Can we say bias?

Salon.com has a July 16th post by a doc titled, “When the bottom line overrides the Hippocratic oath” and I must admit that I was less than shocked when I saw the content of the piece.

Dr. Rahul K. Parikh wrote of his residency days as at a children’s hospital and recalled the unfortunate story of a little boy, his femur fracture (in the dead of the night no less), and the nasty Beverly Hills orthopedic surgeon who asked not about the child’s condition but his insurance coverage. Dr. Parikh went on to say that he was ill prepared to answer such a question and that when he found out the answer (of course he doesn’t remember the details of such a life changing event for a naive new doctor), the surgeon refused to treat the child. Dr. Parikh wrote:

What did I learn that night? Certainly nothing about the preoperative and postoperative management of children with femur fractures. No, I learned how even in the dead of night, in the presence of a child suffering, the bottom line can override the Hippocratic oath.

He went on to discuss the system of health care which admittedly has many problems but when he described a triumph, he pulled a typical class baiting maneuver.

There are triumphs to report. But those often refer to the most fortunate. Take the celebrity mother who went into preterm labor at 35 weeks during a transcontinental flight. She was wheeled into a private hospital room (off limits, of course, to residents), where her private doctor and two neonatal ICU specialists were waiting for her. I was called in a couple of days later and found a very large, intimidating dude standing at the door, checking the IDs of everyone who went in and out. He was the celebrity mother’s bodyguard. While the baby was there, his pediatrician, a 90210 doctor type whose signature wasn’t his clinical acumen but his Tommy Bahama shirts, checked the mother twice a day.

What the good doctor failed to think about in the situation he fuzzily described was the boy and his family. When the Beverly Hills surgeon asked about the boy’s insurance, perhaps he learned that his group was out of network with the plan. A situation like that could result in thousands of dollars out of pocket for the family for a condition that could be treated in the morning by an in-network provider. Perhaps that Beverly Hills doctor really had the best interest of the whole family at heart.

Or perhaps the writing doc’s story is bullshit. We’ll never really know because Dr. Pull Yer Heartstrings poorly described a child’s injury and used class attacks while never really telling us anything except a 90210 zip code and a half remembered story. What I know as the wife of a practicing physician is that the on call doc sees patients no matter financial status so even my perfectly plausible explanation for why a doc might not see a particular patient doesn’t really fit in the scenario provided. If that Beverly Hills surgeon existed, was the only orthopedic surgeon on call and refused to see “those kinds of patients,” he likely would have been facing some kind of reprimand from the hospital’s administration.

But hey, stories like Dr. Parikh’s aren’t really written to inform; they’re propaganda pieces meant to push an agenda while dazzling the reader blind with the authority of the M.D. behind the name and they require emotional upheaval not critical thought. And, let’s face it, it’s hard to get worked up over “I called one of the docs on call at 5:30 and learned that he was non participating with the patient’s plan but found that the boy would be seen in network two hours later. All turned out well and the boy went home two days later.”

~ by Miche on August 19, 2008.