Simplifying care: when is the treatment burden too much for patients living in poverty?

It is usually a grand affair when 'Ms Noelle' makes it to clinic. The 52-year-old mother with a history of hepatitis C cirrhosis, hypertension, uterine fibroids and migraines has been in our care for over a year. Even so, each visit still brings a new crisis. Today, we found out that Ms Noelle, the caretaker of a daughter with bipolar disorder and nine grandchildren, had just been evicted from her home. She had been without any income for months, and her applications for temporary cash assistance and disability were denied. Ms Noelle maintained a remarkable ability to keep her family protected and fed despite all this, but we have watched as she became the ultimate victim: she struggled to remember her medications, their doses and indications, and her cirrhosis was frequently on the verge of decompensation during appointments she was barely able to keep. She was overwhelmed by even...

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