's okay for me to be out and about?" Second, he's complaining about the cost. He apparently has a catastrophic health plan, so his out of pocket expenses were pretty high. Third, he's complaining about a "conspiracy". You see, he apparently doesn't understand fluid dynamics, and doesn't understand how a blood thinner reduces the risk of one of the clots detaching. He's apparently asked multiple doctors and nurses, and is not satisfied with their answers. Again, he goes back to the whole "if I still have the clots, why did you have to admit me in the first place?" and "why are they giving me rat poison?"

Here's where the conspiracy part comes in. In a round of industry consolidation, all of the area hospitals and doctors' groups have been bought up by the same entity. For a 5 county area at least, if you go to a hospital or see a doctor, they will be a member of this network. Since he disagrees with the original doctor, and all of the subsequent doctors have given him the exact same information, it must be a conspiracy where they are covering for each other and protecting each others backsides. Oh, and they admitted him just so they could bill his insurance plan, instead of it being the best therapeutic option for him at that time. He's talking about seeing a doctor in a neighboring state for a third opinion, since that doctor won't be part of the same medical group.

That set off a whole round of complaining and ranting amongst several of the other riders. I finally had to put in my earphones and crank up the music.

That whole mindset just drives me insane. He waits for over a month to have a fracture and concomitant swelling looked at by a doctor. He's allowed a highly dangerous medical condition to develop, and now he's complaining about the treatment regimen. In less than 5 minutes using my smart phone, I was able to confirm that the treatment protocol he's on is the standard one. But for him, there's some sort of conspiracy in place to separate him from his money.

Are some of the medical costs too high? Absolutely. Do doctors oversubscribe tests? Quite often. The thing is, as I understand it, these items are actually related. Doctors are naturally scared to death of malpractice lawsuits. So, they carry insurance, which is quite expensive, which increases their overhead costs. Then, they test things to the nth degree just to make sure they haven't missed something, instead of going with the most likely diagnosis.

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