14 January 2010

Starner Jones, MD

Dear Sirs:
“During my last night’s shift in the ER, I had the pleasure of evaluating a patient with an expensive shiny gold tooth, multiple elaborate expensive tattoos, a very expensive brand of tennis shoes and a new cellular telephone equipped with her favorite R&B tune for a ringtone. Glancing over the chart, one could not help noticing her payer status: Medicaid. She smokes more than one costly pack of cigarettes every day and, somehow, still has money to buy beer.
And our Congress expects me to pay for this woman’s health care? Our nation’s health care crisis is not a shortage of quality hospitals, doctors or nurses. It is a crisis of culture ˜ a culture in which it is perfectly acceptable to spend money on vices while refusing to take care of one’s self or, heaven forbid, purchase health insurance. A culture that thinks “I can do whatever I want to because someone else will always take care of me”. Life is really not that hard. Most of us reap what we sow. Don’t you agree?


Nichole said...

Dear Dr. Jones,

I hope this response finds you well. I am a Post-baccalaureate Premedical Program student at CU in Boulder, CO. I have an MBA and a BS in Medical Technology from Michigan State. I was given severance from a major healthcare company in July after 13 years with them and have been looking for work. I have been on several interviews and have a prospective job in the horizon. My decision to attend school was based on a dream of mine to become a doctor. Hence, I am going to school full time as well.

My severance ended in December, which makes me eligible for unemployment and COBRA. I have had to make several trips to the Unemployment office in Denver and listened to various stories. As a healer and healthcare worker, I became empathetic with others I might have previously judged. Yes, I am Caucasian. There were several people there matching the description of your ER patient. I listened to them, and they listened to me. Many of them were exhausted, and beaten by life. The ones with the strongest personalities and the most "bling" confessed to huge stressors in their lives after I asked them a few questions. They seemed to want to show the world they weren't in a state of panic, and the way they dressed made them feel better about themselves. Their clothing style did not match my taste; it was too flashy for me. Then, add low self-esteem, cultural disadvantages and an economic recession, depression sets. Then, depression leads to addiction issues. Many people, like your patient, use these offerings from the government to gain a sense of empowerment. Some abuse the system as an act of revenge, because they feel the system has failed them.

My friend in the Respiratory Therapy field forwarded your blog to me and others, stating to "pass it along" if you agree. Several did agree. I have to admit I do not agree with you and am concerned. The Hippocratic Oath states, "I will treat without exception all who seek my ministrations." Since you have taken this oath and are a practicing physician, according to this, your judgment of one's Medicaid status and their life choices should not be factored in your care. While you are entitled to your opinion in the US, as a physician, your judgment is not. I used to work in the ER at Detroit Medical Center and understand how exhausting that life can be. The burnout rate can be high for ER Physicians. You sound angry, burned out and exhausted. Perhaps the intensity has gotten to you and is sucking out the life and compassion?

I hope what I am writing does not make you angry. My goal is to not do so, but rather suggest another avenue. Perhaps another residency might work out better for you? I know for a fact that doctors in surgery, plastics, GI, radiology and dermatology do not experience the kind of feelings you wrote about in your blog.

Food for thought...


Anonymous said...

Dear Nichole,
Having read the good doctor's blog to the prez, it reflects what most of us "middle American" red state folks feel like. I went to CU, Boulder, like you. (BS+MS degree) I used to be a flaming liberal now turned ultra conservative and live in Texas. Guess I saw the light about 10 years ago when the Dem Party and ideals no longer represented my philosophy and thinking. Anyway, what Dr. Starner presents is not a "stressed" response, in my opinion, but a logical, well-thought-out deduction of the people who suck the system dry and expect handouts, get pissed when they don't get them. I have relatives in Hawaii that would rather pay 10 bucks for a pack of smoking (yucky habit!!) than pay for food, but they'd take food stamps in a minute and try to convert them into dollars to buy more cigs. What the brave doc is trying to say: "ENOUGH OF THIS NONSENSE!"

Kathy Rollwage - Arlington TX said...

Dr. Starner. Just saw your comment posted on Facebook and loved it so much that I had to snope it and respond when I saw it was true! :) My Daddy grew up in Columbus, MS (passed at age 85 this past January). He never graduated High School, and worked very hard his entire life. He passed this work ethic on to his four kids.

Sadly, I think we have such an entitlement mentality that there are scores of folks that think they can spend all of THEIR money for frivolous things like gold teeth, cigarettes and worse and then are entitled to OURS (VIA TAXES, HANDOUTS, ETC).

People can make excuses for them as to "why", but the bottom line is that we all have choices...and when we make bad choices, bad things happen...REAP WHAT YOU SOW.

There is the rare exception of folks really in need, because they have been dealt a bad hand in life, and are in need, as no fault of their own. But this is the exception rather than the rule in our country. We live in a BLESSED country!

I face paint for a living and there are times when I do it absolutely free and quite honestly, those are the most ungrateful folks...most demanding on what I paint and so on. It's very sad and extremely disappointing. Luckily there is that rare one or two that will thank us for being there and donating our time and talent.

I applaud you for taking a stand! May God bless all your doings in life!

Anonymous said...

while your response is well thought out and put together, it is a response based on a lot of assumptions. being in the medical field myself I am sure you are aware of assumptions making an ASS of U and ME.
that being said, the piece was written as a tax payer, bit as a physician. to think the level of care given was substandard based on his letter is ASSUmptuon.
If you talk to anyone in the medical field for a substantial period of time. they can tell you why costs have skyrocketed. social medicine is already alive and well. every emergency room in the country is free and nobody gets turned away.
good luck to you in your quest to be a physician, I hope along the way you stop making costly assumptions and realize that doctors, nurses, RTtechs,and all other specializations in theed field are also taxpayers and responsible individuals.

Melissa Sulsberger said...

Dear Dr. Jones, I certainly feel your pain. I understand that there are people who take advantage of they system. But there are also people like my family who can't afford health insurance - we are way below the poverty line, however, the government says we make too much money to receive any assistance. I can barely pay my mortgage and utilities - let alone food. I don't have money for gold teeth or tattoos or a brand new Escalade - apparently you have to have these things in order to get medical assistance. Believe me, these are the people who ruin it for the people who truly need help. I am sorry that you have to treat these people. I am wondering if you would help me - since on my form - it would say - NO INSURANCE - and no way to pay my hospital bill! Walk in the shoes of others before you classify "them all together". Sincerely - MS

Anonymous said...

As a former Case Worker for Social Services for over 20 years, I have encounter all types of ppl. For the most part, most ppl really need the help while a small fraction are bilking the system for all it is worth. My frustration came from clients who didn't need help and got it for whatever reasons while having to turn away mothers and children who were destitute. As a mother of 9, I dragged myself bring my children to school/daycare then go work with at times a broken leg or arm and back to work 14 months after brain surgery. (Which was found 3 weeks before I was to start Law School) Having been on both sides of the desk, I would encourage my clients to find training or go to college and use this time to achieve their goals...many took my advice and got off the system. However, my frustration came from those who said "I can't because I have children"!!! So did I but I wanted to teach my children the right way and proud to say they are all now productive, sucessful adults. One thing to bear in mind that some ppl fell on hard times and may have had these material things prior to getting assistance.
I am one of the ppl who needs this help and am suffering because of those who choose to cheat the system...I am one of the ppl that doctors will NOT treat because they refuse my medical coverage that was truly earned from my employment not from cheating the system. What about the Hippocratic Oath you took??? I don't wear designer clothing, don't smoke or drink or spend money frivolously...rather struggling to make ends meet and go without medication and basic needs such as personal hygene products. I water down personal hygene products to make them last longer...I come up short on my food budget and struggle with my diabetes because of it. My doctor tells me to loose weight and eat right...well, I would if I could afford the right foods that are so over priced. This is an example of the REAL ppl who need the medical coverage...ppl who have worked and can no longer do so!!! So this is what NEEDS to be addressed!!!
Oh, and by the way...who paid for your medical training??? I am sure at one time you were the reciepient of Financial Aid...and moreover HAVE YOU PAID BACK YOUR STUDENT LOANS??? OR ARE YOU ONE OF THE DOCTORS THAT DECIDED TO WORK IN A RURAL AREA OR INNER CITY NEIGHBORHOOD IN EXCHANGE FOR REPAYMENT OF YOUR STUDENT LOANS??? IF SO, WHAT MAKES YOU ANY BETTER...YOU TOO, HAVE FOUND A WAY TO BILK THE SYSTEM!!! Hopefully you are doing the right thing also and setting the example. Hopefully you are not like the doctors I have encounter lately who "don't take my insurance" even though my insurance pays out of network and in full, but now doctors want to have practices that cater to the rich and can pay out of pocket. My brain tumor has grown back and brought 2 very large ones with it. The one doctor in my area will do the Gamma Knife proceedure if I can pay up front and then get re-embursed from my insurance company. Since I can't pay out of pocket I will be forced to undergo having my skull opened and the long recovery process if I make it without either dying or being a vegtable. I wonder if I will have to go through the process of having to learn how to read, write, walk and talk again??? So this is what modern medicine has come down to.

Anonymous said...

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