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  • Steven Corn

It's Easy For Doctors To Be Cautious...

An alternate title could be:  "How to waste a few hours and hundreds of dollars".

My wife had the flu. After a few days, I take her to her PCP.  They confirm that she has type B but it's too late for Tamiflu.  The oximeter was showing a lower O2 saturation of 91%.  But the X-rays were negative for pneumonia and her lungs were clear.  Just to be cautious, the doctor said that we should consider admitting her and the only way to do that would be to go thru an ER at a local hospital.  We drive 15 minutes, check into a very crowded (and scary) ER. They put an oximeter on her.  Her 02 is 98%+.  So we go home. No medicine necessary and nothing to do but for her to ride out the flu.

The doctor's visit cost me only $25.  The ER visit will probably cost me $300 since I have a PPO. 

I know that the flu can kill and it often does so thru respiratory distress.   I also realize that doctors are trained to be risk adverse.  My instincts told me that the doctor was overreacting.  Being too cautious.  And yet, I didn't want to put my wife in jeopardy.

An episode like this highlights a common dilemma faced by millions of patients every day:  how do you balance risks against financial costs?

Without a financial barrier, everyone would seek medical care for every symptom whether it is urgent or not.  That would strain the system to its breaking point since we barely have enough healthcare providers to deal with the current usage of the system. 

And yet, plenty of people are taking unacceptable levels of risks to avoid a large bill for a service that may or may not be necessary.    Hindsight is always 20/20.  It is easy to measure the risk/gain of a large bill for an unnecessary ER visit after the fact.

We trust our doctors to give good advice.  Ultimately, the patient has to make their own decisions.  But that is like asking an average person whether or not to raise the Fed Rate. A typical patient just doesn't have the expertise to make well-informed and educated decisions. 

Did I make the right decision to take my wife to the ER?  Definitely yes.  Will I hate paying the bill when it comes?  Certainly! 

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