I try my best to be mindful about costs when dealing with self-pay patients. Most of them are hard-working and want to pay their bills like responsible citizens. We do get the occasional absolute deadbeat who thinks that the world owes them everything and makes sure that you understand that.
Antibiotic choice is one of those things that can really make a difference in terms of costs at discharge. Generic drugs can really save the patient money (and increase compliance), providing they are feasible to use. However, whenever you get an infection in which we have cultures showing resistance, we have no choice but to choose something that is often very expensive. Whenever this occurs, I usually get our case managers involved to see if they can get them in an assistance program. Some people don't even appreciate this, however....
Me: "Ok, I've got you in an assistance program for the medication. You should only have to pay about $20 for the whole prescription."
Patient: "Why can't your pharmacy just give me all the medicine I need to go home with?"
Me: "Sir, this is a $100 a pill medication. I'm getting you a $2000 course of antibiotics for $20. I'd say that's more than fair."
Patient: "But if I get it from you, it's free."
Me: "Our pharmacy is not going to give you $2000 in medicine from our own supply."
Patient: "Why not? I'm not going to pay for this visit, anyway."
Me: *sigh*
#freeisneverreallyfree
4 comments:
Yes, there's nothing free in Freetown.
Dying is Free.
Funerals, however, are not.
argh-- i think i told this story, but it is SO appropriate here. i was a school social worker for four years. during that time, i often helped families pay for field trips or helped distribute book fair money to kids in need. i knew we had an entitlement program when i was doing a "kona ice" fundraiser, and a first grader told her teacher, i don't need to give you any money. ms. xxx will just give it to me for free." but so many families were so grateful and tried so hard, so i just continued to try to bear that in mind. as someone who is now broke and has no insurance, i SO appreciate it when a doctor bears costs in mind throughout my treatment. don't let the entitled ones get you down, doc. some of us are thankful and will remember your kindness!
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