The Cost of Providing Care
I was going to write a blog about neuro-syphilis because I just
recently treated a 29-year-old patient for this condition, however, on
reflection it seems more apt to discuss the enormous financial costs associated
with her care. That being said, neuro-syphilis is a tricky diagnosis; I advise clinicians
to read up on it.
Syphilis is commonly referred to as the great imitator. In
the case of my patient, she presented with symptoms of meningitis. As we began
to peel back the layers of her presentation, we had to consider various
etiologies to explain, understand and ultimately treat her persistent meningeal
irritation. Bacterial? Viral? Was this a vascular problem? All of these
considerations necessitated corresponding tests and extensive lab work, not to
mention specialist evaluations (including us - the ID folks - as well as
neurology) and a lot of antibiotics.
She spent nearly three straight weeks in the hospital. That is
costly for any person, but she was without healthcare insurance coverage. Her
condition mandated treatment; failure to do so could have caused irreparable
cerebral damage and possibly death. Nonetheless, I cringe to think of the cost
of her care and the tidal wave of bills destined for her door. Likely the
hospital will absorb some of these costs, but that seems like a totally
inadequate solution. There has to be a better way.
I wonder how many other providers, new and old, find they
are influenced by the cost of providing care to their patients. Is it best to
restrict the quantity of tests in attempts to spare the patient financial ruin?
In the age of CYA practice, should cost be relegated to the lowest rung of
consideration, financial health be damned?