All fof my comments in this thread have been about private clinics that do not accept government funds and are thus not required by law to treat everyone. Where you get off demanding that a private doctor treat people for non life threatening conditions anytime, anywhere is beyond me. Is it OK to demand that a plumber get up in the middle of the night and come fix your toilet? How about Barry Schapiro? Can you demand he present himself at the police station to represent you when you get a speeding ticket? I wanted to pay for my lunch with my debit card the other day but the resturant wouldn’t let me because the total wasn’t high enough. Can I demand that they take my card because I wish them too? Why does it make me an asshole because I think it perfect reasonable for a private business to be able to set it’s own policies? Where does it end, and what exactly can I force you to do against your will?
I have to agree with others placing the blame for this incident squarely on the employer. Employee gets hurt but because they don’t want to file a Workman’s Comp claim they hand him a wad of cash and send him across the street. No doubt they knew he’d be turned away but there was the chance that it’s work.
So poor guy too freaked out by the blood to stop and use common sense, ie apply pressure to the wound until it stops bleeding, instead drives himself to an urgent care where they were underwhelmed by his injury, stitch him up and send him on his way without so much as a lollipop. I wonder why he was prescribed antibiotics and a tetnus shot . OTC pain meds were probably adequate.
Urgent care most likely told him to follow up with his family physician the next day.
Which hand did he hold the Lime in?
Oh yeah. The Lime was in the Coconut.
For 20 Minutes.
At the bottom of the Marianas Trench.
In 1968.
Make that I wonder why he wasn’t prescribed antibiotics and a tetnus shot .
Well, Dave, if medicine is, in your formulation, just a business exactly the same as any other, then i guess you’re right.
I find that a profoundly amoral position, and i guess we’re just going to have to disagree on what the responsibilities of the medical profession are. I was always under the impression that health professionals had ethical guidelines that extended beyond the issue of remuneration, and of “public” v. “private.”.
I guess that, as someone whose livelihood is dependent on the maintenance of a free-market health system, you are understandably loathe to move beyond the issue of medicine as “private business,” but to me the issues are bigger than that.
It may well be that the doctor in this case was doing what he thought best, but i think that, as a general principle, equating a doctor’s duty of care to a restaurant’s decision about debit cards is a rather narrow-minded exercise.
Will no one think of the coconut children?
Did the guy ever put the machete down? Maybe they turned him away because he was still carrying it in his hand and they just made up an excuse.
Something else I don’t get: would a clinic really ask someone who was supposedly so severely wounded how he was going to pay before even looking at the injury? I can’t imagine a conversation like this.
“Help me! I think I cut my finger off! Or severed an artery - I’m gushing blood, look!”
“Before we can look at you, and while you are still standing here in the lobby in front of the little reception window, we must know: How are you going to pay”?
“I have cash!”
“Sorry, we don’t take cash.”
I don’t know . . . something just don’t seem right here. Perhaps this injury wasn’t as serious as told to Sven? Perhaps they did look at it, determined it wasn’t all that serious, and upon hearing the person only had cash (which they don’t take, for reasons I don’t know), they sent him to another clinic? Or they sent him to another clinic for some other reason that was told to the OP?
That’s it! I’m suing! I have excellent insurance! (Actually I didn’t complain about any pain but my GF got some serious pain killers (with codeine) and I’m jealous. I’ve never taken any mind altering pain killers in my whole life).
If this clinic was a small private clinic that doesn’t get public funds or support (medicare etc) and this guy didn’t die from their refusal, I see nothing wrong here. As they didn’t even call an ambulance I’m thinking this guy really wasn’t in any danger, just discomfort.
Um, Weirddave… it’s not just a matter of business policy. It’s a matter of medical ethics. As DoctorJ says:
Indeed, it may well be that they would have had the ethical obligation not to treat someone they didn’t have the resources to treat properly; but they still ought to have put him in the hands of someone who did, which they didn’t.
My WAG: He comes in with a bandaged-up hand and a wad of cash, says something to the effect of “I cut myself at work, here’s some money, fix me up,” and the staff freaks because legally (I suspect) they have to deal with workman’s comp for stuff like that. They don’t want to get in (presumably) trouble with the state for essentially helping a workplace cover up an injury incurred on the job, and so try to tell him they can’t do the cash transaction. Either in his pain-struck brain or in his retelling to even, or in her angered remembering and retelling to us, that got mutated to “we don’t take cash.”
That’s all well and good, and if we were talking about a life threatening injury it would be another matter, but we’re not. Bearing that in mind, mhendo, my response to your post number 105 is “Why?”. Are you claiming that all doctors are obligated to be on call to anybody, for anything, 24 hours a day? If a doctor is eating at a restaurant, and another diner cuts himself with a steak knife, is he obligated to abandon his dinner and stitch the guy up, or can he allow the ambulance crew to take care of it? Are doctors allowed to be people too, or are they just medical machines, expected to comply with every demand for treatment from the public? Really, I don’t understand your position at all.
Speaking of people cutting themselves in restaurants, you know that scene in Nine Months, where the hostess character, who had earlier hit on Hugh Grant’s character at a party, cuts her hand, and piles into the SUV with Hugh Grant’s character and Juilanne Moore’s character to go the hospital when Julianne Moore’s character starts going into labor in the restaurant? That’s really unrealistic. She should have reported the injury to the restaurant manager, who would have arranged to have her sent to the appropriate ER, in accordance with established Worker’s Comp procedures for that restaurant.
I’m always impeding my ability to enjoy a movie by worrying about stuff like that. It’s really annoying, sometimes.
Wow, nice one.
I made an argument that medicine is not exactly like any other business, and that there are issues of medical ethics that transcend the mere question of business. You twist this into an implication that doctors should be non-human medical machines on call to anyone at any time.
Reading comprehension: a generous D-
Analysis: F, for a bad-faith interpretation
Furthermore, your ridiculous example is completely irrelevant to the question at hand. First of all, your restaurant example assumes that there is, in fact, an ambulance crew coming to fix the problem. If this is indeed the case, of course there’s no need for the dining doctor to get involved. But if, for some reason, outside medical assistance could not be found, i’ll bet that most doctors would be willing to put down their knife and fork and render whatever assistance was within their knowledge and the limits of the equipment at hand. And i’d also wager that most doctors would feel some sort of ethical obligation to do this.
Also, the example given in the OP wasn’t of a doctor in the middle of dinner. It related specifically to a medical practice that was open for business, and whose only stated reason for not providing any assistance whatsoever was that they did not accept cash. You at first tried to excuse this on the flimsy pretext that there might be some concern about the patient’s criminal activities. You seem to have abandoned this argument for the travesty it was, and now are focusing on the rights of a private business to pick and choose its customers.
And my point, in my previous post, was merely that directly equating medicine to every other business, and assuming that they work by exactly the same set of rules and ethical obligations, is IMO a fundamental misunderstanding of the nature of the profession.
You’re full of shit. I was not whooshed and you know it. You made a nasty comment about how CA is becoming a little Mexico, like I’ve heard many, many folks before you assert, and you got called on it. Now you pretend it was in jest. Well I call bullshit on you.
Moreover, that article is absolutely crap. It is meaningless drivel. I live in TX, and I work at a hospital, so I know about Illegal immigration, and I know about Hospital woes. Hospitals are going broke all over the place, and although illegal immigration may be exacerbating the problem in CA, they are certainly not the problem in general. The problem is that the health care system in this country is broken, and the current administration chooses to address Social Security instead of Health Care.
So next time you act like a jackass, expect to get called on it.
This is the part that baffles and shocks me so completely. I know that in some countries, they make you pay for things like bandages and needles before they will do even life-saving emergency work on you, but I didn’t think it was that way in America.
The clinic is a private clinic run by a large medical corporation, but it handles most all the county and public health issues not related to students. If you are on medicare, this is the place they will tell you to go. Their website claims they handle “accidents” and “bleeding.” The people involved only mentioned that the injury happened while cutting a coconut and did not mention that it was workplace related.
The hospital is in the next town over (Soquel) and can be a long drive in traffic. It’s not a very practical option for someone who’s main concern is that they are losing blood.
The workman’s comp thing is shady, but I can understand it. The business is an old hippy holdover that has fallen on hard economic times. It’s a low margin business and they’ve recently lost the volume that keeps them afloat. The owner knows it is just a matter of time until he tanks, but he is trying to keep the place open to keep his employees employed as long as possible. Unemployment is extremely high in this area (a six month period of unemployment is not at all shcoking, and most all jobs are low-paid tourist/service oriented things), and most of the people working at this place have worked there for years and are “family.” It will go bankrupt one day relatively soon, and it will be some little thing like this that just pushes the expenses above the profits. But everyone involved wants to put that off as long as possible because chances are a lot of people- including this guy- are going to lose their ability to pay rent when it does.
Well mhendo, when you live with a doctor for 37 years, I’ll allow that you may have some more insight into the nature of the profession than I do, but until then please don’t tell granny how to suck eggs, ok? Lets take this one at a time:
First, I said that in my opinion, the actions of the clinic in the OP, as we understand them, seemed perfectly acceptable to me. If someone showed up at my clinic with a non-life threatening machete injury and a wad of bloodstained cash, I wouldn’t treat them either, that’s what the ER is for. Assuming that doing so isn’t against the law, I saw nothing incongruent with the clinic’s actions, the injured thief with stolen money was just one example of a situation where the clinic treating the thief no questions asked might be the wrong thing to do. I didn’t “abandon” the argument, it stands as an example. Other people have advanced scenerios much more likely than mine to explain why it would make sense for the clinic not to treat Sven’s friend under the circumstances as we know them from the OP.
Second, when you state that I have a “a fundamental misunderstanding of the nature of the profession”, you couldn’t be more wrong. My father is a doctor, and a damn good one, and I’ve seen time and again what your attitude leads to. I don’t there was a vacation we took where he didn’t wind up looking at some strangers bunion, or listening to some old ladies chest or looking into the ear of a fussy baby with an otoscope. Once someone at a baseball game wanted an examination at Memorial Stadium. My father accepted these intrusions with a smile and good grace and complied whenever he was able. When I asked him about it, he told me that frankly it was part and parcel of being a doctor and he never would have gotten into the profession if he didn’t want to help people. I understand all of that, and a lot better than you might think, but that doesn’t change the fact that It. Is. Fundamentally. Wrong. Period. ( and FTR, my father might disagree with this. He accepted all of the baggage that comes with the profession when he got into it, gladly. I’m giving my own outsiders perspective here) In no other profession that I can think of are the members of that profession expected to render professional services just because some yahoo demands them. In the big picture, it’s nothing more than simple theft. People are stealing the doctor’s time and expertise.
I accept that in a life or death situation, doctors have the moral obligation to utilize their training to the best of their ability to save a life, no matter what the circumstances. I make no bones about that. However, if the situation is not life or death, than I think that doctors have every right to chose not to treat a patient. That fact that you and so many other people don’t believe this is exactly what is responsible for every doctor in the world hearing the phrase “Say, doc, could you just take a quick look at this…” as much as they do.
Just get off the fucking high horse about how your poor friend couldn’t even get a bandage without signing over his firstborn while his arm was lying on the floor. It didn’t happen. He cut his finger and had to go through ALL the trouble of getting driven a few miles to a different clinic, instead of walking across the street. You seem to have lost sight that your friend did, in fact, get treated for the injury.
Fucking-A, my dad lost the tip of his finger in a work accident, and had to be driven a few miles to the hospital, he didn’t whine like a little bitch about the trip. Actually, he spent the trip planning his “Will I be able to play the piano when it heals?” joke. Told me he lived his entire life waiting for the perfect setup for it.
If the clinic accepts medicare, then some of these cites suggest what they did was illegal. Which would also suggest that the problem IS NOT THE MEDICAL SYSTEM, but is with the management of the clinic. Care to tell us who they are?
Not to mention that if Mr. Hippie business owner had just followed the damn law, your friend would have gone there under workman’s comp instead of with a fistful of cash. If people had followed the law there would likely have been no trouble at all. Surprising, isn’t it?
Are you just dead-set on blaming “the Man” and “the system” for this situation? Because it seems to me this “old hippy holdover” establishment is breaking the law and refusing to provide its “family” employees with the coverage and protection they’re guaranteed under the law.
But your very presentation of the “thief” scenario at all assumes that the clinic has some way of knowing that the injury is the result of criminal activity. All people are suggesting is that if doctor’s made this assumption about every cut they see, then medicine would grind to a halt and no-one would get treated.
And you are right that others have “advanced scenerios much more likely than [yours] to explain why it would make sense for the clinic not to treat Sven’s friend.” At least their scenarios were based on a modicum of understanding of reasonable medical practice, and not a knee-jerk assumption about criminality.
Well, you appear to stand as living proof that having a doctor in the family doesn’t necessarily lead to an understanding of what medicine as a profession (as opposed to a business) is about.
Also, you have once again misrepresented “my attitude,” as i explain below.
Well, your whole argument falls flat because i have been addressing, in this whole thread, the issue of what DoctorJ refers to as “urgent” and “emergent” care. If you really think your bunion example, or the intrusion at the baseball game over a regulation examination, are the same thing, you are deluded. And if you really think that my earlier argument about a doctor’s responsibilities would have encompassed those situations, then again you demonstrate you interpretive deficiencies.
In your father’s place, i would have told those people to take a flying leap. Those situations are not analogous to requiring urgent or emergent care, as you very well know. If you’re going to keep shifting the goalposts every time you address this issue, then debate becomes pointless.
Again, you misrepresent my earlier argument as justifying the “Hey, doc, take a look at this” attitude. I made no defence of people who expect routine medical advice from doctors in social situations, as you well know. I have quite a few friends who are doctors, both here and back in Australia, and i’ve never asked a single one of them for medical advice. I think that doing so is tacky and intrusive. But you can bet your ass that if i sliced my hand open and one of them were present, they would help as best they could and/or give me advice about who i should see to fix the problem. As far as i can tell, the clinic in the OP didn’t even go so far as to give advice.
Furthermore, in suggesting that doctors have certain ethical obligations that extend beyond the regular business relationship, i have never once suggested that doctors not be paid for the work they do. Doctors put in years of very hard work to attain their expertise and competence, and they deserve to be paid for what they do. If i injured myself in a public place, and a doctor gave me assistance that relied specifically on his/her medical expertise, and went beyond what any other passerby might do to help, i would certainly think it completely reasonable that s/he ask for some payment from me and/or my insurance company.
Also, i don’t know how the issue of “stealing the doctor’s time and expertise” relates to the OP either, given that it has been very clear from the beginning that Sven’s friend had money.
But this is not an either/or situation.
I completely agree with you that the employer was in the wrong. He should have had this situation addressed as the law requires, i.e., under the CA workers’ compensation rules. That he didn’t is not only illegal, but might have contributed to the injured worker receiving delayed medical care.
But this is separate from the issue of the clinic’s refusal to treat. Whether or not you agree with the clinic’s decsion (some do, some don’t), the fact is that this decision was one taken independently of the employer’s wrongdoing.