Putting Off a Procedure Comes at a High Cost

Some believe pharmacists don’t know a lot about the practice of medicine. I know enough to understand my mom has a pretty serious problem on her hands.

Last month, she was hospitalized with pneumonia. It was believed she had a bacterial infection causing her lungs to fill up with fluid. Actually, it’s the fluid from her chest cavity seeping into her lungs that is allowing the bacteria to grow.

The pleural effusion is back, and it appears as though it will never go away. We can only treat the symptom, and the only options are diuretics and removing the fluid from her lungs with a needle.

Diuretics have proven to be ineffective thus far, and the physician who has been taking care of her in the rehab facility since discharge felt the fluid needed to be removed surgically.

Mom was taken to one of Scranton’s for-profit hospitals to be seen by a surgeon who would perform minimally invasive video-assisted thoracoscopic surgery (VATS), during which a camera would be used to look around her chest cavity.

Simple, right? Wrong.

The surgeon wouldn’t touch her. He felt the pleural effusion was a complication of her mitral valve repair, and should thus be handled by her surgeon in Philadelphia. The VATS procedure there was no problem, even though it was only performed to relieve that complication.

If I turned away someone else’s patient in my pharmacy, I’d be in a meeting the next day, and rightly so.

Although it’s not actually in the Hippocratic Oath, the phrase “Do no harm” is a credo most physicians live by. Putting off a procedure that should be performed as soon as possible could cause plenty of harm.

I have a feeling this isn’t the doctor’s fault. I’ll bet anything that the legal department has his hands tied on this one: “Not my patient. Not my problem. Not our lawsuit.”

To that end, I’m a clinician first and a son second. Risk is always part of medicine, from cutting a patient’s chest open to dispensing a prescription.

But, the thing that really twists up my insides is the additional cost from this whole mess. The going rate for ambulance transport is $35 per mile, so the 254-mile 2-way trip between Scranton and Philadelphia is an $8890 (plus tolls) ride.

The health care system is laughing all the way to the bank at the expense of my mom, her insurance company, and Medicare. Exorbitant reimbursement rates have created a monster.

The more I deal with my mom’s case, the more I think socialized medicine is a good idea. It couldn’t possibly be worse. This is a prime example of how broken and beyond repair our health care system is, and I’m ashamed to be a part of it.

Jay Sochoka, RPh, is the author of Fatman in Recovery: Tales from the Brink of Obesity.