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A Piece of My Mind |

Enough, Already

Michael D. Stillman, MD
JAMA. 2012;308(22):2347-2348. doi:10.1001/jama.2012.14475.
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In May 2012, I left Boston University School of Medicine for a faculty position at University of Louisville in Kentucky. My new job entails both administration and research, but I also precept in a resident clinic that serves a largely indigent population.

Since 2006 when then-governor Mitt Romney signed into law a virtual twin of the Affordable Care Act, only around 5% of Massachusetts' population lacks health insurance. In my Louisville clinic, however, 60% of the patients are uninsured, and they represent the full spectrum of ethnicity, age, wellness, and employment status. While our hospital offers uninsured patients reduced-cost office visits, access to inexpensive generic prescriptions, and sliding-scale charges for laboratory testing, they pay full price for imaging studies, certain preventive vaccinations, and diagnostic tests, including cardiac stress tests and sleep studies. They receive only the care they are able to pay for themselves and lack reassurance that their next minor illness won't destroy them financially.

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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