Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
KevinMD
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
  • 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
KevinMD
  • 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
  • About KevinMD | Kevin Pho, MD
  • Be heard on social media’s leading physician voice
  • Contact Kevin
  • Discounted enhanced author page
  • DMCA Policy
  • Establishing, Managing, and Protecting Your Online Reputation: A Social Media Guide for Physicians and Medical Practices
  • Group vs. individual disability insurance for doctors: pros and cons
  • KevinMD influencer opportunities
  • Opinion and commentary by KevinMD
  • Physician burnout speakers to keynote your conference
  • Physician Coaching by KevinMD
  • Physician keynote speaker: Kevin Pho, MD
  • Physician Speaking by KevinMD: a boutique speakers bureau
  • Primary care physician in Nashua, NH | Kevin Pho, MD
  • Privacy Policy
  • Recommended services by KevinMD
  • Terms of Use Agreement
  • Thank you for subscribing to KevinMD
  • Thank you for upgrading to the KevinMD enhanced author page
  • The biggest mistake doctors make when purchasing disability insurance
  • The doctor’s guide to disability insurance: short-term vs. long-term
  • The KevinMD ToolKit
  • Upgrade to the KevinMD enhanced author page
  • Why own-occupation disability insurance is a must for doctors

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?

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

< 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

  • Why false accusations against doctors destroy careers

    Olumuyiwa Bamgbade, MD
  • Dual physician marriage: stories of love and partnership in medicine

    Deborah Shlian, MD, MBA and Joel Shlian, MD, MBA
  • First-generation physician: Navigating the first attending contract

    Sagar Chapagain, MD
  • Workplace boundaries: How to stop answering e-mails at 5 p.m.

    Yekaterina Angelova, MD
  • The lost art of connection: Why medicine needs to slow down

    Dean Robosa, MD
  • The health care economic crisis: Why the system is failing in 2026

    Harry Severance, MD
  • Most Popular

  • Past Week

    • The dangers of vertical integration in health care

      Stephanie Waggel, MD | Policy
    • The 9 laws of health care quality: Why metrics miss the point

      Constantine Ioannou, MD | Physician
    • Why does sex work seem like a more viable path than medicine in 2026?

      Corina Fratila, MD | Physician
    • The quiet paradox of physician mental health and medication

      Timothy Lesaca, MD | Physician
    • Navigating the patchwork of CME requirements by state

      Vladislav Tchatalbachev, MD | Physician
    • Securing physician autonomy with employer-sponsored direct primary care

      Dana Y. Lujan, MBA | Physician
  • Past 6 Months

    • Missed diagnosis visceral leishmaniasis: a tragedy of note bloat

      Arthur Lazarus, MD, MBA | Conditions
    • Menstrual health in medicine: Addressing the gender gap in care

      Cynthia Kumaran | Conditions
    • The dangers of vertical integration in health care

      Stephanie Waggel, MD | Policy
    • The 9 laws of health care quality: Why metrics miss the point

      Constantine Ioannou, MD | Physician
    • Why does sex work seem like a more viable path than medicine in 2026?

      Corina Fratila, MD | Physician
    • From Singapore to Canada: a blueprint for primary care transformation

      Ivy Oandasan, MD | Policy
  • Recent Posts

    • Autonomous AI agents could strip the soul from medicine [PODCAST]

      The Podcast by KevinMD | Podcast
    • The hidden cost of ignoring public health infrastructure

      Lujain Mattar | Education
    • The truth about psychiatric supplements and mental health

      Muhamad Aly Rifai, MD | Meds
    • Rethinking health care for older adults beyond lab results

      Gerald Kuo | Conditions
    • Why false accusations against doctors destroy careers

      Olumuyiwa Bamgbade, MD | Physician
    • Tracheostomy communication barriers: a gap in medical training

      Alyssa Lambrecht, DO | Conditions

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 dangers of vertical integration in health care

      Stephanie Waggel, MD | Policy
    • The 9 laws of health care quality: Why metrics miss the point

      Constantine Ioannou, MD | Physician
    • Why does sex work seem like a more viable path than medicine in 2026?

      Corina Fratila, MD | Physician
    • The quiet paradox of physician mental health and medication

      Timothy Lesaca, MD | Physician
    • Navigating the patchwork of CME requirements by state

      Vladislav Tchatalbachev, MD | Physician
    • Securing physician autonomy with employer-sponsored direct primary care

      Dana Y. Lujan, MBA | Physician
  • Past 6 Months

    • Missed diagnosis visceral leishmaniasis: a tragedy of note bloat

      Arthur Lazarus, MD, MBA | Conditions
    • Menstrual health in medicine: Addressing the gender gap in care

      Cynthia Kumaran | Conditions
    • The dangers of vertical integration in health care

      Stephanie Waggel, MD | Policy
    • The 9 laws of health care quality: Why metrics miss the point

      Constantine Ioannou, MD | Physician
    • Why does sex work seem like a more viable path than medicine in 2026?

      Corina Fratila, MD | Physician
    • From Singapore to Canada: a blueprint for primary care transformation

      Ivy Oandasan, MD | Policy
  • Recent Posts

    • Autonomous AI agents could strip the soul from medicine [PODCAST]

      The Podcast by KevinMD | Podcast
    • The hidden cost of ignoring public health infrastructure

      Lujain Mattar | Education
    • The truth about psychiatric supplements and mental health

      Muhamad Aly Rifai, MD | Meds
    • Rethinking health care for older adults beyond lab results

      Gerald Kuo | Conditions
    • Why false accusations against doctors destroy careers

      Olumuyiwa Bamgbade, MD | Physician
    • Tracheostomy communication barriers: a gap in medical training

      Alyssa Lambrecht, DO | Conditions

MedPage Today Professional

An Everyday Health Property Medpage Today

Copyright © 2026 KevinMD.com | Powered by Astra WordPress Theme

  • 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...