AllHealthcare

Is it ever okay for a healthcare provider to withhold care to a patient? CA courts recently ruled that doctors cannot withhold care from gay patients (read this article for more info). What do you think? Were the practitioners right, or the courts? Is there a situation in which you would consider refusing a patient because of his/her religion, sexual orientation, or beliefs?

I recently took radiographs for a woman who presented with her arm in a sling reporting that her doctor was just checking up on how the fracture was healing.  She stated that the fracture was over a month old.  With this in mind I expected that she would perhaps present with a fracture of the humeral shaft that was well on its way to healing.  To my horror what I observed was a fracture just distal to the humeral head admittedly with only a slight displacement, but still the sort of fracture that is normally operated on immediately.

Additionally in conference with radiologists that I know well, I learned that this type of fracture is often associated with a primary issue that has weakened the bone at that point such as an infection or other disease process.

She stated that they had wanted to operate on her immediately following her emergency room visit, but that uppon learning she was uninsured she was bounced around from place to place for the simple fact that left alone it would still 'heal.'  Even a non-profit surgery center turned her away because her injury was not 'life threatening.'

This is no manner in which to treat our patients.  They are not commodities to be traded like oil, natural gas, or simply put in storage if the demand drives costs too high.  While increasingly hospitals are adopting business models in order to remain solvent, the focus should never be allowed to stray from healthcare's most basic goal which is patient care.

This is why the suggestion that government should stay out of healthcare and the market will take care of things seems rediculous to me.  The market works in other businesses by eliminating inefficiency through cost, supply, and demand.  By definition charity is not cost effective.  That's why we get tax breaks in order to encourage us to contribute, because we make the same choices that the hospitals and insurance companies do when we get that phone call asking for money.  If we do not have government involvement then people like my patient simply become inefficiencies to be tossed aside while we get on with the process of streamlining care for those patients who can provide revenue to feed the market based economy.

Physicians have a duty to put the patient first, and argue with whoever they need to in order to get re-embursed later.  And if they can't get re-embursed, then take the hit.  I'll come in on unpaid overtime to run the fluro unit for you, and I'm sure there's somewhere out there that will donate the OR time.

No matter if it is for personal or for financial reasons, refusing treatment to patients is unethical, and wrong.