Patients on Strike

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Two posts in one day? I couldn’t help it. Because this Vox First Person essay…

Unpaid, stressed, and confused: patients are the health care system’s free labor

…is my life right now.

I’ve been dying to write a follow-up to A Big Deal (but not a good one), my post about getting a quote for my foot surgery, but since I’m still in the throes of post-op appointments, billing, and general despair, have decided to wait. (Oh, but when I do post about it, it will be a DOOZY.)

Sarah Kliff’s account of her (eerily similar) situation– along with Aaron E. Carroll’s that’s linked in it–has gotten me all fired up all over again. Please go read it immediately.

In the meantime, an excerpt:

Some [patients] have to make a choice between doing their actual work (which pays the bills) and their patient work (which doesn’t). In those cases, prescribing health care with a high patient work burden can be equivalent to denying health care. Medication won’t do much to help a condition when you don’t have the time to make the phones calls necessary to track it down.

There is a risk associated with not measuring patient work: namely, that patients will give up when life gets in the way. This is an especially acute worry for lower-income patients, who often work for hourly wages and have little space to change their schedules.

“When family issues become more urgent, when you need to travel, when your parents get sick, your priorities change,” Montori says. “Life becomes more meaningful than all the work you need to do to take care of your diabetes.”

And I’ll add that, at least in my case, having to put in all that time and effort has made me resent the system/the facility/my doctor and trigger a rebellion in terms of compliance. I can’t be the only one giving my discharge instructions a side-eye or making appointments with plans to cancel them because I’m burnt out from all the work I’ve already done. Can I?

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