In the Bronx it was not uncommon for people to call an ambulance when they had a cold and wanted to see a doctor to get some cough medicine prescribed
Could you define "not uncommon" please? Daily? Monthly? She saw this herself, or 'heard about it'? And the ambulance crews just waved them onboard, like wide-eyed innocents who could be duped that way? Yeah, ok. Did your wife enquire further, or just write it off as the feckless poor?
I am also skeptical of this story, which is at best second hand and at worst an urban legend.
Even assuming it is true, it would point to a transportation problem in the Bronx. I became more aware of this (in Manhattan) when I developed arthritis in my knees and once was unable to walk for a week. In order to get to the doctor, I had to take a cab, which cost me about $40 round trip. What if I didn't have $40? Sometimes there's no public transportation to the hospital even if you can walk. (BTW, according to Michael Moore's movie Sicko, the British hospitals reimburse patients for cab fare.)
Is the City paying thousands of dollars in ambulance fees that they could have avoided by paying $40 in taxi fares? Or $20 for car service?
Another reason I'm skeptical about this story is that I heard a talk by Lewis Goldfrank, director of the Bellevue Hospital Emergency Department, who said that because of budget cuts, they were forced to stop giving out a lot of drugs from the hospital pharmacy, including over-the-counter drugs. So are hospitals in the Bronx giving out OTC cough medicines that Bellevue is no longer giving out? Would the City save thousands of dollars in ambulance fees by giving people on Medicaid money to buy OTC drugs in their local drug store?
In San Jose, she sees tons of drunks and drug users... after a while the doctors have to prescribe something just to get the person out of the way so that patients with real needs can be seen.
In San Jose, they need to have their alcohol and drug addiction services massively improved. Addicts should know that they will be referred to specialists. Why isn't your wife tackling this, rather than just handing out the pills?
That's right. For a doctor to complain about drunks and drug users in the ED is like a sailor complaining about the ocean. Did she know when she went into medicine that a lot of people are sick because of drug and alcohol problems? Did they ever teach her how to deal with patients with drug and alcohol problems?
Goldfrank once asked one of his residents what cases were left, and the resident said, "Just some human garbage." Goldfrank told him, "Anybody who refers to patients as human garbage doesn't belong in this hospital."
It doesn't sound like your wife should be caring for this patient population. Perhaps she should go into a specialty with patients in her own social class, like cosmetic surgery. You can make more money running a hair transplant clinic than you can make by saving a diabetic woman's leg from amputation.
Also virtually nobody in the USA chooses between a $90 doctor's visit and feeding their family.
I'm guessing your circle of family and friends includes a wide number > 21 yrs old on minimum wage? Thanks for the perspective on what someone in the top 1% thinks of the bottom 10%.
I've talked to doctors who were fucking idiots. One doctor said that poor people could afford health insurance if they just spent the cost of a latte every day on health instead. When you're so out of touch with the realities of your patients' lives, it's malpractice. A lot of prescriptions don't get filled because the patient can't afford it.
A doctor wrote an essay in he New England Journal of Medicine about how her hospital was reprimanding doctors for violating the rules against giving patients their own personal money. She said one mother didn't have money for food for herself and her two children, so she gave the mother $20 (and told her it came from a "special fund" so the mother wouldn't be embarrassed).