Going to the Hospital and Ending Up in Court

I was listening to NPR on my drive home from work.  The story of the hour was dedicated to a hospital suing lots of patients for unpaid medical bills.  This particular hospital happens to be the dominant player in our region.  In fact, it’s the hospital I’ve worked with for more than 25 years!

There is a lot to think about here.  The article is lengthy and there are many points.  The audio version is eight minutes long (see the link).

In particular, one part of the article stood out:


Kirchgessner says he plans to argue that hospital contracts, often signed under duress during a medical crisis, aren’t valid. Makary is ready and willing to be an expert medical witness, to testify about whether there are hospital markups or unnecessary procedures.

But Kirchgessner hasn’t had a chance to defend a Mary Washington case in court yet, he says, because each time he gets close to a trial date, the hospital withdraws its case against the patient. 


It’s an interesting theory.  The hospital’s nervousness makes me wonder.

Anyone who has ever been in the hospital emergently understands a couple of things:

A lot of forms get shoved in front of you to sign.  Most of them involve money.

There is definitely an element of duress. You are sick.  You might die.

You really have no idea how much anything is going to cost.   …And, if you ask, the hospital will say it has no idea, either.

You also don’t know how much your insurance will cover and how much you will have to pay.

You cannot even be sure the doctors participate in your insurance. 

One thing you can be sure of:  No matter how good your insurance, you will be surprised by a lot of bills and you will end up paying far more than you ever imagined.  

The billing process plays out over many months or even years.

Emergent healthcare is not something you can negotiate.  When you are in the ER, you are totally at the mercy of the hospital. There is no deal and counter-deal. There is no walking away.  

You sign now or you die.  This is a contract where the hospital holds all of the cards.

I’ve written and cartooned  previously about the insane discounts given to insurance companies compared to the mere pittance offered to cash patients. 

Hammering Those Without Insurance

Yes, hospitals have to get paid or they go out of business.  Yet, the current system is a total mess.

Steven Mussey MD

Steven Mussey, M.D. is a physician in Internal Medicine, practicing in the Fredericksburg area for more than twenty years. He grew up in Springfield, Virginia and earned a degree in Physics from The University of Virginia, Phi Beta Kappa. He earned his medical degree at The George Washington University and was inducted into the medical honor society AOA. He is Board Certified in Internal Medicine. He served in the Air Force for four years before entering into private practice. He particularly enjoys geriatric medical care and working with complex patients. For almost a quarter century, he has been practicing with one other Internist. Both doctors enjoy practice in a small, but busy office, and plan on working into their 70s, as long as they can still find their way to the office. Dr. Mussey is also an avid cartoonist and has a weekly cartoon in the local newspaper. He also enjoys cartoon animation and has had several public service cartoons playing regularly on the television cable systems. 

  2 comments for “Going to the Hospital and Ending Up in Court

  1. arthur gindin
    June 30, 2019 at 6:25 pm

    Yes, signing under duress is accepted by the courts as INVALID.
    A Gindin MD

  2. Sir Lance-a-lot
    June 30, 2019 at 7:53 am

    EMTALA requires every ER to evaluate and stabilize everyone.

    So what would happen if the patient and family refused to sign anything until the patient was stable and able to read and understand all the paperwork, and have a list printed of all the prices of all the expenses, and of all the doctors involved, so insurance could be called and checked?

    That would be an interesting protest movement to start…

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