Courtesy of Fashioning Change. Adriana Herrera: I finally gave in and decided to see a doctor.

Fashioning Change

A social entrepreneur tries to change the way people shop.

Three days after we established the Fashioning Change house in Santa Monica, I was in a car accident. I was rear-ended, and upon impact I felt like I had the wind knocked out of me. Despite the pain, I didn’t give it much thought. I assumed it was because the seat belt had done what it was supposed to do.

Following protocol, I went to exchange information with the driver of the other car. The woman who hit me was in her early 20s, had an empty child seat in the back of her car, spoke broken English and was shaking. Fortunately, I speak Spanish and we were able to communicate. As we exchanged information I learned that she was from El Salvador.

As soon as she said that, I understood that she might not be an American citizen. I took a moment to call my father to ask his advice. He said that because I was in pain, I needed to report the accident. At that point I started to shake. I began to anticipate what this accident might mean for the woman’s life. Following my father’s advice, I called the Santa Monica police to report the accident and the dispatcher asked if there were any major injuries or damage. I told her no and she said that they were directing all units to something else that was happening. Her advice was to exchange information with the driver and call our insurance companies.

I took that as a sign that I should go with my instinct and try to keep the impact of the car accident as minimal as possible for both of us. We exchanged information with the understanding that she would have to cover any costs I would incur from the accident. We both seemed at ease with not having to involve law enforcement.

But in the weeks that followed, the pain in my side never went away. In fact, it got worse. There were mornings when I would wake up and the pain would be so bad that I’d get sick.

Why didn’t I go to the doctor? Well, I don’t have health insurance. I’ve always been a healthy person, and at the time I priced out health insurance I felt as though the money would be better spent building the company.

The timing of the car accident could not have been much worse. We had just begun to establish ourselves in the Santa Monica area, I was running from meeting to meeting, and it was the holiday season. To manage the pain, I started taking ridiculous amounts of Advil. I’d find myself sitting in a car right before a meeting, fighting back tears and telling myself to “Suck it up, suck it in,” a phrase my mother and I say when we’re trying to deal with a problem and maintain a smile.

The holidays passed, we were in January, and the pain still hadn’t gone away. I finally gave in and decided to see a doctor. When I shared this with Kestrel, who is in charge of product sourcing and is also my roommate, she was obviously relieved. She had watched me deal with the pain on a daily basis and had been very respectful of my choice not to see a doctor, until now. The choice had been part not wanting to deal with not having insurance, part really hating going to the doctor, part having more than enough to keep me busy at work, and part believing in living as naturally as possible. I assumed that my body would figure it out.

But that hadn’t happened, and now Kestrel suggested that I try a clinic in South Central Los Angeles for people without insurance. I called and tried to make an appointment but they didn’t have any availability. They suggested I come as a walk-in at 6:30 a.m., the time they open. Because the clinic is in a part of town with high crime (and because she is awesome), Kestrel came with me. When we got to the clinic at 6:30 a.m. on a Thursday, it was already full of people.

Four hours later, a doctor examined me for 10 minutes and told me that my pain was in my gallbladder and that I would probably have to have it removed. This was both scary and confusing since the pain had started when I was rear-ended. He said we’d know for sure if I had to have surgery once they ran blood tests and I had an ultrasound. He wrote me a referral to get the ultrasound and blood work.

So I got my blood work done and went to a radiology office where everything was paid for out of pocket. It was $50 for the ultrasound – a price I gladly paid, knowing it can cost far more. The woman who did my ultrasound was really nice. As I walked into the room, she could read the worry on my face. To ease my nerves she made conversation and told me what she did and did not see. She did not see anything wrong with my gallbladder, but she did see an enlarged liver. I shared the details of my car accident with her, and she said she suspected that I had a fractured rib that was poking my liver. But she was not a doctor.

It was frustrating to think I had been walking around this way because I wanted to avoid the medical expenses. It was also frustrating that the woman who rear-ended me seemed to have fallen off the face of the earth. But I have not had second thoughts about not waiting for the police. I find it harder to face the idea that I would have been responsible for keeping that woman from raising her child in this country.

It has been several weeks since I went to the doctor and they never got back to me. I called several times and no one ever answered the phone or returned a message. Needing to begin my healing process, I spoke with my parents — both of whom have worked in the medical field — and my mother gave me some advice on getting good, affordable care.

Step one, she said, was finding a good primary care physician. She made a list of doctors she thought I might like and I was lucky enough that my first choice took me as a new patient. Step two was knowing about the discount that comes with immediate “self pay.” If you pay for the appointment in full at the time of service, many doctors give a discount. In my case, I saved 40 percent.

Step three was knowing about professional third-party vendors through which I could order my own lab work, save money and take the results to the doctor. This is the process I went through, and it turned out my liver is fine — although I have a severely bruised rib that hasn’t healed because I haven’t slowed down enough to let it heal. The doctor prescribed pain cream but I never filled the prescription. I prefer natural steps, so I’m conducting more meetings through Skype, doing a little less running around, and asking for help carrying things.

Allowing personal challenges to get in the way of day-to-day operations can be deadly for an early stage start-up like Fashioning Change. No one that I met with in recent months had any idea how much pain I was in. I even hid the pain I was dealing with from my team as long as possible, which was particularly hard when we would laugh. Despite these challenges, the fourth quarter of 2012 was our best quarter ever.

Meanwhile, somewhat reluctantly, I am in the process of pricing out insurance.

Any suggestions?

Adriana Herrera is chief executive of Fashioning Change. You can e-mail her at adrianah@fashioningchange.com, and you can follow her on Twitter.

Article source: http://boss.blogs.nytimes.com/2013/02/15/why-i-have-no-health-insurance/?partner=rss&emc=rss