The insurance and government dominated system is failing our patients. A physician friend of IP4PI shares this shocking example about the system claiming another victim:
A 59 y/o man presented to my last employed practice, with an almost elephantiasis swelling bilateral legs. He had pinpoint marks on the skin of his legs. He held up a jar with what looked like a couple of tiny maggots. He said, these come out of those holes every so often. I said how long has this been going on?? He said 1.5 years. “I’ve mentioned to several doctors, they just shrug and don’t do anything.” I said we would do something, and called the hospitalist immediately to admit for workup and treatment. I was directed to the nurse gatekeeper for approval for admission. What’s wrong, she asked. “4+ edema in both legs, which are also full of maggots.” Hmmm, she said. There is no medicare admissible diagnosis of ‘maggots in legs’. What about his rising creatinine of 1.7? Not bad enough to qualify under guidelines. Call us back if it gets worse. I did try to do some outpatient workup, but I think the man was disgusted. He never followed up. He was dead within the year.