In These United States

The quality of care in the U.S. varies quite a bit. Everyday, I see patients who might do better elsewhere but can not afford specialist care. There are lots of docs here who specialize in diseases of the rich and well-insured.

Case in point. 55 year old woman with no health insurance. She has an epidermal inclusion cyst of the left inner canthus. It was 2 mm from the lacrimal duct.



I said: You should see an ophthalmologist.
She said: I have no insurance. Can't you do this?
I said: I can try, but I am not sure this will shell out easily.
She said: Please try -- anything will be better than this. How much will it cost?
I said: Okay. How about $45.
She said: Fine, I thought you'd ask a few hundred.

Procedure: Under local 1% xylocaine with epi I dissected the cyst. Luckily, it shelled out nicely. I had hoped not to have to close the defect; but needed to place a 6-0 nylon suture.
I guess it will look better.




I felt like a doctor for a brief moment. The doctor who was there. I knew an ophthalmologist could have done better; but most of them take their patients to an operating room where there is a big charge. This is the reality of health care here.

George Bascom said it better. See "Being There" Click on poem to enlarge.