[Moses]

I don't intend this as a rant, but since healthcare has been actively discussed here on the board recently I thought I'd give you a peek into my last 24 hours.

Last night an 18 year old undocumented immigrant came to our local hospital thinking she might be in premature labor. (she was right). She does not work. She has visited our hospital 6 times in the last year. She uses a different name and address each time. Although she was offered MediCal insurance for this pregnancy, she would rather not deliver her baby in Oakland (I can understand that. I was born there.) So instead, she just drops into our local suburban hospital to get her free healthcare.

State and hospital regulations require that I get out of bed to evaluate the patient and get her admitted to the hospital. So I didn't sleep last night. I was busy writing a medical history and documenting a physical examination, ordering ultrasound and blood work and monitoring the patient and her pre-term baby.

At 2 AM an anesthesiologist was summoned out of his bed and brought to the hospital to give the patient her (free) epidural for relief of labor pain. The anesthesiologist also spent the whole night at the hospital. He spent most of that time doing paperwork related to this patient.

I'm getting ready to start seeing patients who have waited several weeks for their appointments with me. I will be called to the hospital in the middle of my office hours to deliver this premature baby. I will be gone about 2 hours if I'm lucky. My overhead costs about $350/ hour.

At the end of the day, I will have lost another nights sleep and be out-of-pocket at least $700. Like me the anesthesiologist, pediatrician and radiologist will be "donating" their time and effort.

The fact that our work is done for free does NOT protect us from lawsuits if ANYTHING goes wrong with the delivery of this premature infant.

Truth is, this isn't really about money. I donate lots of money to charity and I give away a lot of free care. When I typically give free care, the patient is appreciative and grateful. That's very satisfying for me. Patients like these, however, are compelling me to work for free with no hint of a "thank you" at the end of the day.

The beauty of charity work is that you get that warm, fuzzy feeling of having offered a gift to someone in need. This feels different.