Stories

Training on Cost Decisions at the Bedside

Posted by on Oct 20, 2014 in Blog, Stories | 2 comments

Training on Cost Decisions at the Bedside

By Nandita Mani and Elizabeth Oler Medical students are brilliantly frugal. And it’s no surprise — according to the AAMC, the average U.S. medical student incurs $170,000 of debt from medical education. We are a resourceful, smart, and cost-conscious group — so why is the medical school curriculum practically silent on the cost of medicine? During medical school, we are taught to be excellent diagnosticians. The third and fourth years of training provide 60 to 80 hours a week of hands-on learning in the hospital and clinic. We diligently elicit patient histories, perform...

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Comparison of Care: Why One Child Will Die After a Dog Bite and Another Will Survive an Incurable Heart Condition

Posted by on Oct 13, 2014 in Blog, Stories | 1 comment

Comparison of Care: Why One Child Will Die After a Dog Bite and Another Will Survive an Incurable Heart Condition

By Caroline Smith As I finish my post-operative care routine for my nine-day-old patient, I notice that the cerebral oximetry machine is not picking up a strong signal. Despite troubleshooting, I am unable to figure out how to fix the problem, and I head to the Pixus to get a new sensor. Unfortunately, this one does not work either, and we must use a smaller sensor to pick up an adequate signal on this very sick baby. As I meticulously apply the sensor, a nurse jokingly chides me, “Don’t worry, those only cost $200 a pop.” I must look horrified, because another nurse turns to me....

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Willing and Able

Posted by on Oct 6, 2014 in Blog, Stories | 2 comments

Willing and Able

By Nupur Garg, MD I hear an ambulance fast approaching. I’ll be able to breathe soon, I think. Minutes later, I arrive at the Emergency Department with an IV drip, oxygen mask, and neck brace in place finally breathing again. Three months later, still wheelchair bound with my arm in a sling, a collection’s bureau agent was explaining to me the intricacies of the Palo Alto 9-1-1 system. “The ambulance you took after your accident was not covered under your insurance, you see. You owe the city $798.” “You realize, I didn’t order that particular ambulance, right?” It didn’t...

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Costs of care at a student-run free clinic

Posted by on Sep 29, 2014 in Blog, Stories | 3 comments

Costs of care at a student-run free clinic

By Neel Butala, MD There he sat, hunched over with rugged, muscular arms stretched across his abdomen, his weary eyes stealing hopeful glances from behind an otherwise steely facade. Mr. J was a 53-year old Latino agricultural laborer with a history of H. Pylori who presented at our student-run free clinic with persistent abdominal pain, unchanged from his multiple previous visits. As I learned more about Mr. J and his story, I realized that treating him effectively would require understanding not only his medical complaints, but also his broader socioeconomic context. Working at a...

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All on the Same Page

Posted by on Sep 22, 2014 in Blog, Stories | 0 comments

All on the Same Page

By David Cooke, MD “Mr. Jones’ chest x-ray looks normal.” the intern said to me on morning rounds.  Mr. Jones just had a transhiatal esophagectomy or THE.  The esophagus is the muscular tube that connects the back of one’s throat to their stomach.  It can develop cancer or become completely dysfunctional because of benign processes, and therefore need to be removed.  A THE involves cutting out the patient’s esophagus, in Mr. Jones’ case for cancer, bringing the stomach up behind the heart, and sewing it to what’s left of the esophagus in the neck so the patient can eat...

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