I’m irritated, bordering on angry. I know the economy is bad. I know that patients are having problems paying their bills. Our office has helped many patients through their financial difficulties over the years. Like many other physician offices across the country, we write off large amounts of bad debts yearly. As reimbursements drop and bad debts rise, our own survival is threatened. The overhead in a medical office is staggering. In order to collect what Medicare or the insurers owe, a medical office has to employ a large number of coders and billers! Yes, it’s all part of the business of medicine. So, why am I irritated and angry?After months of trying to work with a patient to restructure the over $1,000 of debt he accumulated for the care of him and his family, my office received the bankruptcy notice. Yes, patients go bankrupt, leaving the doc who provided their family’s care holding the bag if they include the doctor’s debt in the list of creditors. It’s sad. It happens. The debt is wiped out and hopefully the family recovers in time.Within weeks of receiving the bankruptcy notice in the mail (the patient never calls), the patient posts a pic on Facebook of their family’s new house. It looks pretty nice. Weeks later, pics are posted of the family vacation. Over the ensuing months, more celebrations, more vacations, more pics. What’s wrong with this picture?Yes, bankruptcy alleviates the legal responsibility of your accumulated debt, but what about the moral responsibility? When I work hard to care for a family, I expect that family to care about me. I know that sounds selfish, but it’s true. I also accept that a family recovering from a bankruptcy should have a right to live and enjoy their lives. However, I don’t expect them to proudly post picture after picture, month after month, of them living the high life while others are stuck recovering from losses the debtors left in their wake of financial destruction.I guess I’m just old, living in the past. Many of today’s 30-40 year olds seem to have completely lost the concept of personal responsibility and morals. If I have some of this wrong, please let me know.