Medicine’s Fall From Grace: When is an exam not an exam?

Dr. Patricia Farrell
5 min readJun 26, 2019

Well, we could send you for a bone density test, but I don’t know if they’ll pay for it. You can only get one every two years.” So said a physician to a patient taking medication that would affect her bones. The quandary may not seem inordinate immediately but think about it. How is it prudent to not order a possibly needed medical test for a patient based on insurance reimbursement? How much of this “if insurance will pay” based treatment is now an acceptable form of medical practice?

Patients, in dire need of medical care, in the State of Tennessee, the Volunteer State, is proving that volunteers are providing the lifeline for people in desperate need of care. Why is it so? Their governor refused to expand Medicaid in their state. Why might that be? People should ask him. Because of his actions, his constituents will suffer and die, their children will suffer and the state will experience a reversal of their reputation for kindness. It will become “the state where volunteers step up when the state engages in planned cruelty.”

But Tennessee isn’t alone because there are other states engaging in calculated cruelty and neglecting the medical needs of the people who are unfortunate enough to live and die there. Is the political machine in these states solely responsible for this? No, because hospitals have done a 360 in their approach to “business” rather than medicine. Marcus Welby be damned might be their motto.

Axios recently stated that “Hospitals are swimming in cash, which has attracted investors to them. But hospitals’ financial pursuits have raised concerns about whether they are continuing to chase revenue and inflate health care costs at the expense of patients.”

Photo by Wei Ding on Unsplash

At a recent hospital meeting, they banned reporters because the meeting was for investors only. What about patients and how the hospitals will treat them? The emphasis is bottom-line thinking and that erodes the very mission of medicine; to help and to care. Although corporations are entities now, they have not evolved into…

Dr. Patricia Farrell

Dr. Farrell is a psychologist, consultant, author, interested in flash fiction writing (, and health.