I see and hear this all of the time…
Let me share a couple of stories from the past month.
The first is a man who came in complaining of abdominal pain. There are a lot of things that can cause abdominal pain, and coming in to the ED with that complaint guarantees that you will get an abdominal CT scan. In this guy’s case, he had an appendicitis. It was already inflamed and looked about to burst. The doctor admitted him to the hospital, and the surgeon was prepared to do the emergency surgery that evening. The man refused, saying he had a job interview that afternoon and couldn’t stay. He signed out against our medical advice.
He returned to the ED at 8am the next morning, said he was ready for the surgery, but only if we could get it done and have him out by noon. When it was explained to him that he would have to spend the night in the hospital, you guessed it, he said we were only doing that so we could make more money.
Then there was the guy who had an abscess and calcium deposit in the tip of his penis. He came to the ED for treatment. He wanted us to cut open his penis to drain the abscess and remove the calcium deposit. He explained that his urologist had refused to do it in the office and wanted to admit him to the hospital in order to perform the procedure. The ED doctor said, “If your urologist, who specializes in this sort of thing, won’t perform this surgery on an outpatient basis, what makes you think I will do it here in the ED?”
The man then looked at me and asked, “Can you just do it?” My response was “Uh, no. I’m a nurse, and I am not performing a surgical procedure on you.” He then said the magic words: “You are all doing this just to get more money out of me. I will just have my wife do it.” Then he stormed out.
Are we well paid for our high degree of knowledge? Of course we are. Have you tried to have a plumber come out and do anything? I wanted to put a sink and a water conditioner in my house. The plumbing company I called wanted $600 to hook up a sink or $900 to hook up a water conditioner. The difference is you don’t die of sepsis if you get the sink’s piping incorrect, and when the plumber gets it wrong, no one sues him for millions of dollars.
Oh, and here are a few things that have been cured by modern medicine:
- Hepatitis C
- Tuberculosis (TB)
- Syphilis
- Chlamydia and gonorrhea
- Trichomoniasis
- Stomach ulcers caused by H. pylori
- Cataracts
- Testicular cancer
- Smallpox
25 Comments
TCK · October 10, 2026 at 3:28 am
To be fair, that complaint seemed to be aimed at big pharma companies in specific, and not hospitals or the medical industry in general. And after some of the shit they’ve done in just the last half decade, can you really blame anyone for their opinion on this particular subject?
gary gray · October 10, 2026 at 6:26 am
The TV has trained the <80 that anything can be cured, with smiling faces all around, in 30 minutes and never any mention of money.
Last month we had a water line to a shitter replaced, another new shitter installed that I had purchased, total cost: $800 plus I had to buy the new shitter for $200. So, $1k to get 2 shitters running. The good thing was that they actually answered the phone when I called and they did the deed the very next day. Cheap, Fast, Good, pick any 2. They are now a contact on my phone for future ref. I had called 3 other places and left messages with no call backs.
Himself · October 10, 2026 at 7:10 am
We have two big hospital systems here in DFW – Baylor and Texas Health. Three if you include Methodist. I’ve had good interactions with both. Whether it was a procedure or test, I’ve found them super competent and professional. Or the two, I prefer Baylor. Everyone there seems happy. They seem to treat their people well. I have a son-in-law that works for them, He tells me that all the time.
My issue with medicine is what happened with the perversion of Obamacare. Seems like it’s tough to see the actual doc when you aren’t feeling well. You’ll generally see a PA. I’ve been battling an ear infection for the last few weeks. It’s lingering and I needed to see the doc yesterday. Nope. First appointment – Tuesday, with the PA. What’s the point of having a GP doc if you can’t see them when you are sick? So half the time I end up and a doc-in-the-box, which is a crapshoot. If you’re lucky, you’ll get Dr. House type that for whatever reason ended up there. Otherwise it’s a pajeet, who is useless.
Many specialists I’ve used trimmed back to only doing procedures, leaving the office visit to the PA. Hell, my endocrinologist retired, and they moved the rest of the practice to the main office. I got passed to a new doc – a pajeet. Next seen him. Not in three years. Only the PA. When I got my next appointment they said something like have to see the doc every other appointment. They were shocked I’ve never met the man. That’s a different issue – utterly incompetent office staff.
Far as pharma goes. I have no complaints. It keeps my BP good, My thyroid from making me crazed, and my stomach from melting down.
Where they make their money is things like GLP-1s for fatties. You could work to lose the weight and keep it off, but you are lazy and get the fat-jab instead. Your lifestyle is making them rich.
FWIW, if my nob had an abcess I’d pay the urologist whatever it takes.
Don Curton · October 11, 2026 at 7:48 am
I have the same issue with my GP doc – any appointment has to be made months in advance. Anything quicker requires either seeing a PA or just going to Urgent Care and taking my chances on whoever is there that day. That said, my luck has been pretty good with both. It helps that I don’t have anything chronic (other than some gastro issues) so most of the time whatever I go in for is minor stuff.
Grumpy51 · October 10, 2026 at 7:23 am
Once worked in a rural environment. The assistant CEO of the hospital told me there was no lack of doctors in the area – “every patient you’ll see is a WebMD”. Enough to where patients “already knew” what was wrong with them and just wanted me to write a prescription for X. My standard reply has always been – “if you already know what’s wrong with you, then write your own prescription.”
For those who question said reply – EVERY SINGLE TEST or PRESCRIPTION I write I am legally responsible (read liable) for; the results (tests), the side effects of medications, any interactions with other medications you told me about, etc. So no, we don’t “just write a prescription.” The stupidest ones are the ones demanding an antibiotic – ok, so if you know what’s wrong with you, WHICH antibiotic?
Long night with a LOT of social issues for which patients don’t want any of my recommendations, but still demand to be “taken care of.”
Don Curton · October 11, 2026 at 7:55 am
I’m one of those so-called WebMDs – if I have to go to the doc, I’ll spend several hours first researching my symptoms and coming to my own conclusion first. That said, I don’t march in and demand anything. I give my doc the symptoms, what I think, and then ask their opinion. So far I’ve been right most of the time. There’s a right and wrong way to do things, but I think you’d have to be a fool not to at least look stuff up first before going in. The information is right there on the internet for free, why not look it up. Just show some respect in the office when discussing it.
Jorge · October 10, 2026 at 8:44 am
A physician calls a plumber to fix a leaky faucet. After working for a half hour and fixing the faucet, he hands the doctor a bill for $600.40. The doctor says please explain the bill, so the plumber tells him it’s for 2 washers at 20 cents each and 1/2 hour of labor at $1200 per hour.
The physician exclaims, $1200 per hour, that’s more than I make!
The plumber retorts, well when I was a physician, I didn’t make that much either.
Divemedic · October 10, 2026 at 9:06 am
yeah. Proving that this blog is getting long in the tooth, that joke was posted here a year and a half ago.
https://areaocho.com/plumbers/
Alex Lund · October 10, 2026 at 9:03 am
You know that people go to the doctor to end the pain? Yes, I dont complain about staying in the hospital but about the procedure.
Let me explain:
A close relative had kidneystones and was in pain. The doctors gave him some tablets and the chemicals in them would dissolve the kidneystones. And it took about three hours while he was in pain.
A few years later I also had kidneystones but they moved and so the pain ended. But I needed surgery. So they took something flexible and went through the bladder to the kidney, crushed the stones, removed them. I was about two hours out.
I later asked and they told me, that the surgery alone took only 30 minutes or so.
So, compare 3 hours pain to 30 minutes and then the pain is gone.
That is where I complain. I want the pain to end and if there is a way to end it fast, then I want this method. I dont want to spend hours in pain.
Divemedic · October 10, 2026 at 9:09 am
That’s valid, but not every kidney stone is the same. Some are easy to reach, while others are not.
Ureteropelvic Junction
Ureterovesical Junction (UVJ)
Mid Ureter
Bladder
Each requires a different approach. There is no one size fits all way to deal with them. So comparing your experience to someone else isn’t a good comparison
Chris · October 10, 2026 at 12:36 pm
I have fairly decent insurance. Self employed, so I pay it myself. Had to have a tetanus shot last year.
The shot was 4 grand. Insurance didn’t cover it. I paid it out of pocket. I wasn’t real happy about the cost. I was there 15 minutes.
Divemedic · October 10, 2026 at 12:47 pm
Dude. Costco has that vaccine at their pharmacy for $58
Chris · October 11, 2026 at 3:44 am
Yeah man, I know that now. I guess I should have mentioned I was in the ER at 1AM after stepping on a huge nail. 😉
C · October 11, 2026 at 11:25 am
It’s cheaper and easier to keep your shots up to date. Then you could have followed up with urgent care or your family doctor. The visit would have probably ended with an oral antibiotic and instructions for home care. We live and learn though.
My rules for most injuries:
Clean it up, clean bandaging (not duct tape and napkins), and family doctor if it’s not bleeding profusely.
If it is bleeding profusely. Stop the bleeding. Pressure, clean bandages, and urgent care.
Only go to the ER if it’s arterial bleeding, an inside thing is outside, or something that was attached has now become detached. Pressure (TQ is also pressure) clean bandages, and a prayer until I get to the ER.
SiG · October 10, 2026 at 12:40 pm
The logical reply to a statement like that meme started with is “how do you know that a cure is even possible?” The meme assumes a cure was ignored, or discontinued in favor of something that could guarantee “income for life”. Reality is more like finding a “cure” might take lifetimes of research and fail, or they could spend several years finding something that brings some relief but doesn’t actually make the condition go away. In the second case, I think most people given a choice between nothing and something that makes it easier to live with would choose the latter.
People think in terms of antibiotics not something that isn’t treatable by a “magic potion” or a couple of pills every day for two weeks.
Divemedic · October 10, 2026 at 12:49 pm
Too many people come in to the ED with complaints based upon illnesses caused by years or even decades of bad habits (smoking, obesity, substance abuse, sedentary lifestyle) and poor decision making, then expect a magic cure that will take 5 minutes, a shot or pill, and then discharge. Oh, and they want it to cost no more than $200.
That’s why so many people believe in the miracle curative powers of Ivermectin.
Grumpy51 · October 10, 2026 at 1:30 pm
LOL….. Had a nursing home patient (oh, excuse me, Skilled Nursing Facility patient) with BMI > 60 (our best guess) who was a diabetic, never got out of bed (physically couldn’t). I walked in one day and found a half-eaten quarter-sheet cake, with her demanding I adjust her insulin. I replied, ma’am, my job is to provide the best care I know, and that doesn’t involve chasing your blood sugar just because you can’t keep your pie hole shut from cake. She fired me…… This country is filled with people who accept ZERO responsibility for their healthcare, most are on some form of public assistance, which sucks our tax dollars down the drain, and for what???
As a country, we don’t want to have the hard conversations…..
On another note from above – IF you spend $4K dollars on a tetanus, you’re part of the problem. I’m guessing you also pay top dollars for all your other expenses, versus shopping around. Getting a Tetanus vaccine in the US, when one has already had primary series, is NEVER an emergency – even with injury, you have several days to get covered.
gary gray · October 10, 2026 at 3:45 pm
I agree $4k is way too much (even I know that) but how was he or anyone else to know Costco has it for $58?
Grumpy51 · October 10, 2026 at 11:15 pm
Ummmm, Google (verb, not noun)???
A quick google search (Brave) “cost of Td vaccine near me” turns up a multitude of pharmacies offering Td for $40-80.
JNorth · October 10, 2026 at 1:33 pm
I have lymphedema tarda so I’m super suspectable to cellulitis and have been hospitalized for that a bunch of times, enough that the local ER knows me so they just get a culture before giving me Vanco or something weaker depending on what they see in the culture while getting me up to a room for a couple days of IV anti-biotics. The crazy part, though, is once I’m admitted and in a bed with a giant stack of pillows keeping my left leg above my heart, the doctors and nurses commenting how they are surprised I’m doing what they told me to do… If I’m not going to do what the doctor says, I’m going to not do it at home, if I’m putting up with being in the hospital it’s because I don’t have a better idea, so I’m going to listen to them and do what they say.
pcb_duffer · October 10, 2026 at 2:58 pm
My PCP is always happy when she looks at my blood pressure log. It seems that lots of people aren’t very reliable about actually taking their medicine. She’s also honest enough to look at the x-rays of my knees & hips and say “Other than sending you to {State University hospital of last resort} I wouldn’t even know where to start.”
C · October 11, 2026 at 11:44 am
Concerning the plumbing post. I wouldn’t have even charged you half of that. I’d have only charged you that if I was driving from SC to Florida, billed you half a day rate for labor, and threw in some maintenance/upgrades at material price.
The bigger corporate plumbing outfits. A lot of them pay their plumbers a percentage of the job. So the only way they can make great money is to bill you as much as much as possible. I only tell people to call those places if they don’t like my prices. Which go up if they call me back after getting quoted 100-200% more.
I don’t make exceptions for family either. I offered to fix my sister’s floor problems. The piers holding up the center plate of the house had settled. I quoted $2500 to fix that, add steel reinforcement, install jacks, and replumb the house while I was under there. She said that was too much and called a foundation repair company. Their quote? $25,000
EC · October 14, 2026 at 5:56 pm
I always theorized TB went away with the advent of the electric lighting, when people quit breathing polycyclic aromatic hydrocarbons in the soot from candles and oil lamps cooped up in their houses.
Divemedic · October 15, 2026 at 6:09 am
Right now, TB is endemic in our homeless population. Many emergency nurses, my self included, have positive titers for TB. I have to get an annual chest x-ray because of it.
EC · October 16, 2026 at 9:43 am
Thanks, I hadn’t realized that.
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