No patient should ever have to say: "I couldn't afford to come see you, doc. That's why it's been a year since my last visit".
In the meantime, they've been profoundly hyperthyroid, or their diabetes has been uncontrolled.
I saw several of these patients this week, and it was frustrating, and made me sad. To realize that the system is so complicated, so broken, that we encounter episodes like these.
And who ultimately suffers?
When naive medical graduates first take the Hippocratic oath, pledging to help humanity, none of us knew then the complexities of practice. Medical economics, bureaucracy, medical insurance, medical malpractice, cost of pharmaceuticals.
We just wanted to heal the sick. Simple as that. Not always cure as we do not have divine powers, but always to heal.
But when situations like these arise, truth be told it makes me feel instead that I've signed a pact with the devil.
In the case of my Graves' patient, she looked frankly cachectic, and has lost 40 lbs off her already lanky frame. And while the labs are pending, I know she's going to be thyrotoxic still.
And so, I made her promise that should finances ever become a barrier again, to call me. If I can't treat her in clinic, I can treat her over the phone. And we can minimize the need for labs once we get her levels stabilized.
But it's such a broken system.