In the beginning….. Adam

When Adam turned 1 year old, my wife and I took him to the pediatrician’s office to get his vaccination shots.  It was in the middle of winter so we bundled him up in a warm fleece snowsuit outfit that covered his hands and feet, leaving only his cute chubby face exposed.  We arrived to Adam’s well visit, which was free and covered by his insurance.  However, when the nurse took his temperature, Adam had a low grade temperature of 100.4.  Alarmed by this, she took it again.  Indeed he had a fever.  She rushed off to get Adam his liquid tylenol and alerted our pediatrician.

The pediatrician examined him and said “it’s probably just a virus that he has.”

But he has no symptoms?

“He may develop cold like symptoms soon,” said the pediatrician.  “So, we can’t give Adam his vaccination shots today, because of the fever.”

As we were checking out, the office staff stopped us and said that we had a copay.  We said that we were not here for his fever, but for his vaccination.  The staff then said that due to his fever, this visit became a sick visit and now we had to pay for this visit.

 

We have good insurance and the copay was only $25.  A minor inconvenience, one would say.  First world problem, another would say.  True.  But, it was the injustice of it all.  We were not there for a fever.  We didn’t even get his shots.  And we had to pay.  Also, the pediatrician didn’t do anything.  I wasn’t even reassured by his diagnosis.

 

This event got me thinking about another unjust case that I had in the Emergency Room.  A young man had come in for his chronic back pain.  He was unemployed due to his back pain and lost his insurance.  He came to the ER, because he believed that something was wrong with his back and wanted an MRI. I discussed with the patient that unfortunately his chronic back pain without any other complicating symptoms were not serious enough to get an MRI approved by the radiologist from the ER.  He became angry, because he felt like he was getting neglected by the health care industry.  He shouted at me as he was walking out that he better not get a bill, because I didn’t get him an MRI that he wanted.

This patient interacting really stuck with me.  I truly felt bad for the patient and wished that I can help him get an MRI.  However, I could not lie to the radiologist and falsify his medical records to make his illness more severe so that he could get an MRI in the ER.  Never mind that he would get an astronomical bill for the MRI from the ER.  The angry patient has a valid point though.  Why was he getting charged from the ER, when I did nothing for him.  Was my “advice” really worth several hundreds of dollars?

 

So, this is where the ideas for Access Doc started to sprout.  Can we give FREE online medical advice for minor medical complaints to low risk populations?  I believe the answer to this is “yes”.

 

P.S. Adam never got sick when we got home.  He never spiked another temperature again.  We blame the fever on the fleece snowsuit that he had on.