Just when you think you’ve heard it all.  Here’s another “not for profit” hospital shakedown story.  Keep this in mind when you hear some spokesperson talking about how much “community benefit” we receive from these mercenaries.

A good friend of mine is an ear, nose and throat surgeon.  Good guy.  Doesn’t mind taking on reallly tough patients that seem to fall throught the cracks.  The type of patient that probably qualifies for some type of entitlement program but doesn’t feel right about it and so doesn’t sign up.  Anyhow, a hardworking but very obese woman developed a nose bleed.  My friend was smart enough to look for the cause and sure enough the cause of her problem was a very aggressive malignant tumor.  Because the patient had no insurance and not much money, my doctor friend worked hard to stop the nosebleed in the emergency room so that the patient wouldn’t have to enter the hospital and face that financial burden.  The nosebleed was controlled, the patient satisfactorily sent home and all was well.  Well…not quite.

My surgeon friend receives a call from one of the administrators at the hospital.  “We need for you to document that the patient was obese and that they required a nutrition consultation.”  “You know that while the patient was there, the nurse spoke with them about how problematic their weight was, and we can charge the patient for a nutritional consultation based on that.” “That’s $200 more revenue we shouldn’t turn our back on.”

When I was in medical school, a very provocative teacher used to challenge us with very disturbing stories and situations then say calmly, “what do you say next and why?”  What would you have said to the hospital administrator?  What would you accomplish by saying anything at all to someone like this, a virtually soul-less mercenary?  The administrator’s comments struck my friend as so outrageous, he assumed that there must be some misunderstanding. 

“Wait.”  “Did you know that this patient has no insurance?” 

“Why yes.”  “Why does that matter?”

“Did you see that the cause of the nose bleed was an invasive malignant tumor?”

“Yes, I did.”  “When do you think you will be able to get to this documentation, doctor?”

When you see the new glitzy hospitals and their clinics and all of the television and newspaper advertising they buy, remember where they got the money to do all of this stuff.  As I’ve said before, the “not for profit” hospitals are less in the business of health care than they are in the business of shaking down the sick and fleecing entire communities out of hard earned wages.

By the way, my friend told the administrator what he could do with his “documentation.”  Hopefully the poor patient will be spared any further contact with this man’s attempts to not make any more profits.

G. Keith Smith, M.D.