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New Grad NP

The Cost of Providing Care

Published November 1, 2012 11:17 AM by Samantha Damren

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?  


Ms. Lenz,%0d%0aI could not agree with you more! It is a daily struggle treating patients with financial constraints and limited, to no health coverage. It is so disheartening when a provider has to decide which diagnostic tests or medications to order to provide the best care and keep the patient from starving.  Hopefully, with the Affordable Health Care Act, we will have better means to dispense health care to our patients in the very near future.                                                                  %0d%0a%0d%0aMargareth

Margareth Erie, Primary Care - FNP, County Health Dept. November 12, 2012 8:56 AM
Lantana FL

This is a difficult ethical question.  What is the right course of action?  

I have also seen individuals who could afford to purchase health insurance coverage but instead use the funds to buy a bigger house, SUV, or motorcycle.  And after years of making poor health choices they are a shipwreck - with regards to diabetes, HTN, etc.

How can we know what is the right thing to do?  I have concluded that one must keep an open mind to each patient and situation.  Not apply categories.   Work with the patient where they are at.    

Brenda Lenz November 3, 2012 10:04 PM

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