Posted: 06/09/09
With hospital discounts on emergency services being rare and the continuing recession, more patients are refusing emergency care because they fear they can not afford it. Emergency room doctors report an increase in the number of patients refusing procedures and admissions due to cost. "I have definitely seen an increase in this problem," said Dr. Sara L. Laskey, who works in the emergency department of MetroHealth Medical Center in Cleveland, Ohio. "They're really making conscious decisions about what they do and don't want done." These cases are creating an ethical dilemma for the doctors who must either persuade the patient to have treatment or discharge the patient "against medical advice". Doctors warn that those who leave against medical advice are at higher risk of returning, becoming seriously ill or dying.Some doctors report instead of discharging patients against advice, they are having more detailed discussions about the risks and benefits of procedures with patients. These discussions may guide patients to solutions other than refusing care. Most hospitals provide some level of charity care and will work with patients to establish payment plans. Some hospitals may assist patients connecting with services such as Medicaid, but a hospital discount plan may be an option for those who do not qualify.
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