Doctors are unhappy by dialysis payment policies in some US states, which fail to provide undocumented immigrants with services until they are close to death, according to a new study.
There are approximately 6500 undocumented immigrants with end-stage kidney disease in the US, many of whom are unable to receive routine dialysis vital to their health because of payment policies that cover such treatments only during emergencies, an Annals of Internal Medicine report has revealed. As well as the increased expense, with emergency dialysis costing four times more than routine dialysis, and the toll in the lives of patients, such policies place doctors in impossible positions, contributing to burnout and job dissatisfaction, the authors claim.
Dr Lilia Cervantes of the University of Colorado School of Medicine and Denver Health says that doctors form personal relationships with critically-ill undocumented immigrant patients and their families. Those suffering from end-stage kidney disease who are only allowed emergency dialysis have a mortality rate 14 times higher than those in a similar condition who receive routine dialysis. Cervantes says that witnessing high mortality and needless suffering is distressing for doctors.
50 clinicians, including nurses, doctors, and other professionals in the healthcare industry were surveyed for the study. Most reported emotional and physical exhaustion due to the daily barriers to providing care that exist at an organizational and system level and said that providing substandard care because of immigration status was unethical.