Sunday, September 23, 2012

Our bodies, our cars

If you're reading this column over breakfast or are inclined to a queasy disposition when faced with a story that involves medical procedures gone awry and hospital bills piling up for these procedures, be forewarned. A reader from California's question to me may give you pause. Or it may remind you of just how frustrating lingering medical conditions can be when a remedy proves hard to find.

Several years ago, the reader had surgery for prostate cancer. Because the surgery left him with mild incontinence, he has had many tests and undergone multiple procedures from several urologists. His problem has not been fixed.

He's found himself in the emergency room on three different occasions as a result of his condition. "I've just received the billing statements from the latest unpleasant attempt at getting dry," he writes.

For the most recent office procedure (collagen injections), he writes that he was charged $1,500, the same as he was charged for the prior two office visits. He says that this most recent round resulted in great pain and a lot of bleeding.

"Coupled with what may have been an allergic reaction to the drugs given, another office visit was required -- at an additional $100 charge -- on the following morning I was told to go to the emergency room at the local hospital," he writes.

His total bill for the emergency room visit totaled $5,000, plus another $400 charge for the emergency-room physician.

"The previous two abortive occasions resulted in similar billing amounts from the office procedures and the resulting emergency room follow-ups to put me back together," he writes.

"It seems to me that if a doctor attempts a procedure which does not fix a condition, but instead results in a significant cost to counteract its outcome, it's unethical to bill the victim for his failure," he writes. "Shouldn't I expect the same billing consideration from my doctor as I do from my auto mechanic?"

My reader raises a good point. When we go to an auto mechanic and he works on the car to fix, say, the brakes, if we find that two weeks later the brakes don't work, we expect the auto mechanic to make good on his work without an extra charge for that same work that should have fixed the problem in the first place. If it turns out that the brakes are fine, but something else goes wrong within a couple of weeks, we might not like that the auto mechanic didn't catch the problem, but we wouldn't expect him to eat the cost of fixing the new problem.

In the reader's case, the same problem seems to be recurring and the doctors haven't been able to fix it, but it's hard to make an argument that the human body is exactly like a car. I'm not a doctor, but it seems like a reasonable expectation that while more often than not our doctors help heal us, there are times when finding a solution proves challenging -- even if it means trying a similar procedure more than once.

Given the frequency with which he's had the same experience with this doctor, were it me, I might seek out a second opinion. But the right thing for the reader is for him (or his insurance company) to pay the bill for the procedures done and to continue doing whatever he can to work with doctors to find a solution to his problems. Whether the cost of medical care is woefully out of whack is a whole other question. 

Jeffrey L. Seglin, author of The Right Thing: Conscience, Profit and Personal Responsibility in Today's Business and The Good, the Bad, and Your Business: Choosing Right When Ethical Dilemmas Pull You Apart, is a lecturer in public policy and director of the communications program at Harvard's Kennedy School. 

Follow him on Twitter: @jseglin 

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(c) 2012 JEFFREY L. SEGLIN. Distributed by Tribune MediaServices, Inc.

1 comment:

William Jacobson said...


Comparing humans to cars here is a flawed analogy. Humans are far more complex than cars and component parts can not usually be swapped out for defective parts as they can with mechanical devices.

The state of 21st century medicine provides that you are paying for a procedure to be performed, not guaranteeing the outcome of that procedure. If the procedure is not performed to current medical standards, medical malpractice provides relief.

A satisfaction guaranteed standard where medical professionals had to guarantee outcomes or provide refunds would drive medical costs (and insurance) to even more astronomical levels and price most of us out of the market.

Perhaps your reader should look at his glass as half full... he survived prostate cancer. Thats a heck of an outcome at any cost.

William Jacobson, esq
Anaheim, CA

Can I skim some books from my friend's donation?

A reader we're calling Josh, owns a pickup truck. Josh seems a good enough fellow, indicating that in addition to using his truck as...