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stuckupmyownera
10-07-2009, 10:10 PM
My character has lost his memory. He doesn't know where he is and he doesn't know where he lives. He doesn't know his own name, and he has nothing but the clothes on his back (no wallet, phone, ID, keys - nada). Oh, and he has no money.

He wants to see if a doctor can help him.

But will he struggle to see a doctor with no money and no health insurance (that he knows of)?

I just don't really know how it works over there.

(The answer I'm looking for is that no doctor will see this man, but that seems a little harsh in reality - I'm sure concessions must be made for special cases. Perhaps, I'm hoping, most ordinary doctors won't see him, but if he goes some special place, or some huge hospital, maybe they can help him there. Help me out with some scenarios?)

JoNightshade
10-07-2009, 10:22 PM
(The answer I'm looking for is that no doctor will see this man, but that seems a little harsh in reality - I'm sure concessions must be made for special cases. Perhaps, I'm hoping, most ordinary doctors won't see him, but if he goes some special place, or some huge hospital, maybe they can help him there. Help me out with some scenarios?)

Is this really how the rest of the world sees our health system? ;)

Unfortunately I doubt you'll get the answer you're looking for. He could walk into any hospital ER in the US and get instant assistance. Okay, well, he might have to wait a few hours since he's not bleeding to death. ERs are required to treat people, regardless of coverage. Nobody gets turned away if they have a broken arm or a severed finger or whatever. ;)

Others can give you a more accurate scenario, but basically if he has no memory and nothing else, he is going to walk into a hospital, probably be seen by some kind of nurse or evaluative person. I imagine he would then be seen by a doctor to check for any obvious head injuries. Before they started doing any major scans I'm guessing that there might be some calls made to a social worker (in case the problem is mental) and the police department (in case he is a missing person). I am not entirely sure where it would go from there. But honestly, in the medical community, there are almost always doctors who would step up and help you out if it's obvious you've got something serious going on.

Basically the issues we have are with long term and preventative care. So if he's looking to get some medications for an ongoing problem, he'd have trouble with that. Or if he needed treatment to STOP something from happening to him.

ETA: What he would probably not be able to do is call up a specific doctor's office, make an appointment, and be seen at a private practice. If he had no insurance and could not pay out-of-pocket, they would likely refer him to the ER. As I said above, however, there are exceptions. Many doctors are quite generous with people who are truly in need (not just trying to work the system) and would be especially so with a very interesting case - like true amnesia. As an example, I have a friend who was undergoing fertility treatments because she cannot conceive naturally. Then her insurance coverage changed and no longer covered it. She could not afford to continue. The doctor himself called her up and told her he would like to continue treating her for no cost.

backslashbaby
10-07-2009, 10:31 PM
Most ordinary doctors won't help him, really! Anywhere private will send him away, from what I've seen and experienced. The ER is what I've heard, too, to get treatment without money.

Those walk-in clinic places? They made me count pennies from my car while I had acute, terrible abdominal pain. I was a waitress with no credit cards and didn't have my checkbook with me at the time.

pink lily
10-07-2009, 10:48 PM
I think the Emergency Room is the only place where a person with no ID can get medical treatment. I wouldn't know about clinics; in my state, clinics are exclusively for pregnant women to get either prenatal care or abortions. There are also STD/HIV clinics here.

In the OP's scenario, there could be some old-fashioned "country doctor" who takes on the risk of an unidentified, nonpaying client, but in real life it's so far-fetched that such a premise would be very hard to accept.

I have heard about amnesia cases in the news. The patients begin in the ER in order to get help.

veinglory
10-07-2009, 10:59 PM
A hospital would be the obvious place to go.

stuckupmyownera
10-07-2009, 11:05 PM
Is this really how the rest of the world sees our health system? ;)

Sorry. :o

This is all useful stuff though everyone, thanks.

He's out in the desert so I imagine he'd be a long way from an ER. If it's believable that local small-town doctors won't help him then he'll have to keep travelling before he sees someone, and that's just what I need.

Now off I go to Google maps to see how far away I can put him from a hospital...

JoNightshade
10-07-2009, 11:10 PM
In the OP's scenario, there could be some old-fashioned "country doctor" who takes on the risk of an unidentified, nonpaying client, but in real life it's so far-fetched that such a premise would be very hard to accept.

I don't live in the country and I know several doctors with practices who do help people pro bono in real life. I cited the example of the one giving free fertility treatments. One I've known since I was very small... he often gets paid in food from people who can't pay him otherwise. (And many of them, frankly, are probably illegal immigrants.) A year or two ago a woman in a nearby town was seriously maimed by a guy who took an icepick to her. My mom works for one of the doctors who helped her, for free.

Doctors are people - some of them are in it for money, but many of them are in the profession because they truly have a passion for helping people. The fact is that they don't ADVERTISE their pro bono work, because then everyone would start demanding it and they'd get overwhelmed. Stuff like this usually happens on a case by case basis and is kept very private. For instance, the one who gave my friend free fertility treatments asked her not to tell people who she was seeing. Some doctors do stuff like going overseas to help people in foreign countries; others do it in their own communities. So if you don't know any doctors on a personal basis, you probably aren't aware of it.

dirtsider
10-07-2009, 11:12 PM
Most likely, he's going to be picked up by the police, most likely state, if found wandering around. From there, they'll bring him to the local hospital when they find out he has no id and no memory of who he is and how he got there.

veinglory
10-07-2009, 11:26 PM
The local doctor would call an ambulance to take him to a hospital. Complete amnesia is a serious disorder be it physical or psychological, a doctor won't just ignore it unless he is a completely incompetant or unethical one. The only way I would believe it is if the doctor thought he was lying or malingering for some reason.

stuckupmyownera
10-08-2009, 12:30 AM
The local doctor would call an ambulance to take him to a hospital. Complete amnesia ia a serious disorder be it physical or psychological, a doctor won't just ignore it unless he is a completely incompetant or unethical one. The only way I would believe it is if the doctor thought he was lying or malingering for some reason.

Good point! Thanks, I'll take that into account.

maryland
10-08-2009, 12:35 AM
Couldn't he just go into a police station? They're easily found nearby.

stuckupmyownera
10-08-2009, 12:44 AM
There are certain clues to his identity that are keeping him away from the police for now...

JulieHowe
10-08-2009, 12:52 AM
Sorry. :o

This is all useful stuff though everyone, thanks.

He's out in the desert so I imagine he'd be a long way from an ER. If it's believable that local small-town doctors won't help him then he'll have to keep travelling before he sees someone, and that's just what I need.

Now off I go to Google maps to see how far away I can put him from a hospital...

He would be sent to the nearest emergency room. A small-town doctor (in my opinion) would be even more likely to help him, and to make sure that he safely reached the nearest hospital. In a desert, even in unfriendly California, a Good Samaritan (especially if they lived in the area)would stop to help him or they would call the police.

PeterL
10-08-2009, 01:09 AM
My character has lost his memory. He doesn't know where he is and he doesn't know where he lives. He doesn't know his own name, and he has nothing but the clothes on his back (no wallet, phone, ID, keys - nada). Oh, and he has no money.

He wants to see if a doctor can help him.

But will he struggle to see a doctor with no money and no health insurance (that he knows of)?

I just don't really know how it works over there.

(The answer I'm looking for is that no doctor will see this man, but that seems a little harsh in reality - I'm sure concessions must be made for special cases. Perhaps, I'm hoping, most ordinary doctors won't see him, but if he goes some special place, or some huge hospital, maybe they can help him there. Help me out with some scenarios?)

I hate to disappoint you, but he probably would be immediately admitted to a hospital. Earlier this year a man walked out of a park in Seattle (I think), and he had no memory of how he got there, what his name was, etc. He hailed someone, who called the police, who had him taken to a hospital, where the man stayed for some time. It took a while, but people figured out who he was, but he still doesn't remember.
Here's an article about him: http://www.journal-news.com/news/nation-world-news/seattle-mystery-man-still-going-by-jon-doe-260072.html

emandem
10-08-2009, 01:23 AM
Doctors help people without being paid more often than most people realize--so believe me, JoNightshade is right. It is often not advertised b/c word DOES spread in a community and it is difficult to accomodate more than a few cases like this. Believe it or not, most docs aren't total animals... When there is a TRUE need, I know very few of my colleagues who would turn a patient away. It's kind of the unsaid thing you do--you do what needs to be done when there is a dire need, and you just write off the pay.

icerose
10-08-2009, 01:25 AM
There are certain clues to his identity that are keeping him away from the police for now...

An unidentified man who walks into a hospital who has no recollection would immediately cause the police to be called. So like it or not unless he seeks zero help, the police are going to be involved.

They'd run his prints to see if they could get an ID, at the very least to try and find next of kin, if the prints were a wash, like he wasn't in the system, his face would immediately be put through missing persons and his mug would be all over TV trying to find anyone who knows him.

If you're dealing with small towns and he's picked up by the police, he would be taken to the nearest hospital not a private clinic also. Besides, a private doctor really couldn't do much without the hospital help, they would need the MRI as well as CAT scans to ensure he's not in a life or death situation and try to figure out why he can't remember anything.

dirtsider
10-08-2009, 05:52 PM
An unidentified man who walks into a hospital who has no recollection would immediately cause the police to be called. So like it or not unless he seeks zero help, the police are going to be involved.

They'd run his prints to see if they could get an ID, at the very least to try and find next of kin, if the prints were a wash, like he wasn't in the system, his face would immediately be put through missing persons and his mug would be all over TV trying to find anyone who knows him.


That's not to say that identification may not be delayed for technical reasons, backlogs, or the fact he may not be in any police/LEO databases.

WriteKnight
10-08-2009, 05:58 PM
The Seattle case is your baseline. This is exactly what you're looking at. REad it carefully.

StephanieFox
10-09-2009, 05:50 AM
Emergency rooms are required by law to treat everyone regardless of their ability to pay. I think that a case of amnesia would get a lot of attention because it might be a symptom of a serious brain disease. If it were a classic psychological amnesia, the doctors would like to treat it because it would be a once in a lifetime case and would be interesting.

RJK
10-09-2009, 07:47 PM
There are certain clues to his identity that are keeping him away from the police for now...

This puts a big hole in your plot. How can he have no memory but know enough to stay away from the police, or even know he should go to an emergency room.
The ER people would call the police, assuming he was a missing person, the police would eventually get around to fingerprinting him if no other method of identifying him worked. If he's not in the system, he'd probably be referred to a city mission and given a 'John Doe' name. The medical community wouldn't have any obligation for long-term care of this person if he could care for himself. He'd remain an open case for the police, and they'd try to match him to any reports of missing persons that cross their desks.

jennifer75
10-09-2009, 08:00 PM
I think the Emergency Room is the only place where a person with no ID can get medical treatment. I wouldn't know about clinics; in my state, clinics are exclusively for pregnant women to get either prenatal care or abortions. There are also STD/HIV clinics here.

In the OP's scenario, there could be some old-fashioned "country doctor" who takes on the risk of an unidentified, nonpaying client, but in real life it's so far-fetched that such a premise would be very hard to accept.

I have heard about amnesia cases in the news. The patients begin in the ER in order to get help.

Yea, I'd say an emerg. room would be best. If he walked into a doctors clinic, he wouldn't get passed those darned receptionists. They're tuff, let me tell you.

Or you could change things up, have him walk into a church. That would be interesting...Come, let us help you.

jennifer75
10-09-2009, 08:03 PM
An unidentified man who walks into a hospital who has no recollection would immediately cause the police to be called. So like it or not unless he seeks zero help, the police are going to be involved.

They'd run his prints to see if they could get an ID, at the very least to try and find next of kin, if the prints were a wash, like he wasn't in the system, his face would immediately be put through missing persons and his mug would be all over TV trying to find anyone who knows him.

If you're dealing with small towns and he's picked up by the police, he would be taken to the nearest hospital not a private clinic also. Besides, a private doctor really couldn't do much without the hospital help, they would need the MRI as well as CAT scans to ensure he's not in a life or death situation and try to figure out why he can't remember anything.

More the reason to change it up and have him stumble into a church.

Bwahaahahha.

ideagirl
10-11-2009, 01:31 AM
My character has lost his memory. He doesn't know where he is and he doesn't know where he lives. He doesn't know his own name, and he has nothing but the clothes on his back (no wallet, phone, ID, keys - nada). Oh, and he has no money.

He wants to see if a doctor can help him.

But will he struggle to see a doctor with no money and no health insurance (that he knows of)?

I just don't really know how it works over there.

(The answer I'm looking for is that no doctor will see this man

You can use that answer--it would be true, but only in part because of the lack of insurance. The biggest obstacle he'd run into is that it's just about impossible to make an appointment with a doctor quickly, even if you're already that doctor's patient, which this guy is not (or anyway, he doesn't know who his doctor is so I assume he's just randomly calling doctors in the phone book?). Particularly since he doesn't know who he is--that's just going to make it 100% impossible, as opposed to the 97% impossible that it already was.

If you need to see a doctor immediately (like today or within the next couple of days), and you don't already have a doctor, your ONLY option is to either go to a hospital emergency room or go to a clinic for low-income people.

veinglory
10-11-2009, 01:56 AM
Well, I think it would be oddly understated if he called and did not mentioned his symptoms. Because if he was a walk in or mentioned his symptoms over the phone I should think they would treat it as an emergency and contact the authorities.

backslashbaby
10-11-2009, 02:03 AM
If you need to see a doctor immediately (like today or within the next couple of days), and you don't already have a doctor, your ONLY option is to either go to a hospital emergency room or go to a clinic for low-income people.

No, around here we have several "Walk-in Clinics" that are private and definitely not for low-income folks. They are just open late and on the weekends and see you in the order you sign in. They are for stitches and sprains and colds and things.

StephanieFox
10-11-2009, 02:17 AM
We have what are called Urgent Care Clinics, which are for folks who need help right away, but don't think they have an emergency bad enough for a hospital emergency room. These are cheaper than emergency rooms and the wait is shorter because they're not dealing with trama like bad car accidents or heart attacks. They have full a full staff including doctors and nurses.

Walk-In Clinics are for people with colds or milder illnesses. They are often very small and in shopping centers or in drug stores. I went in once for in infected belly-button. They gave me some ointment and told me that if it wasn't better in four days to go see my doctor. (It was.) This is where folks can go for a flu shot, too. They often have only a nurse on staff (with extra training) who can call a doctor if someone with a serious illness comes in.

All of these want cash, credit cards or insurance cards. These are NOT required to see someone who can't pay.

If someone had amnesia, I'm pretty sure that a shrink would be called as well as the police, once it was determined that the anmesia was real and not caused by a life-threatening illness.

Dawnbird
10-17-2009, 11:38 PM
Something to keep in mind-in some places, hospitals are not required to treat you-they are required to stabilize you. An individual presenting with a non-life-threatening condition with no ability to pay for his treatment will not be a priority, and depending on hospital policy and the ethics of the personnel involved, may be discharged as soon as they've established he will not die without immediate care. There can be a huge difference in treatment. Should you walk in with a gushing gash to a limb, they'll clean and stitch it. Should you need a heart transplant, well, they'll make you moderately comfortable and send you home to die.

In regards to a private clinic, in a small town the doctor is likely to be willing to treat the individual out of curiosity and a change in the day-to-day tedium of running a practice. The limitations come on their lack of medical imaging equipment and treatment abilities outside of a hospital or clinic. If the man is obviously in distress or an abnormal mental state, the receptionist (speaking from experience) is going to grab the physician in the back and consult what he wants done with the individual, be it putting them in an exam room, calling an ambulance, or shooing them back out the door. If she doesn't have the authority to grab the physician, she'll grab either one of the nurses or the office manager and pass the buck. This is continuing on the idea that it is a small private practice of one to three physicians and a resultantly small staff. A person presenting with genuine, total amnesia is a creature of great interest to medical professionals. True amnesia is rare and partial amnesia much more common.

If your man seems to be in a relatively calm state of mind, the receptionist is probably going to refer him to the hospital. His level of agitation will also set the receptionists response to him-the calmer and more reasonable he is, the likelier she'll be to 'just ask the doc for me?' The more aggressive or upset he gets, the more she'll stonewall him and attempt to remove him from the location, including calling the police on him. Angry patient+my doctor=crabby doctor=bad day for me. Speaking from experience from behind the counter, medical receptionists are like pitbulls. I've left metaphorical bite marks on people before.

MMcDonald64
11-01-2009, 11:58 PM
Something to keep in mind-in some places, hospitals are not required to treat you-they are required to stabilize you. An individual presenting with a non-life-threatening condition with no ability to pay for his treatment will not be a priority, and depending on hospital policy and the ethics of the personnel involved, may be discharged as soon as they've established he will not die without immediate care. There can be a huge difference in treatment. Should you walk in with a gushing gash to a limb, they'll clean and stitch it. Should you need a heart transplant, well, they'll make you moderately comfortable and send you home to die.

Not sure they would be quite that callous. Most hospitals have case managers whose job it is to help patients in those situations. Some patients may be eligible for Medicaid, for example, and just didn't know how to apply.

foreverstamp
11-02-2009, 01:34 AM
Perhaps it’s not the same everywhere, but here physicians are only required/allowed to report a patient to the police if there is evidence of dangerous criminal activity. Eg – gunshot wound, stabbing, child abuse/neglect…etc. having a symptom that may be unrelated to a crime, is not only not a reason to call the police, but would be a violation of the patients rights if the doctor did so anyway. I just talked to a doctor (happens to be a family member) and they said that they would stabilize the patient, run tests, interview, and then discuss the options with the patient. That would include getting the police involved (to see if missing person’s reports had been filed). Otherwise, no obvious criminal activity= no cops. If patient says “no cops” then there’s no cops. (again, patient doesn’t have the choice if obvious criminal incident put patient in hospital).
As an example, if someone comes in with an overdose of cocaine - police are not called.

metaldreamer
11-02-2009, 03:33 AM
If this guy is in the desert, water is more of a concern than anything else. Dehydration is nasty! This condition can realistically lead to disorientation. Most states that are desert terrain have to give water to someone that asks by law. Is this a rural remote scene or is there a small town nearby, or a major city? Small towns are not always equipped with a hospital. If you do not want to go to the police, or to the hospital how about a fire station that has a EMS?