Another Random Musing

I was not able to volunteer on Friday because taking pictures of our transfections took much longer than expected. It actually took up almost the entire time I usually go to volunteer, so I decided to head home since I already had plans for that evening. However, as always, I constantly have random musings about health care, and I thought I'd make today's blog entry lab-themed due to the aforementioned circumstances.

With health care's status quo, there is a struggle between the morality of managed care and defensive medicine. Also called the "shotgun approach" to diagnosis, defensive medicine caters more toward the middle class and upper economic, insured brackets. Doctors issue an extraneous amount of lab tests and scans in order to remove any legal liability of neglect should an incorrect diagnosis occur.

On the other end of the spectrum, managed care happens mostly with HMO's when insurance companies and doctors are looking to save as much money as possible and issue the minimum amount of lab tests and scans. There is also usually a financial incentive for the doctor if they save money by "undertreating." Sometimes, this results in cutting corners by outrightly refusing some test the doctor may deem "unnecessary" at the moment.

Where in this range does an underserved institution like San Jose Clinic stand? The majority of their patients do not have insurance. Hence, that is why they are a charitable institution catering to the underserved and uninsured. However, as a doctor volunteering one's time at the clinic, how does this affect what tests you recommend to the patient? Do you err on the side of caution and more defensive-type medicine, or do you only inform only about tests within the financial reach of the patient? What can be done should a low-income, uninsured patient require an expensive procedure? Do the doctors and administration at San Jose take the time to petition for lowering the cost of costly medical procedures?

Medicine faces an infinite number of moral quandaries in its practice, and San Jose Clinic and other institutions of that type have their own sector of medical ethics to contend with. It's the side of the ethical debate you don't hear much about, and it takes musings like this to actually stand up and take notice of that exact lack of attention.