Duty · Life in Da City! · Pains in my Fifth Point of Contact

Once Upon A Time….

So, TINS©, TIWFDASL©…Let me take a tangent, here, for a brief moment. (Yep. “Ooh! Shiny!”) The Darling Wife-Mark II and I were visiting my son and his wife, My Darling Daughter In Law, let us call her Esmeralda, and he (the son) had asked me how work was going. I (of course) replied, “Thing of beauty! Why, I spend my days Fighting Disease, Saving Lives, and Beating Back The Scourge Of Zithropenia!”

Esmeralda did not appear to comprehend the level of sarcasm that is my baseline, because she responded, “So, writing scripts for Zithromax is pretty much your entire workday?”

Sigh.

So, back to my story: there was this soul, once upon a time, in a clinic far, far away, who was on Medicaid (since my agency’s mission statement is pretty much, provide healthcare access to those who otherwise are underserved), and was diabetic. But! Wait!

This soul also had a burn on their extremity, attributed to spilling some boiling water thereon. This had occurred a day or two previously, and looked rather gnarley. (No, that is not, strictly speaking, a medical term.)

For those of us who are not In The Sick People Business, extremity burns generally are considered a reasonable referral to a burn center, because if contractions or scar tissue limit the utility of that extremity, life changing disability can result.

The local wound center could not accept him for the serial assessments, dressing changes, and suchlike that treating his wound would require. (don’t recall the rationale for this clinical decision).

I called the burn center at Tremendous State Megaversity, seeking care for this soul. They responded that they did not participate with his flavor of Medicaid. Therefore, I was told, my patient (remember: on Medicaid, which generally maps pretty accurately onto relatively impoverished) would have to pay kilobucks, out of pocket, for their care.

Of course.

So, please remember that the Venn Diagram of “folks on Medicaid” and “impoverished folks” results in a bulls eye of sorts, wherein the “impoverished” circle, encompasses the “Medicaid” circle.

Therefore, my patient did NOT have, nor have access to, kilobucks. So, did I send him to the local wound clinic, which for whatever reason had already told me that they could not accommodate him?

Nope.

Did I send him to Megaversity Burn Center, who had subject matter expertise in, oh, gosh, er, umm, BURNS?

Nope.

Of course, he returned to our walk in clinic, The World Renowned Center Of Excellence, In All Matters That The Subject Matter Actual Experts For Whatever Reason Cannot Handle, for his wound care and his serial assessments.

Because, I’m not bitter. Nor burned out. Nor sarcastic.

Not a bit.

4 thoughts on “Once Upon A Time….

  1. If you can’t afford a burn, don’t get one. If you can’t afford a government, burn them. Do not permit them to get treatment, they only have stolen money; repeat the burning until you get it right.

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  2. Sorry, was especially bitter and nasty yesterday. How is the burn patient doing? I managed to fill a rubber boot with boiling water once, while I was wearing it. No fun, which is why I have not repeated the experience. The worst part was periodic throbbing and pain waves as it healed, only remedy was elevating the foot immediately and rehearsing useful words learned in various military events and places. Weird phenomenon, never understood the cause. Hope your guy doesn’t have the same.

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