Friday, September 30, 2011

24-Year Old Man Killed by Tooth Infection??

I read an unfortunate story on Medscape's news section (originally reported online here) earlier this week. It was about an aspiring paralegal who was also an out-of-work father. He was young - about the age of my younger brother. He got an infection in his third molar (wisdom tooth), and two weeks before his death doctors recommended that he have the tooth extracted. Since he didn't have insurance, he decided to try to ignore the pain.

Two weeks later, he started experiencing headaches and severe swelling, so he went to the emergency room. Doctors there wrote him prescriptions for pain medicine and antibiotics, but he could not afford both and ended up choosing the pain medication. The infection quickly spread to his brain, causing it to swell, resulting in his death.

Stories like these tend to give me a hard time. Sure, he made a bad decision in choosing the pain meds over the antibiotics, just hoping that the problem would go away on its own. He probably wasn't thinking straight; I don't know how much pain he was in, but he was probably willing to do just about anything to find some relief from the pain. However, if someone had just offered to pay for his antibiotic prescription, his six year old daughter would still have a father. I can't hold the hospital at fault; chances are, he just didn't fill the antibiotic prescription at Walgreens when he found out how much it would be without insurance.

The money isn't really the issue; it's the policies that are involved. I understand that hospitals cannot just offer to pay for everyone's prescriptions, and I am not advocating that they should. It just seems like there must be a better option in situations like these... I wonder - did his doctor do a good job of informing him of the risk (death, disability, etc.) if he allowed his infection to go untreated? Or did the doctor do his full duty, and the patient just decided to not trust his doctor because "they don't know what they're talking about?"

(As an aside, I got some hairs cut a few days ago. The woman doing the snipping was chatty, and I ended up giving an outline of the process one has to go through to become a doctor. She was flabbergasted at the time and resources that go into training doctors, laughing as she said, "Yeah, and after all that training, people say that doctors don't know what they're talking about." Sure, doctors are humans and make mistakes, but her point was that anyone who spends 7+ years of post baccalaureate training for their job probably knows a lot more than the average person, yet average people are constantly ridiculing physicians for "not knowing anything." Crazy...)

That's where the new health care law comes in. I have been trying to educate myself on it as best as I can (check out this great timeline of when different parts of the new legislature will come into play), and as I learn more I become more polarized. Some things look great (making it illegal to refuse to insure people with specific pre-existing conditions, requiring all plans to provide free preventative care services, like colonoscopies and mammograms, increasing govt. funding to institutions that provide preventative medicine cheaply), some not so great (mandating what certain primary care physicians can charge based on an assessment of the level of "value" of the care that they provide, transitioning from systems where patients and insurance companies pay for the individual services rendered to systems where patients pay one "package price," regardless of what services are rendered). I worry that it may create as many problems as it fixes due to a lack of foresight, but that's not really the point of this post.

The point is that deaths like this are pointless and SHOULD NOT HAPPEN - especially not in a place like Cincinnati, or anywhere else that literally has the easiest access on the planet to simple solutions like antibiotics. As much as I don't like the principle of it, one positive result of making it illegal (or making you pay a fine) for not having health insurance is that it will make things like this happen much less frequently. Additionally, if the government really can offer cheaper plans, people like the man in this story will be more capable of purchasing healthcare. As a taxpayer, I wouldn't mind paying a little more to fund a plan if it means that girls like that daughter get to grow up with their parents...

1 comment:

Anonymous said...

Amoxicillin was the drug most likely prescribed. It is free at giant eagle;

There are also tons of other free antibiotic programs and $4 drug programs. None of the major pain meds are on a $4 list. (ibuprofen and naproxen (aleve) are both on the list) So this individual choose to pay full price for a pain med (most likely NORCO 5/325, $49.67 for 30 pills, and skip out on the more important and cheaper medication. The hospital also should have sent him home with a print out that lists ALL the complications that have been known to happen from his aliment (death is listed on almost all of them).

I know that we should feel bad and want to change to system. But he made many many bad decisions (not getting his COBRA while out of work, not going to the dentist, not going to the doctor, finally going to the ER and not doing as instructed, going for pain meds instead of antibiotics) It is a terrible tragedy that a human life was lost, but we don't feel bad when someone drives drunk and kills him or herself and they only made one bad decision (driving drunk).

We want to help others and pass this health care reform. But we can't treat stupid.

Also the reform is only going to make it harder for you as you enter med school. Less subsidized loan money, no waiver of loan origination fee, you will start repayment in residency (instead of being able to only pay the interest until you get out), and cutting funding for residency programs (which will have less spots then graduates in a couple of short years). So in residency when you are getting yelled at constantly and under tons of pressure, you will be making around $45,000 a year for working 80 hours a week (legally, and prolly more off the clock) and studying and be forced to pay back on your loans. So we need more physicians and it is becoming harder and harder to become one, along with making less money. An interesting article you may like to read about physician income;
(article should be called the deceptive income of physicians, im not too great at this computer stuff)

Best of luck to you in your goal of becoming a doctor and doing it for all the right reasons

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