Uninsured Patients in Retail Healthcare
I am finding that more and more people are presenting without health insurance. I am also finding that more and more people are presenting with problems that are inappropriate to this setting as well as a traditional health care setting. Are the two related?
The other day a patient presented for evaluation with left arm and chest pain. She was immediately sent to the emergency department. There have been many instances when patients have presented with that same complaint and other acute emergencies like abdominal pain, severe headache or severe cellulitis, to name a few (they were also referred to the ED). We also have patients requesting medication refills for their chronic conditions; many have been out of them for a long time.
I appreciate the confidence these patients have in us. We could take care of them in the correct setting of course. But, as we know, presenting in an office setting of any type with these inappropriate conditions can be potentially detrimental to patients' health.
I believe that most people are aware that we are here for nonurgent episodic care. But now in this time of high unemployment and no health coverage, people are desperate and not always thinking clearly about their best health interests. For example, they hope that we can look at them and tell them they are not having a heart attack.
Some of the stories people convey about their circumstances will tear your heart out. They've been out of work for a long time, or they've just lost their house. It takes a lot of talking and convincing to persuade some of them to go to the emergency room or urgent care. We keep lists of local health departments, physicians, local indigent clinics, etc. We also try to keep a working knowledge of other types of programs available for people who are underinsured or have no insurance at all. For example, we have a program in Georgia called Breast Test and More for women 40 years old and over who are uninsured which enables them to get their pap and mammogram at reduced or no cost to them.
Educating people about the things we can do in this setting is a very important part of our job. Educating people about how to access appropriate care is a vital part of our job and one of the things we do best.