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When I was 25 I got pregnant with my first child. I worked in a medical office and my husband was a construction worker. Needless to say, we didn’t have insurance that would pay for the delivery of my baby—so we decided to go on Medicaid. I felt justified in the decision and continued to work throughout my pregnancy.
That’s just a little background for what I want to discuss. You see, I never dreamed back when I was 25 and on Medicaid that I would receive any different care or be seen any differently than any other pregnant woman when going to the doctor. And frankly, I don’t believe my amazing doctor at that time, or the hospital where I delivered, treated me in a biased manner.

Fast forward to what I see today on the other side of the bed: clinic patients, i.e. those on Medicaid or without insurance, sure DO receive a different standard of care. Not from me, or my nursing coworkers, but from SOME of the attending doctors. I am mortified and absolutely ashamed.

I can’t really go into specifics. Let’s just say docs really drag their feet, pass the buck, etc. with clinic patients because the money isn’t there. For example, a clinic/Medicaid delivery pays a fraction of what an insurance delivery pays, so docs don’t feel doing deliveries for the clinic is “worth it.”

But I can say, that with the economy the way it is, and insurance being so hard to obtain, it is hard for me to understand why there would be a bias against those people who have to resort to using government programs (legitimately) or have no options at all. And why in the world would that make a difference in the care they receive? It blows my mind.

In fact, it puts patients in real danger when this behavior occurs. And it puts my career in danger. I end up teetering on going beyond my scope of practice in some cases just to protect and care for my patients. And though I can’t detail the situations I find myself in, it would not be exaggerating to say that I get nervous for my license. I am constantly put on the spot!

Yes, there are laws, and the state supposedly watches over things and bla, bla, bla. But the reality is that there is a HUGE problem. I am seeing it and it disgusts me. Besides reporting it, I am at a loss.

This is where patient advocation plays a huge part in our jobs—but I’ll be honest and tell you my advocating does little to nothing. The healthcare machine itself is broken, and until it’s fixed, advocation is just a band aid that hardly covers a gaping wound.

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