Drug test at the hospital?

[rscott0001]

What is the name of your state (only U.S. law)? North Carolina



I just went to the hospital's emergency room. I asked to be treated for my chronic back pain, and for help to stop smoking cigarettes. I was asked for a urine sample to check for a bladder infection. I suspect that because I am unemployed, indigent, and have sought treatment there three times previously within the past couple of months for chronic back pain, they were planning to use the urine sample to check for illegal drugs. I refused, stating that I would seek treatment elsewhere.

Could they have used that sample for a purpose other than that which they claimed? Could they have refused treatment based on the results of such a covert drug test? More importantly, do I have to worry about harrassment from law enforcement? I felt that they were attempting to invade my right to privacy, but now I wonder if my decision to refuse the test, and the treatment which was contingent upon that test, could cause problems for me, especially if I seek treatment there again.

[lealea1005]

Back pain is a symptom of a unrinary tract or kidney infection. They would have run a urinalysis and sent it for a culture.

Could they run a drug screen with the sample? Sure they could.

[rscott0001]

They have it on record that my back pain is caused by degenerative disc disease. I wish I'd had the presence of mind to tell them that. But I'm guessing that even if I'd told him that, he could have ordered the test anyway, and then run whatever tests he "deemed relevant," in other words, any test that he could even remotely associate with back pain or nicotine addiction--including a drug screen. Is that pretty much accurate?

[lealea1005]

Originally Posted by rscott0001

They have it on record that my back pain is caused by degenerative disc disease. I wish I'd had the presence of mind to tell them that. But I'm guessing that even if I'd told him that, he could have ordered the test anyway, and then run whatever tests he "deemed relevant," in other words, any test that he could even remotely associate with back pain or nicotine addiction--including a drug screen. Is that pretty much accurate?

Yup. It would have been well within the standard of care for the Physician to order any test s/he deemed necessary for an accurate diagnosis. Telling them you have been diagnosed with degenerative disease is irrelevant. They order tests and treat you deemed on your present symptoms and their examination.

If they felt it necessary to run a drug screen, and it came back positive for illegal drugs, they most certainly could (and probably would) refuse to treat you with narcotics.....not to mention the danger of mixing narcotics/alcohol with treatment for nicotene addiction.

[rscott0001]

Thanks, it's helpful just to have my suspicions confirmed--even though I'm mad as hell at the covert attempt to invade my privacy, I at least have some satisfaction in knowing where the law lies. I greatly appreciate your time.

[Zigner]

Originally Posted by rscott0001

Thanks, it's helpful just to have my suspicions confirmed--even though I'm mad as hell at the covert attempt to invade my privacy, I at least have some satisfaction in knowing where the law lies. I greatly appreciate your time.

You know - you could avoid this by NOT utilizing our overworked ER system for chronic conditions and stop-smoking cessation assistance.

[cbg]

And because they CAN does not mean that they DID.

[rscott0001]

Zigner: If I could afford insurance, I might be able to avoid using the ER, but thanks for your time and concern.

cbg: They COULD, and they could do so legally without explicitly telling me so. I feel I should not have been forced to compromise my privacy for my health. Besides, my medical records clearly show that my chronic back pain is caused by degenerative disc disease; a test for a bladder or kidney infection would have been a waste of the ER's resources at best, and at worst it was a pretense for an unwarranted drug screen. Thanks for your time and concern.

I have the information I requested; again, thank you all for your time.

[cbg]

Yes, we have established that they COULD do such a test without telling you. We have NOT established that they DID do such a test without telling you. So just exactly where has your "privacy" been compromised?

[lealea1005]

Originally Posted by rscott0001

Zigner: If I could afford insurance, I might be able to avoid using the ER, but thanks for your time and concern.

cbg: They COULD, and they could do so legally without explicitly telling me so. I feel I should not have been forced to compromise my privacy for my health. Besides, my medical records clearly show that my chronic back pain is caused by degenerative disc disease; a test for a bladder or kidney infection would have been a waste of the ER's resources at best, and at worst it was a pretense for an unwarranted drug screen. Thanks for your time and concern.

I have the information I requested; again, thank you all for your time.

Do you think people with chronic back pain do not get UTIs?

Obviously, you did not read what I wrote: back pain one symptom of UTI, kidney stone, or kidney infection. It would have been negligent NOT to obtain a urine sample to rule either out. The ER Doc is not, and should not be utilized as your PCP. At the ER you are treated on an EMERGENT, episodic basis only.

You did not fool anyone by refusing to submit a sample. You just confirmed any suspicion they had about the real reason you were there.

[ecmst12]

An appointment at a doctors office is a heck of a lot less expensive for a self-paying patient, then a visit to the ER. Treatment in the ER costs thousands when the same services done in the office cost only a few hundred.

And if you're "unemployed and indigent", you should easily qualify for medicaid. If you're merely unemployed and not actually indigent, then you should pay for the services you need, rather then going to the ER with the intention of ignoring the bills.

[lealea1005]

Originally Posted by ecmst12

An appointment at a doctors office is a heck of a lot less expensive for a self-paying patient, then a visit to the ER. Treatment in the ER costs thousands when the same services done in the office cost only a few hundred.

And if you're "unemployed and indigent", you should easily qualify for medicaid. If you're merely unemployed and not actually indigent, then you should pay for the services you need, rather then going to the ER with the intention of ignoring the bills.

But ya see....s/he doesn't have to pay the ER on the date of service like they would at a Doc's office. That way they could pay cash when they pick up their Rx.

[rscott0001]

It's not that it's impossible that I have a UTI, it's that the cause of my chronic back pain had already been established. If the point of checking for UTI's is to establish the cause of my back pain, it seems redundant to have that test when they know (or could have found out by asking me, or checking my records) that I have DDD. And the case for checking for UTI's, kidney stones, etc. because it would be negligent not to, is shaky at best. If this had been my first time in the hospital with back pain, with no previous diagnosis of the back pain, sure. But I had back surgery--in that very hospital--nearly two years ago. The cause of my back pain is well-documented.

My point about privacy is that, whether they would have used the urine sample for a drug screen or not, my privacy was compromised because the sample COULD have been used for that purpose.

Let's say you're an ER doctor. If I give you my urine sample, which contains evidence that I used an illegal drug, I have compromised--or perhaps a better word is 'waived'--my privacy, whether you test the sample for an illegal drug or not. Now, as an ER doctor, you are legally obligated to provide medical care for me, whether I can pay or not. However, you can refuse to give me the treatment unless I give you the urine sample. Additionally, it is legal for you to demand that sample as a condition of treatment, even if 1) you say that the sample will be used to test for a UTI, and 2) you don't tell me that you could check the sample for an illegal drug and 3) the symptom of the UTI for which you are testing has already been established to be caused by DDD. You have therefore circumvented your obligation to treat me by demanding a urine sample for which you have no reasonable need. Essentially, you can hold my health for ransom by imposing upon my right to privacy.

If I made any error in my encounter at the hospital, it was in telling the nurse that I was indigent, but she kept badgering me to see my primary care physician, so I finally told her why: I'm injured, therefore unemployed, therefore uninsured, and poor to boot.

The unfortunate truth is that people like me have no recourse other than ER's and free clinics for our health care. And as to Medicaid, I won't qualify until next year because I cashed out my 401K for living expenses, because I lost my job, because I have DDD. Early 401K payouts are considered income, and count against need-based services.

And through your questions, you have brought us back to essence of my grievance: None of you have any evidence that I use illegal drugs. Neither did the doctor, or the nurse. All of you have assumed that because I'm unemployed, indigent, have professed to have chronic pain, and have am willing to stand up for my right to privacy, that I am guilty. THAT is my issue--being treated as guilty just because I SEEM guilty.

I will not entertain any more questions on this subject. Thank you for your time and info, and for giving me an opportunity to share what kind of humiliation the poor must endure.

[ajkroy]

Originally Posted by rscott0001

Now, as an ER doctor, you are legally obligated to provide medical care for me, whether I can pay or not.

I've been in healthcare for 14 years and I had no idea that an ER physician is legally required to treat non-emergent conditions, regardless of ability to pay.

[lealea1005]

Originally Posted by ajkroy

I've been in healthcare for 14 years and I had no idea that an ER physician is legally required to treat non-emergent conditions, regardless of ability to pay.

If a person presents at the ER. it is assumed it is for an emergent problem and they are obligated to treat the patient.