Cash For Medical Care

There is something wrong with a healthcare system that won't see cash paying patients. Recently, I had a patient who had no medical insurance. She had just finished her practice teaching and was in between college and her first job. When I saw her she had signs and symptom that one would have with a brain tumor. I recommended that she see a neurologist for a comprehensive work up including a MRI. Much to my dismay, I could not get her seen by any private neurologist in the Nashville area. Why, you ask? Because she had no medical insurance. That's right she was paying cash. How many businesses walk away from cash? Not many!

I did not stop there. After all this is Nashville, home of Vanderbilt and Meharry Medical Schools. Surely, one of those institutions would see my patient. After all, they have future doctors to train. Wrong again. No Luck at either institution.

Eventually, she was able to see a retired neurologist practicing a few days per week in a free medical clinic. He saw the importance of getting an MRI and made a few phonecalls. He was a former staff member at Vanderbilt and was able to call in an old favor and get her in for testing. No tumor was found and the patient has been monitored for the strange tumor-like appearance of her optic nerve for a little over a year now. Had this been a severe brain tumor, the patient might have died during those weeks it took to get her in for a MRI.

Don't get me wrong. I am not sure what the fix to our healthcare system is but I do know the system is broke. Health insurance costs are skyrocketing at 16-23% a year. Believe it or not, these increases are not going to the doctors. Over the past several years doctor reimbursements have remained level or declined in most cases.

I am not sure where the blame lies or what the cure is. I am anxious about what lies ahead for patients and for doctors. I do know one thing and that is when I have a patient with a condition that could be life threatening, I want them seen, even if they have cash.