Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

I’ll be a doctor soon, but I can’t understand my hospital bill

Lisa Jacobs, MD, MBA
Physician
April 21, 2013
Share
Tweet
Share

I did not want to go to the emergency room. I really didn’t.  Resisting the idea, I lay doubled over with the worst abdominal pain of my life for 12 hours, unable to eat or drink or move, and finally vomiting before I considered it. I was well aware that this sequence of symptoms made me a textbook case of appendicitis, but I still consulted an ER doctor to ask: was he sure I needed to go?

Business school taught me that ERs are centers of waste and inefficiency, and that their overuse is both the cause and effect of many of our healthcare system’s problems. I learned in medical school that ERs are hectic and dirty, and wait times are long.

Plus, I couldn’t afford it. I was finishing my second year of medical school and already $200,000 in debt. My loans allowed a yearly budget of $17,000 for all of my expenses. Two of my cousins, both in their 20s and healthy, had recently gone into debt after racking up huge bills from hospital visits that started in the ER.

Here’s what happened during my nine-hour ER visit: I got fluids and morphine. I told the doctors I thought I had appendicitis. They also thought I had appendicitis. According to my history and physical exam, the suspicion of appendicitis was high enough to justify taking me straight to the operating room without imaging. Instead, they ordered a CT scan.

Hours passed while it was taken and read. The results were upsetting. Perhaps it was because it was 4 AM and I was on narcotics, but I felt jolted by shock and anger at the results: inconclusive. Apparently, I was too thin, so there wasn’t enough fat contrast. It was impossible to identify my appendix at all, let alone tell whether it was inflamed.

“Why couldn’t they see how thin I am before ordering a test that costs thousands of dollars?” I demanded. They laughed, as if I was making a joke.

I was admitted for observation and discharged 12 hours later at my own pleading. During my stay, I saw six doctors once or twice each and was never diagnosed. Surgery was repeatedly mentioned as a possibility, but no one explained its risks and benefits. I don’t know if or why they ultimately decided against it.

The final cost of my one-day hospital stay was $16,500. After discounts or perhaps negotiations, the insurer actually paid $6,500. I paid $100 personally. I am still not sure what came of the large sum my insurer paid on my behalf.

In a larger sense, I don’t understand the value of my first experience as a healthcare consumer: I still don’t know if I had appendicitis or whether it was an initial bout of something chronic that may bring me back to the ER repeatedly before getting diagnosed. Or maybe it was just passing gastroenteritis.  Either way, I still have my appendix, so there is a 7% chance I will return to the ER with appendicitis some day.

The $6,500 only bought pain-control. My trip has no potential long-term benefits. Knowing what I know now, having discussed my case with surgeons during my hospital rotation, I would have opted to have my appendix removed and intestines examined laparoscopically. My visit would have been more expensive, but at least it would have accomplished something.

I also don’t understand the value of the money spent in a literal sense, since my bill is so complex. Documenting my stay of less than 24 hours were 32 billing lines, each with a CPT payment code. I tried to click on the codes in my bill online to analyze the care to which they corresponded. I was interested in reflecting on the course of events, and thought the activity would be a fine illustration of how hospitals bill for services.

I was surprised that the codes were not hyperlinked, so they didn’t lead to word-based explanations of the goods or services they represented.  I eventually resorted to Google, and after a huge amount of time wasted, was only partially successful. Finally, I gave up, deciding that understanding my bill was not very important, anyway, since someone else paid for it. This is probably how most insured people think about their healthcare.

I went to business school, where I took graduate courses in accounting and healthcare economics, and in 18 months, I’ll be a doctor, but I can’t understand my hospital bill.  If I can’t, how can anyone?

ADVERTISEMENT

Lisa Jacobs is a medical student.

costs_of_care_logo_smallThis post originally appeared on the Costs of Care Blog. Costs of Care is a 501c3 nonprofit that is transforming American healthcare delivery by empowering patients and their caregivers to deflate medical bills. Follow us on Twitter @costsofcare.

Prev

What being mindful will reveal to us

April 20, 2013 Kevin 1
…
Next

A creative way to meet our health needs: Direct practices

April 21, 2013 Kevin 1
…

Tagged as: Emergency Medicine, Surgery

Post navigation

< Previous Post
What being mindful will reveal to us
Next Post >
A creative way to meet our health needs: Direct practices

ADVERTISEMENT

More by Lisa Jacobs, MD, MBA

  • We need to talk about mental illness in the medical field

    Lisa Jacobs, MD, MBA
  • Stressed and sad as a medical intern? You’re not alone

    Lisa Jacobs, MD, MBA
  • Amid chaos and desperation, this floored me

    Lisa Jacobs, MD, MBA

More in Physician

  • How subjective likability practices undermine Canada’s health workforce recruitment and retention

    Olumuyiwa Bamgbade, MD
  • Why judgment is hurting doctors—and how mindfulness can heal

    Jessie Mahoney, MD
  • Why evidence-based management may be an effective strategy for stronger health care leadership and equity

    Olumuyiwa Bamgbade, MD
  • The gift we keep giving: How medicine demands everything—even our holidays

    Tomi Mitchell, MD
  • From burnout to balance: a neurosurgeon’s bold career redesign

    Jessie Mahoney, MD
  • Why working in Hawai’i health care isn’t all paradise

    Clayton Foster, MD
  • Most Popular

  • Past Week

    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • Why health care leaders fail at execution—and how to fix it

      Dave Cummings, RN | Policy
    • How digital tools are reshaping the doctor-patient relationship

      Vineet Vishwanath | Tech
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
  • Past 6 Months

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
    • Why Medicaid cuts should alarm every doctor

      Ilan Shapiro, MD | Policy
  • Recent Posts

    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Decoding your medical bill: What those charges really mean

      Cheryl Spang | Finance
    • The emotional first responders of aesthetic medicine

      Sarah White, APRN | Conditions
    • Why testosterone matters more than you think in women’s health

      Andrea Caamano, MD | Conditions
    • A mind to guide the machine: Why physicians must help shape artificial intelligence in medicine

      Shanice Spence-Miller, MD | Tech
    • How subjective likability practices undermine Canada’s health workforce recruitment and retention

      Olumuyiwa Bamgbade, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 14 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • Why health care leaders fail at execution—and how to fix it

      Dave Cummings, RN | Policy
    • How digital tools are reshaping the doctor-patient relationship

      Vineet Vishwanath | Tech
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
  • Past 6 Months

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
    • Why Medicaid cuts should alarm every doctor

      Ilan Shapiro, MD | Policy
  • Recent Posts

    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Decoding your medical bill: What those charges really mean

      Cheryl Spang | Finance
    • The emotional first responders of aesthetic medicine

      Sarah White, APRN | Conditions
    • Why testosterone matters more than you think in women’s health

      Andrea Caamano, MD | Conditions
    • A mind to guide the machine: Why physicians must help shape artificial intelligence in medicine

      Shanice Spence-Miller, MD | Tech
    • How subjective likability practices undermine Canada’s health workforce recruitment and retention

      Olumuyiwa Bamgbade, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

I’ll be a doctor soon, but I can’t understand my hospital bill
14 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...