Medical Story of the Week

This comes from a regular physician reader of the Authentic Medicine Blog:
Around Christmas time, a family member on Medicare went to her “Local Mega HMO Clinic” because she was still anemic from bleeding hemorrhoids which had been operated on successfully several months ago.  They NEVER checked her B12 levels, just iron and hemoglobin levels.  This does not surprise me because a B12 injection costs less than $2, but a blood transfusion is like red gold.  But that isn’t the real outrage here
So she goes to get yet another blood transfusion at the clinic and has an allergic reaction this time.  Her provider deems it appropriate to transfer her to the hospital next door (of course, we can correctly assume this brand new hospital is attached directly to the clinic so the clinic can bill higher rates).  Because this is a small town, the clinic/hospital is correspondingly small, too.  To walk between the front doors of the clinic and hospital is maybe 500 feet on the outside, even less inside.  They called the ambulance crew to put her in a gurney and take her over to the hospital.  She just asked if she could walk over there herself or if her husband could wheel her over in a wheel chair via the indoor corridor.  She was then informed that “due to HIPAA regulations she had to be transported via gurney in an ambulance.”  She was loaded into the ambulance which ceremoniously drove all the way behind and around the complex and then ended up back at the front, but other door.  She and her husband were so disgusted by this theatrical antic imposed on them that her husband sarcastically asked if it wouldn’t have been better to helicopter her next door.  The head nurse in all seriousness replied, “Oh no we can’t.  It is too foggy to fly today.”

Does anyone need to ask why our healthcare costs are skyrocketing out of control?

Do you have a story you want to share?  Send them in and let our readers comment.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  8 comments for “Medical Story of the Week

  1. Dub
    February 6, 2014 at 10:19 pm

    Bet the hospital had bought the practice!

  2. DrHockey
    February 5, 2014 at 10:00 am

    Occasionally I see a patient with fecal impaction in my office. When I first went into practice, we arranged for a visiting nurse to go to the patient’s home to disimpact them — no muss, no fuss, no patient complaints. It was a fast, successful, and low cost solution.

    All that ended when Medicare stopped paying for the visiting nurse. Now, the patient has to go to the E.R., incur new and additional charges, and even though we call in advance and send them with a note of what to do, they occasionally get a C.T. scan “just to be sure.”

    • Sir Lance-a-Lot
      February 5, 2014 at 10:37 am

      You didn’t really just say “no muss” about a disimpaction, did you?

      • DrHockey
        February 7, 2014 at 8:15 am

        Touché! 😉
        Oh no, there will be another tongue-in-cheek comment about this, too!
        Ah, shades of ye olde Placebo Gazette.

  3. Lee
    February 5, 2014 at 9:55 am

    Non-medical person here – at 70 got first kidney stone – real pain – called my small town ambulance for ride to local hospital – they were “out-of-service” so next town over had to get me – never mind what went on after – the town over charged BCBS $1638 for the ride whereas 23 months earlier for a ‘heart attack’ my own town to the SAME hospital billed BCBS $619, to be fair, this was at Noon and the latest was at midnight – perhaps After Midnight the fee doubles – the late great JJ Cale would be proud ………….

  4. Kristzina
    February 5, 2014 at 8:29 am

    In the last hospital that I worked at there was an attached Veteran’s home with a hallway that leads to the ER. But, any patient being sent to the ER for evaluation (most often for nothing serious) would have to be transported not by wheelchair down the hall, but by ambulance. The poor patient would have to be swaddled in blankets and strapped to a gurney, rolled outside and into the rig, then driven through the parking lot to the ER ambulance door to be off loaded. EMTALA law supposedly applies because it’s considered a transfer.

  5. Sir Lance-a-lot
    February 5, 2014 at 6:39 am


    We have patients refuse ambulance transport to the hospital every day (and it’s several miles away).
    We just warn them about how they could have a heart attack / pass out / die on the way, have them sign the release form and let them go.

    You can’t force people to take the ambulance if their mental status is normal. It’s illegal.

  6. Sarah
    February 5, 2014 at 6:11 am

    Medicare requires an ABN for ordering a b12 level with the diagnosis code anemia. Maybe they wanted to order it before but couldn’t find an “appropriate” ICD code.

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