I simply refused: Non-payment for shocking medical bills

John James' story:
When my son died as a result of the poor quality healthcare he received, I simply refused to pay any of the uninsured costs. For at least 6 months after my son died his cardiologists were sending their bills in his name to our home address in Houston. Even after the fact, if the outcome has been less than "advertised" let those who would bill you for poor quality care know you will make an issue of the quality if they insist on billing you.


In another instance, I negotiated some costs with a highly recommended urologist, including the cost of pathology that would be involved. I got his estimates in writing. When the pathology bill came in thousands of dollars over the urologist's estimate, I simply sent a copy of the estimate to the pathologist and said that it would be unethical to charge me more unless he had done something unusual, which I knew he had not. That's the last I heard from the pathologist. I know what it costs to do pathology and the bill from the pathologist was outrageous.

The classic definition of the Yiddish word "chutzpah" [ pronounced "khoots-pah"] refers to a defendant who insists the judge should look favorably upon him because his murder of his parents has left him an orphan. The staff involved in billing John on these two occasions showed exactly that kind of chutzpah.

Read John's draft of The American Hospitalized Patient's Bill of Rights in my book, Getting Your Best Health Care: Real-World Stories for Patient Empowerment. Thanks to John for sharing his story with the Facebook group, "IHI Patient Activists." John is a pathologist, and author of a moving memoir, A Sea of Broken Hearts.

I thought this was an odd response: A father’s intuition on misdiagnosis

John James' story:
Early in my son's failed diagnosis I told his lead cardiologist that I could get a previous electrocardiogram [which produces graphs of the heart's electrical activity over time] done a few months before my son's non-fatal collapse. That cardiologist wasn't interested in this previous EKG. Since I carried a small card in my wallet with my EKG, I thought this was an odd response from the cardiologist if he knew what he was doing. My intuition said I need to find another hospital for my son. Unfortunately, I did not follow my intuition and my son lost his life to incompetent medical care. The changes in my son's EKG would have pointed the way to the proper diagnosis, which was acquired long QT syndrome [a rare heart condition].

John James' Advice: If I could tell patients only one thing it would be to follow your intuition. If you think there is something wrong where you or a loved one is being diagnosed or treated then take charge, get a second opinion, or just get out.

Read a happier story about the role of a patient’s intuition in choosing medical treatment. Thanks to John James for this story.

Click here to get John’s book and e-newsletter subscription.

In our darkest time: The role of faith

I've given short shrift in the blog to the role of faith in physical healing and emotional healing after loss, as this reflection by Dr. John James on the recent story by Cori Liptak made me realize:

I liked the story you sent out today about cancer victims/survivors sticking together. Many of us in the Christian faith community ask why there must be suffering and the story you passed along answers that question. Suffering is essential so that we understand the suffering of others. Once I recovered from the acute grief of loss of my 19-year old son to medical errors, I came to a new understanding of what my faith expects of me and where God was during my son's days of dying. God was there in those who came to us in our darkest time and showed uncommon compassion. No one really wants to be there when a child is dying, but God puts them there nonetheless.

And so it happened not long afterward that good friends at church lost a daughter to an accidental overdose of therapeutic drugs. And not long after this a co-worker lost her son for the same reason. Having experienced the loss of a child, I was able to listen to their grief, their doubts, their "what ifs," and their hopelessness. Because of my suffering I was able to minister to them in ways that someone who had never lost a child could never hope to do. It is promised to us that we can turn all things to good if we love God. I would never wish the death of a child on anyone, but even this can be made the basis for a good purpose in life.

I've concluded that his world was created intentionally as an imperfect place where suffering abounds. My faith tells me that we are to love one another, but there would be no need for love if there were no suffering. Suffering is the vacuum into which the Breath love enters to lessen the suffering. Unfortunately, the Christian faith community has come to suppose that by sufficient praying and righteous behavior all will go well. That is obviously not the case, but my fellow Christians keep at it supposing that somehow God is delivering specific blessings when in fact, God expects loving responses to others, and assumes that we are prepared to suffer and carry our cross as life hands us suffering.

John wrote the book "A Sea of Broken Hearts" after his son's death due to medical errors. His comments about the beneficial effects of suffering reminds me of an observation by Rabbi Harold Kushner in his book, "When Bad Things Happen to Good People." Rabbi Kushner's young son Adam had progeria - a rare, debilitating and fatal illness. Rabbi Kushner said the suffering certainly deepened his own spirituality - but that the rabbi would gladly give up all that gain to have his son back....

Advice to those who’ve experienced a tragic loss: Faith, and praying with others in your community, can strengthen your purpose in life.

Read another story on the healing role of faith.