Is Caring for the Homeless and Uninsured Really Someone Else’s Problem?

There is also, unfortunately, the issue of the possibility of a lawsuit against all the providers if all doesn’t go well. In sum, the otolaryngologist takes on a good deal of risk. One may ask, “Is it worth it?” or “Why not let it be someone else’s problem?”

Everyone’s Problem

Fortunately, our profession is guided by a code of ethics, a code of moral conduct, ethical principles, and professional virtues, all of which give us the answer to the questions posed above. While we all believe in helping patients and not harming them, we also must understand our obligation to the principle of “social justice.”  

This principle is evolving in its modern application to healthcare obligations, and we now understand that it applies to all patients, regardless of their socioeconomic status or where they live. We are obliged to care for those who need our skills and capabilities, without judgment or bias, and to the very best of our abilities and experience. Homeless and uninsured persons aren’t “invisible” to us, aren’t “subhuman,” and shouldn’t be objects of pity. They are human beings who, for their own reasons (or society’s reasons) choose to live outside the social environment with which we are most familiar. We must see them as real people, empathize with them, understand them, and help them however we can. Yes, caring for the homeless and uninsured may be a challenge, and they may take more of our valuable time than other patients, but if we deny them our care, we stand to lose a bit of our professional soul in the process.

So, in answer to the clinical scenario presented at the beginning of this article, you should go examine this young man, talk to him, and get to know him. Identify ways you can help him and ask for his consent. Then, go about making the effort to get all of the resources you’ll need for him rounded up and willing to help. It isn’t “charity,” but rather human compassion and a recognition of our professional duty to him as physicians and surgeons.    

Dr. Holt is professor emeritus and clinical professor in the department of otolaryngology–head and neck surgery at the University of Texas Health Science Center in San Antonio.