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Invited Commentary
November 30, 2020

Desktop Medicine and the Practice of Wealth Care

Author Affiliations
  • 1University of Pennsylvania, Perelman School of Medicine, Departments of Medicine, Medical Ethics and Health Policy, and Neurology
JAMA Intern Med. 2021;181(2):227-228. doi:10.1001/jamainternmed.2020.6441

A fellow geriatrician received an unusual letter from a patient. Enclosed was one of those many forms Medicare sends its beneficiaries, the one with the beguiling header “THIS IS NOT A BILL” and yet, enclosed as well was a check for $331.00 made out to my colleague.

This patient was paying for a recent visit where the physician had diagnosed her with Alzheimer disease (the dollar value of the check was the Alzheimer disease International Classification of Diseases, Ninth Revision code). The disease was quite plainly costing her money. Her error was both a sign of the disease and the need to rally her caregivers to address her failing financial capacity.

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