My patient’s care was denied because he lived outside Dallas County | Opinion
Dallas County residents can rely on a safety net thanks to Parkland Hospital. Health care for non-county residents can be unaffordable, writes Aman Narayan.As a physician working at a safety net hospital in Dallas, I have become accustomed to helping patients obtain needed care regardless of their insurance status. Recently, I cared for a 40-year-old man with cirrhosis, or end-stage liver disease. Normally, patients with this condition require careful monitoring to prevent complications.
Fortunately, Dallas County has a robust safety net that organizes the necessary primary and specialty care that would otherwise be unaffordable for many. My patient was working as a landscaper to make ends meet and had not had a drop of alcohol for nearly 10 years. We decompressed the built-up fluid in his abdomen, and I emphasized the importance of close follow up after leaving the hospital.
Without the proper medications, the fluid would reaccumulate and require him to return for repeated procedures. He was motivated to prevent such complications because they disrupted his work schedule. However, when I placed the referral for specialist care, it was denied. Unfortunately, my patient did not have access to county charity care because he lived 10 minutes outside of Dallas County. I was disheartened, knowing fully well that he would return to the emergency room for an emergent decompression in the near future.
I looked into options for my patient as a resident of a neighboring county. He was a single, childless adult man. Because Texas has not expanded Medicaid, that would effectively
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