In the Life of a Fickle Intern

August 31, 2010

Social Work

Filed under: Daily Lowdown — dailymedicine @ 21:23

Medicine is 40% medical care and 60% social work, at least on Internal Medicine in this city. I have been playing social worker for the last few patients that I have been taking care of. One lady had to stay in the hospital an extra three days because we could not arrange for her to go home with oxygen because she was not insured. Not only that, it was over the weekend and apparently, normal people don’t work on weekends and I could not get in contact with anyone. It really sucked because she wanted to go home, I wanted her to go home, and society wanted her to go home (since it cost approximately $1000 a night to stay in the hospital and she was uninsured). Either way, it was a frustrating situation. There was no medical reason for those extra three days! I finally got her out yesterday after many, many phone calls to social workers, case workers, etc.

Another one of my patients has Aspergillus, a fungus, growing in his lungs. It is yet another relatively uncommon problem in patients with normal immune system, and his presentation of the disease is very atypical. This patient has been a social case since the start. He has some history of tuberculous but there is no record in our system of it so I’ve been on the phone with the health department daily for the last week trying to gather his medical records. Now with this new diagnosis, he has to take this really expensive drug (voriconazole) daily for 6 months. For a 30 day supply of this medicine, it costs around $2600!!! Isn’t that ridiculous!?

Well, being an older, unemployed gentleman who doesn’t speak much English, there is no way that he’ll be able to afford this or find ways to get it. After talking to the social worker, the case manager, and the Pharmacist, I ended up calling the Pharmaceutical Company and asking them if they had any patient assistant programs available. After an hour on the phone, as my patient’s advocate, he is now qualified for a free month of this medicine! I am not going to lie, I felt pretty great afterwards. I’m just thrilled that from a medical perspective, I provided the best care possible. I still have to do a lot of paperwork to get him the other 5 months of meds, but as for now, I’m happy with my small step in helping someone today.

Though all this extra work is not medically related and it takes up so much of my time during the day, I am still glad that I’m actually getting something done for these people. However, every day, I gain more and more appreciation for the social workers!!

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