The "poor" in the eyes of doctors

A worker who fell from a high-rise construction scaffold was brought to the emergency room in severe shock. After surgery, the patient was transferred to the intensive care unit for observation. After another ten days of treatment, the patient was finally released from danger and transferred to the general ward.

After several weeks of convalescence and rehab, the patient was ready to be discharged. The afternoon before they were scheduled to be discharged, the patient's wife asked the ward treasurer to do a trial calculation of the hospitalization costs. Knowing the amount payable, the family pulled me aside and said, "Doctor, is it true that you are charging that much for the self-pay drugs you mentioned earlier? It's too much, and I'm the only one left in the family who works, so I can't afford to pay for it. Can you please give us a discount or have this amount reimbursed by health insurance?"

"If there are financial difficulties, I can only help you contact social workers to assist." I really couldn't intervene in the money matter. The social worker then had a long talk with them and the final negotiation was for them to pay this amount back in installments, month by month.

I thought this was the best plan, but that night, they left without saying goodbye, leaving behind an empty ward and some worn clothes. The couple just evaporated from the earth and did not even come back to see the clinic. The last time I saw the patients' names was a few weeks later when the hospital received an official document from the Health Bureau alleging that a patient had complained that we were "overcharging for self-pay items.

After many years, I never heard from them again. Whenever something like this happens, I can't help but ask, "What exactly is a priceless life?" There are always family members who give doctors red envelopes before surgery, which may represent how much they think life is worth. Unfortunately, people can be bought, but death is not so easily bought. Life is priceless, as long as you can save a life, no matter what the cost is worth. However, there is another group of people in this corner of society who put money before health because the burden of the economy leaves them no choice.

During another clinic visit, an elderly gentleman accompanied by his well-dressed and bejeweled daughter came to see the doctor. The old man had fallen while walking two days before and had bruises and abrasions all over his body. I tore off the gauze from the patient's body, examined the wound, and taught them how to change the medicine.

"Can we have some gauze and saline?" The patient's daughter pointed to the gauze on the medication change work cart and said, "I'd like some of the beauty tapes, too, if that's okay."

"That may be difficult. I can prescribe the medicine for you, but you have to prepare these medical materials for changing the medicine yourself. Pharmacies are selling them, and the price is not expensive."

"The price is not expensive but also counts as money, your hospital is so stingy." She complained. I didn't want to explain much, so I just pretended I didn't hear it. Due to the secretions and blood stains remaining from the wound, the gauze covered last time had stuck to the wound, and when I tore it off, the old man frowned in pain. "Doctor, please be gentle, my father is in pain." The patient's daughter could not bear it and rushed to remind me from the side.

"The gauze will be stuck after the ointment dries out, you must bear with it. You can also choose the artificial skin, which is an oil-based dressing and won't hurt as much when you tear it off." Artificial skin is not reimbursable by health insurance, but people generally know that there is a less painful way to change the dressing and rarely refuse it.

"Great! Then it's a good idea to put artificial skin on!" She said. I instructed the nursing staff following the consultation to help the old man prepare the artificial skin while explaining to the patient's daughter how to use it: "In the first few days of a new injury, the wound will have more secretions and the artificial skin must be changed more frequently. With as many wounds as your father has, a single change requires about five or six pieces. The artificial skin needs to be purchased at your own expense, and if you run out, you can buy it directly from the pharmacy."

"You have to pay for the artificial skin?" The old man didn't say a word, but his daughter fussed and looked incredulous.

"And how much is a piece of artificial skin? How many times will my father have to have it replaced? How many pieces do you need in total?" She asked a series of questions, all revolving around money. "It's just a few dozen dollars a piece. For a wound like his, you might need a total of one or two dozen pieces, a few hundred dollars at most." I made a slight estimate. Judging from the watch worn on the patient's daughter's wrist to the designer bag carried in her hand, I believe a few hundred dollars is not a problem for them.

"Didn't you say at the beginning that rubbing the ointment would make it better? The cost of the ointment should be reimbursed by health insurance, right? Do I just need to buy some gauze?" I was a little surprised by her question, but it's true that just rubbing the ointment will also heal, so I nodded somewhat helplessly. They left after changing the medicine but didn't take long to turn back again. "Doctor, can you please tell me if you can get a discount on medicine at the pharmacy attached to the hospital downstairs with the receipt from your visit?" When she found out that there was no additional discount, she complained again and I had to ask her to leave.

Although I am always confused by similar cases, I will continue to see patients without changing my mind and stick to the principle of "life is priceless".