In my four years of med school and three years of residency, not once did I ever see a patient bill, and not once on rounds did I ever hear discussed the financial impact of our care. The hot debate was whether to use low budget streptokinase for strokes vs. TPA which was ~$1000 a dose. That’s chicken feed today, and I haven’t heard mention of streptokinase for over a decade. Patients today face choices like “hep C or a home?”…”cancer or college tuition?”… even with Obamacare.

If we lived in a country of fully socialized medicine (which I’m not advocating), then we in medicine could be purists, focusing on our patients’ mental and physical needs alone. But we don’t. Our soup is capitalism and as such, money is a third pillar to consider if patient wellbeing is a true priority. Some in medicine are in it to make a buck, but the rest of us are here to make lives better by chasing down mental instability, physical disability… and poverty.

This week’s article from NPR Doctors Press For Action To Lower ‘Unsustainable’ Prices For Cancer Drugs winds me right up. Draining the coffers of people facing life and death decisions is unconscionable and gross.

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