The Doctors Recommendations Don't Matter... not if you can't afford them

05/19/2010 05:12 am ET | Updated May 25, 2011

With all the debate about guidelines for mammograms, pap smears, and PSA testing, one fact is lost... guidelines don't matter if you don't have the money to follow them. Across the country, people are going without needed care. This reality is readily apparent in both our clinics and hospitals.

I was in surgery yesterday and one of the nurses commented that it was quiet again. In Rhode Island, unemployment has risen to 12.7% and people have lost not only their jobs, but their health insurance as well. While this situation has overwhelmed the free clinic where I volunteer, the opposite is true for the hospital operating rooms, which feel eerily quiet. We have the 10th largest obstetrical service in the country and are a National Center of Excellence in Women's Health. However, the total surgeries performed during February have declined steadily in the last three years from 722, to 639, to 566.

Our population has not changed much recently, nor do I suspect have our health needs, so how do we account for the drop in surgical volume? People are delaying or forgoing necessary care.

Down the street, the RI Free Clinic now holds a lottery to determine who can be seen. The growing number of uninsured patients has surpassed our ability to care for them.

Last Monday Rhode Island was forced to suspend its Women's Cancer Screening Program until July. That means no mammography and no Pap screening unless you have insurance. How many cases of breast cancer will go undiagnosed until the summer? How many opportunities will be missed to detect cervical cancer while its still treatable? This is unacceptable.

The current health care bill aims to alleviate this. The bill will not only insure millions more Americans, it provides tax credits to small businesses so they can hire and provide insurance for employees, it will help seniors pay for medications, and it will make sure that health insurance doesn't disappear when we get sick.

In my own congressional district, the bill would cover 19,500 more uninsured citizens, improve coverage for 350,000 residents, improve drug coverage for 87,000 Medicare recipients and protect 1,100 families from bankruptcies resulting from uncovered medical costs. Find out what the bill would do for your own community and urge your representative to support our health.

Back at the hospital, it's still slow. I have time to write, but would rather be caring for patients.