One Reporter's Painful Decision : Shots - Health News NPR's Richard Knox took a dive from ladder this weekend and nixed a costly trip to the E.R. Was that smart?

One Reporter's Painful Decision

A trip to the E.R. can cost thousands. When is it OK to say no? / hide caption

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I broke a rib or two this weekend. And I saved the US medical system thousands of dollars.

Here's how:

Breaking the rib(s) was amazingly easy. I fell backwards off the third step of a ladder, landing with full force directly on the vacuum cleaner. A stupid fall, as all falls are. But you don't know that until it's too late.

My daughter, alarmed by my gray-ish hue, called 911. Within about seven minutes, it seemed, a volunteer rescue squad appeared at my side -- this was 11 p.m. on a Saturday night in the woods of New Hampshire.

The lead EMT knew what she was doing. Blood pressure and heart rate normal. Neurologic signs, check. Medication history. Then an extensive mental status check.
At one point one of the other EMTs asked if I could recite the Declaration of Independence. "The what?" I replied. "Could you?"

(Should Knox have headed to the E.R.? Find out what he did after the jump.)

Somehow I convinced them I was lucid. I could tell because they presented me with a form to sign saying I wouldn't sue if I died in the night from internal bleeding. I knew if they had any doubt they, quite properly, wouldn't have given me a choice.

I also knew that if I had said I'd like to go to the hospital to check things out and be observed, it would have cost a few thousand dollars. And by this time the EMTs and I were pretty sure the intense pain in my lower right side was from broken rib(s), for which there is really no treatment.

After a very uncomfortable night I got a call from the lead EMT to see how I was doing, which I thought was really nice. (A grateful note and donation are on the way.)
During our 15-minute chat she said I could get an x-ray which would tell me whether multiple ribs were involved, and if there had been separation or just crack.

"Would treatment be any different if I knew?" I asked. "No, but you'd know how long it would hurt."

I'm thinking about it. After all, I've got things to do, and it would be nice to know how long this invisible mugger guy is going to be standing behind me, ready to sink his shiv between my ribs when I move slightly in the wrong direction.

I'll doublecheck with my doctor. But I'm thinking I'll forego the x-rays. After all, that would probably cost another thousand bucks or so. I'll just let my body do its healing thing.

Miraculously, that's free.

Have you ever said no to health care -- for good reasons or bad? Please do tell us your story. I'd like to know I'm not alone.