Today I’m going to write about a topic that has to be said.

It has to be said because, we have to speak (or write) the truth, the whole truth, and nothing but the truth. Even concealing something and preventing the truth from being known, is wrong.

Sometime ago someone asked me for medical advice. Yes, its quite common being one of the few medical doctors in the family to be consulted on various occasions and having opinion sought regarding a wide range of matters, not just among family, but also among non-medical friends.

So someone’s child fell and sustained a cut, what we doctors like to call a laceration. The parent told me the child was waiting for admission in the emergency department of a private hospital. They do attend that same hospital for other services too.

laceration
The laceration…

I imagined it must be quite a horrible laceration to require admission and suture under general anesthesia so i asked how big is the cut, and the answer was 1-2 inches and I said, please send a picture.

Ok I admit, I did not see or attend to the patient. It is also not my specialty although I do have practical experience suturing in the emergency department and also experience working in pediatric emergency department. Scrutinizing the picture, I asked, why didn’t they just apply glue? The cut did not look that big and it was not at a pressure area. So I didn’t see any good excuse not to at least attempt gluing it first.

I asked my husband, who is a plastic surgeon, and he completely agreed. So we asked the parent to ask the doctors over there to at least try glue first. There were many answers, like it was too close to the eye, that the laceration was deep etc. We still thought that glue attempt was the best action, in the interest of the patient. Even though GA is deemed very safe nowadays but why unnecessarily admit a patient and spend time and money for something completely not needed in the first place.

Well it turns out, I was told the next day, that the patient must be admitted in order for the insurance to pay for the services. If the hospital had just put glue and steri strips and then discharged the patient, insurance will not pay.

Why? Why will insurance not pay? It was an accident. The child didn’t purposely fall to cut the forehead. The parents or employers pay premium, they deserve to have medical treatment that will be paid by the insurance.

I think the medical insurance companies play a huge role in this whole mess leading to unnecessary treatment by the hospital.

Something should change. Something must change. Nothing is ‘free’. In the end someone does pay for the unnecessary medical treatments, and it is through increased premiums.

healed
Scar is healing.

By the way, the patient did well, was discharged and had the stitches removed. I advised the parents to massage the scar as per plastic surgeon instructions to give much better appearance within 4-6 weeks.

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