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Treating the Unaccountable Patient


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healthcare costs

The ambulance arrives at emergency with a comatose patient.  The emergency team recognizes him immediately.   He is a type I diabetic that fails to take care of himself and manage his type I diabetes.

The patient is one of several who frequent the hospital.  Healthcare providers refer to them as “frequent flyers” and in the case of the diabetic patient, he has earned platinum status.  Immediately blood draws are collected and sent to the lab.  His blood sugar is 1300 when 120 is considered normal.  He has ketoacidosis a result of not having sufficient insulin in your body.  Pharmacy is called to prepare an insulin drip IV.

emergencyFurther results of his blood reveal methamphetamine and alcohol in his blood on this visit to ER.  Previous times to the hospital have shown narcotics (opioids), marijuana, and Xanax™ in his blood.    The question becomes why does this young man of only twenty-four abuse his body and ignore healthy habits to have a productive life?

DKAThe patient comes to the hospital two or three times a month with the same condition.  Hospital staff get his blood levels back to a healthy state which in turn alleviates his diabetic coma; they provide insulin, antibiotics to treat his infections, correct his electrolyte levels bringing them to a normal state, and offer him healthy meals.   The patient is released.  Unfortunately, he returns in a week or two with the same repetitive condition.

The health system does not provide any assistance with counseling to help him with his apparent mental state.  The patient is totally unaccountable for his health.  You would think he is suicidal, and perhaps that is what he is attempting to do, end his life.  He is apathetic to life, has nothing to live for but getting high on various drugs.

What can healthcare do for such a patient?  It sounds calloused and crass, but it is these patients that rack up healthcare costs and put financial stress on government and healthcare systems.  Hospitals and health care providers continue to provide excellent and compassionate healthcare to all those in need.

What are your thoughts on the challenges facing healthcare?