True. But certain types of wounds would require that the doctor inform the police.
Agreed. In fact I was thinking after I posted that of course gunshot wounds call for police notification. And I guess there might be others…I don’t know what the legal requierment is. But of course that’s still different. You notify the police AND you treat the patient. If the patient doesn’t want you to notify the police…well then you can regeretfully inform him you can’t treat him otherwise.
But that’s rather different than saying we won’t treat you until you have ID because you MIGHT have committed a crime.
Well, it’s true that the employer shouldn’t have been paying in cash under CA law.
But that has nothing to do with the main issue of this thread, which is whether or not the doctor should have provided service for the injury. The link you give is from the Division of Workers’ Compensation, and spells out the obligations of employers under California Workers’ Compensation law. It makes no mention of a doctor’s duty of care as it relates to the method of payment or the patient’s identity. Completely separate issue.
And i really don’t know how anyone can suggest that identification should be required in order to receive medical treatment. This presumption of guilt is silly, and the consequences in cases like this could be pretty dangerous. Especially compared with the extreme unlikelihood that requiring ID will actually thwart crime or ameliorate its consequences.
Also, having spent most of my life living in countries with socialized medicine (Australia, Canada, UK), and having seen more than a few people receive rather urgent attention by medics, medical centers, and hospitals, i can say that in my experience ID has never been an essential prerequisite of service. Sure, ID is generally taken, but not necessarily before treatment. Also, many free clinics run by public hospitals require no ID at all.
Furthermore, the fact that countries with socialised medicine might require ID would actually strengthen the OP’s argument, because to the extent that countries with socialised medicine require ID, it is usually taken in order to determine a person’s eligibilty under the socialised medicine system.
America, which lacks such a system, shouldn’t require any identification, as long as the person can show an ability to pay. I mean, Weirddave, you’re a believer in capitalist medicine aren’t you? Why should a person with the ability to pay be refused care simply for not having ID?
That is certainly true, but i’m willing to bet that a knife cut to a persons hand or finger isn’t one of them.
If anyone can find a CA statute that says otherwise, i’ll happily concede the point.
Well, i guess it’s worth doing my own research and looking up the California Penal Code, which states:
There’s more information on the page about the methods of reporting, and there are also sections dealing with neglect and abuse.
I guess that, under (2) above, it would be possible for a doctor to interpret basically any cut as being “the result of assaultive or abusive conduct.” I wonder exactly what proportion of cuts to the hand get reported, and whether there’s any correlation between reporting rates and a person’s general appearance.
That’s correct. If I go into a hospital emerge, I’ll be asked for my medicare card, not because they want to verify I didn’t burn myself with hot fat while robbing a Chinese restaurant, but so they can file the medicare claim.
If I don’t have my medicare card with me, I understand that I will be treated as normal, but then billed for my treatment, which I can then settle up at a later date once I’ve retrieved my card (or if I’m from out of province, made my arrangements with my provincial medicare or private insurer).
Yeez is this a private train wreck or can anybody play?
There is one more logical reason for doctor #1 to refuse treatment; it is possible that he felt he was not qualified to treat such a wound.
Now before everybody hits reply, let me explain. In 1994 I cut three of my fingers badly, my left index almost to the bone at the last knuckle. Medical plan referred me to a local surgeon. This guy was a bozo. Held his tongue out of the corner of his mouth while he was sewing me up. Had the manual dexterity of a wildebeest. He also did not know how to talk to his nurse in anything less than a scream. (If I had a hand that wasn’t bleeding, I would have decked the SOB, the way he treated his employee was just wrong.) Anyway I would not let this surgeon take out my trash, much less work on me after what I saw at his office.
Anyway the next AM I was so pissed, I got the medical plan to approve a visit to a plastic surgeon to examine the work.
The nurse unwrapped my index finger, and her comment said it all
Anyway in talking to the plastic surgeon, I found out that fingers should really be worked on by a plastic surgeon due to the large number of nerves there.
Oh, and yes, I still have a dead spot with no feeling on one side of my index finger. makes starting bolts and nuts a real challenge.
I would have much preferred that if that first surgeon had known when to hold ‘em and known when to fold them.
don’t know if that is what happened here, it is however possible.
Rick, that’s fucked up.
And you’re no doubt correct that some injuries require passing the patient along to someone better equipped to deal with them. But the OP in this case specifically said that the doctor didn’t accept cash.
Simple common sense suggests that if a doctor was declining to treat you because s/he felt the wound needed more expert attention, then:
a) s/he would at least provide some preliminary care in the form of bandages, antiseptics, and whatever else a cut might require
and
b) would actually tell you the reason for passing you along, rather than saying that it was because s/he didn’t accept cash.
and
c) call an ambulance…
Bizarre. I went to an urgent care clinic recently with a sore throat, and the doctor wrote me a prescription for Darvocet “just in case”, even after I told him I’d been doing fine with Advil. And I’m a scruffy looking guy in my early 20s, who had just barely woken up yet at 4:00 in the afternoon. Guess he liked my insurance!
I did not mean to suggest that this particular wound would arouse suspicion.
A few points:
–In general, a clinic has the responsibility to evaluate and stabilize a patient who shows up with an emergent condition to the best of their ability. This doesn’t mean they are obligated to fully treat anyone who shows up; it may not mean much more than calling an ambulance.
–“Urgent care” is often called such to specifically distinguish it from “emergent care”. Emergent=I need to be seen right this second; urgent=I need to be seen before the doctors open their offices tomorrow.
For instance, our hospital just opened an urgent care facility across the street from the ER. I haven’t worked there, but my guess is that anyone who needed serious suturing or a possible hand surgeon consult would be sent to the ED proper.
–My guess is that the OP’s injury was not objectively as serious as he felt that it was, and that the clinic felt it would be fine to keep pressure on it until he could get to a more suitable facility. It’s also possible that it was very serious and was simply beyond that clinic’s ability to deal with it, but since he was able to get it taken care of at a doc-in-the-box without being sent to the ED, I doubt it.
Of course, it’s also possible that the clinic in question was incompetent, corrupt, or both.
–Letting his workplace pay cash rather than filing a formal worker’s comp claim is a bad, bad, bad idea. CrazyCatLady had a dog bite a couple of years ago; it initially looked like it would just need irrigation and some oral antibiotics, but two days later she had to have it drained surgically when the infection got worse. She was out of work for the next six weeks.
If your friend indeed had some nerve damage or any tendon/ligament damage, he may need to see a hand surgeon himself, and he will definitely need follow-up visits. He may also need time off work. All these are going to be hard to arrange absent a formal worker’s comp filing, and my guess is that it would be harder to file it in retrospect if complications arise. If this costs the company through the nose, perhaps they’ll take more precautions next time before turning employees loose on coconuts with machetes.
It’s also hard to imagine that if there is a legit WC claim that they would not also cover pain meds for him.
“OHMYGOD! What is this world coming to?! A busload of orphans plunged into a crevasse today! They were stuck there for HOURS before a tow truck came! Screaming and crying and blood all over the place…How can this happen? They should never have had to wait that long! The bus driver and the chaperones were praying to god to spare their children, and for all we know, they all could have DIED before anyone got there! Something has to be done!”
“Are you serious? A crevasse? That sounds pretty bad. Do you have a link?”
"Well, they weren’t actually orphans. Just one kid lost his parents last year. It was a church youth group, and they ran into a pothole and the axle broke. One kid cut her mouth pretty bad when she hit the back of the seat in front of her, and the kids near her got kind of upset when they saw the blood.
“So the bus driver called AAA on his cell phone, and while they were waiting, the teachers had the kids sing “Jesus Wants Me For A Sunbeam” to keep their spirits up. But the POINT is, they had to wait ALMOST HALF AN HOUR for a stupid tow truck! That’s TERRIBLE!”
That’s horrible. They just dish out anti-biotics?
Whoosh.
Hey knucklehead…read. I realized that sven’s friend went to a clinic at first and got turned away…my tongue-in-cheek response is to become an illegal citizen so you can get FREE care at an ER (since he was short on money as well).
As for the Minute Men remark…I’m not the kind of idiot that would sit at the border…I’m the kind of idiot that realizes that the Mexican Government needs an overhaul…better yet a revolt by its poor people to get rid of the corrupt government officials there.
You obviously don’t know my stance on illegal immigration that well to be making such snarky remark…or you don’t live in California and experience our problems first hand. Only then would you have realized your whooshedness.
Depending on how you got cut, antibiotics are often a good idea.
Hate to tell you this, but a whole ton of American citizens do that too - they suffer from some ailment, put it off because they can’t afford to go to a regular doctor, finally something catastrophic happens, then go get seen at a county hospital’s ER, can’t afford to pay, and often the hospital ends up writing off the bills because they can’t manage to collect, or the patients get on Medicare/Medicaid and their bills are retroactively paid.
At least, that’s what I’m assuming the illegal aliens are doing in the article cited, because it didn’t exactly describe how they’re getting this free care, and I’m assuming it’s the same way lots of other people do.
True enough, but I don’t think people truly understand the risks.
Considering the number of railroad cars strewn around the landscape, I guess I’ll have to concede that the question of what constitutes the “main issue of this thread” is one that reasonable people may differ upon.
But as for me, I’m coming to the conclusion that the real villian of this piece isn’t the physician who told the bleeding patient to go elsewhere or even the healthcare delivery system in the United States (although both of those seem to deserve censure). I think the real asshole here is the employer.
One of his employees hurts himself badly on the job and what does he do? Call 911? Drive him down to the emergency room at Dominican Hospital? No, instead he hands his employee some cash and tells him to go to the rinky-dink storefront clinic across the way so that they can avoid filing a workman’s compensation claim. First off, that’s flat-out illegal and secondly, it meant that the kid got shuffled from one place to another until he found a place that could treat him and would accept cash.
To me, this whole business of IDs or lack of insurance is a distraction. The kid had insurance: workman’s comp. It was just that his jerk of a boss told him not to use it. And even if the kid didn’t have insurance, if he’d just been sent to a real emergency room at the hospital, he would have been treated and stabilized (by physicians specially trained in emergency medicine, no less) with absolutely no need for any insurance or cash.
I think it just looks like the employer cared more about the size of his insurance premiums than he did about the health of his employee. If he was really serious about keeping his premiums low, wouldn’t it have been better to have given his workers more training, better equipment, and a safer way to do their jobs? Surely swinging a dull machete isn’t the state-of-the-art in coconut-opening technology these days.
If it was me who’d cut my hand on the job and been treated like that, I think I’d be very tempted to drop a couple of dimes to the California Department of Worker’s Compensation and the California Division of Occupational Safety and Health. I think this employer crossed the line and put profits ahead of his employee’s welfare.
I have to agree. We don’t know what precisely the type of clinic involved is; maybe they’re an urgent care clinic and couldn’t handle nearly-severed fingers, or maybe he just sliced himself deeply and they’re an emergency clinic that triaged him as not being serious. Maybe he ran in and said he cut himself at work, and offered cash, and the personnel said “whoa, hey, we can’t take cash for this” - knowing that they should be dealing with workmen’s comp. Hell, they might even be charged with something if they knowingly did an “off-the-books” treatment for cash in a workplace accident case.
I don’t care how small the business is, the boss shouldn’t fuck around with the law in this respect. That worker deserved better care than what he got, but it started with his boss.
But he couldn’t afford painkillers? 
He was only supposed to use this cash from his employer for getting the finger fixed? Not for painkillers?
Something definitely seems missing from what the friend told the OP. I’d like to know how a struggling business can have all these people with well-paying jobs, yet have no clue how insurance works, and also believe that a relatively minor accident might put them out of business. They seem, from what we’ve been told, kind of half-baked.