When is a hospital admission not an admission?
Answer: When, for Medicare patients, it’s coded as “observation” status only.
Before the days of discharging patients ASAP (or not admitting them at all), doctors used to frequently admit patients “for observation.” It signified that a patient was not critically ill, but his or her condition warranted careful watching, i.e. observation.
Unfortunately for the last decade or so, that term has come to have a very specific meaning with very specific financial consequences. But most patients still consider it a casual phrase that doesn’t mean much, and that ignorance can end up… Continue reading
A remembrance of things past
I picked up a book the other day that filled me with nostalgia, a yearning for a return to the way medicine used to be practiced 30 or more years ago.
Yes, I’m probably guilty of looking at the past through rose-colored glasses, but reading God’s Hotel: A Doctor, a Hospital, and a Pilgrimage to the Heart of Medicine by Victoria Sweet, MD, reminded me of the era before “bureaucratic medicine” when doctors and nurses had more time and more autonomy to deliver the slow medicine or patient-centered care she describes.
Related post: “Knocking on … Continue reading
What is too much medicine and why is it bad?
I’ve talked about it before: Health care costs are crazy high; the cost of insurance is increasing to meet those costs; and more patients than ever are being harmed by the treatment that is supposed to help them.
The overuse of medical care is directly responsible, and increased patient (consumer) awareness is needed to help turn this trend around.
Reading The Treatment Trap: How the Overuse of Medical Care is Wrecking Your Health and What You Can Do to Prevent It by Rosemary Gibson and Janardan Prasad Singh would be … Continue reading
Ratings for safety
Yesterday, Consumer Reports published its annual hospital ratings, and this year it focuses on hospital safety. Why? Because hospitals can be hazardous to your health.
Infections, surgical mistakes, and other medical harm contribute to the deaths of 180,000 hospital patients a year, according to projections based on a 2010 report from the Department of Health and Human Services. Another 1.4 million are seriously hurt by their hospital care. And those figures apply only to Medicare patients. What happens to other people is less clear because most hospital errors go unreported and hospitals report on only
… Continue reading
Access to your records is important
If, like me, your health care has been disrupted by new insurance coverage and the loss of your doctors and/or hospital network, it’s important that you have a hard copy of your health records.
I’ve always advised patients to keep copies of all their important health reports—x-rays, lab results, operative and pathology reports, etc.
A timeline of surgeries and hospitalizations is a good idea, too.
And it’s vital to keep an up-to-date medication list, including any frequently used over-the-counter products such as baby aspirin, ibuprofen, antacids, vitamins and herbal supplements (to name but a … Continue reading
The anatomy of a prolonged death
In 2001, author Katy Butler’s father suffered a stroke. Thus began her and her family’s long journey through our health care system detailed in Knocking on Heaven’s Door: The Path to a Better Way of Death.
After his death, I would not rest until I understood better why the most advanced medical care on earth, which saved my father’s life at least once when he was a young man, succeeded at the end mainly in prolonging his suffering.
During vigorous rehabilitation to regain strength following the stroke, Ms. Butler’s father developed a hernia—a … Continue reading
“I need to sleep!”
As a nurse, I’ve always known that a hospital is a lousy place to be sick. Why? You can never get a decent amount of sleep! And who needs sleep more than someone who is recovering from an illness or injury?
I loved this YouTube video I ran across while reading an article about patient-centered care:
It was made by 15-year-old Morgan Gleason, who, according to the article
First…contracted meningitis while getting an infusion for an autoimmune condition. Then, hospitalized, Tuesday morning she got fed up with how she was being treated, and laid down
… Continue reading
Well, 2013 is ending and what a year it’s been in health care! I fear 2014 will deliver more confusion, cost and concerns related to health care and health insurance, but for now I’d like to end this year on a humorous note.
Like me, many of you will be old enough to remember seeing the Monty Python movie The Meaning of Life when it hit the theaters in 1983. Even though it’s 30 years old, there is a hilarious operating room scene that is still applicable today.
In it, the doctors are so obsessed with new technology, including the … Continue reading
In the market for a new hospital?
This last week I’ve spent quite a bit of time researching hospitals online. Why?
First, I recently posted about the book, Unaccountable: What Hospitals Won’t Tell You and How Transparency Can Revolutionize Health Care, which questions the safety standards of American hospitals. The author, Dr. Marty Makary, writes about the difficulties both patients and patient safety advocates have in choosing and evaluating hospitals when the necessary information is not made public.
Second, my family is in the process of choosing both a new insurance plan and a new hospital and doctors. Our… Continue reading
Medicine’s code of silence
I remember I was a very new and young nurse when I realized most patients haven’t a clue what goes on behind the privacy curtain of medical care in a hospital.
Working in the operating room, I quickly learned who were the best—and the worst—surgeons. The best had skill and good judgement, and I would enthusiastically refer my family and friends, if needed.
And the worst? “Why do these docs still get patient referrals?” I used to wonder. “Why doesn’t the hospital do something? How are patients supposed to know?”
I still ask myself these questions.… Continue reading