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With no insurance, broken arm becomes long ordeal
Richard Hershman couldn't find a doctor to fix his broken arm. When he finally did, his arm needed to be rebroken.
In an e-mail, a Rothman spokesman said it was policy not to comment on individual cases. "Rothman Institute, as a private medical practice, works closely with self-paying patients in an effort to accommodate their needs, including offering structured payment plans for self-pay patients," the e-mail said.
Hershman said he called around, looking for doctors who would operate, elected officials who could help him, and got nowhere.
Hershman said it took six weeks "of me being in utter agony" before he was approved for medical assistance by the state Department of Public Welfare.
He was aided in this effort by the staff of the Pennsylvania Health Law Project, which helped speed along his application for medical assistance - state-provided health insurance for the poor - effective March 1.
Then he got an appointment at Temple University Hospital with Asif M. Ilyas, assistant professor in the Department of Orthopaedic Surgery.
Hershman says the doctor's first question was: "Why did you wait so long to get surgery?"
Hershman said he told the doctor he tried, but nobody would help.
Ilyas operated on March 2.
"He had difficulty finding a surgeon because he didn't have health insurance," the doctor confirmed.
"Typically, we get to this within the first one or two weeks," Ilyas said of breaks like Hershman's.
Because of the delay, the doctor said, "the fracture began to heal in an abnormal position. As a result, the procedure was more extensive and more complicated than had I been able to do this when it was a fresh injury."
"We had to re-break the bone, reset it, use bone grafts we don't normally use, and bone implants."
Hershman has nothing but praise for his doctor and is grateful for the surgery.
Because of the delay in surgery, the scar, rather than an inch or two, now runs all the way from his shoulder down his arm. "I look like Frankenstein," Hershman said.
Hershman says his arm is weaker than it used to be, and the doctor concedes the chances of a full recovery are smaller because of the delay.
Did the delay increase suffering?
"No doubt, no doubt," Ilyas said.
Emergency rooms in the United States are required to stabilize patients with life-threatening injuries.
But hospitals and doctors are not required to conduct tests, give chemotherapy, or do surgery on broken bones - "things that would hurt you slowly, or kill you slowly," the doctor said - if a patient doesn't have insurance or can't pay.
The surgeon said he was no health-policy expert. And changing the system would be complex.
