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The Guest
Refrigerator Door

Now I' m sharing magnets from my mother's fridge.

Doesn't show too well, but this is a finger with a string around it, as a reminder.



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WHAT I'M READING...

I'm a Stranger Here Myself

by
Bill Bryson

also

Battersea Park
Road to Enlightenment


WHAT I'M WATCHING...

ER


Pictures from the Pride March in SF on Sunday are now up at Club Photo


That's it for today!

HEALTH ?CARE

29 June 2001

Iíve been watching the reports on the proposed Patientís Bill of Rights, which will allow patients to sue their HMOs when they screw up. The classic excuse Iíve heard for not supporting this bill, why this wonít work, is that it will "drive up the cost of insurance to the consumer." The spokeswoman for an HMO sat there, looking perfectly coiffed and Oh So Sincere, and actually tried to convince me that this is a Very Serious Consideration and patients should think much before they decide if this is something they really want to do.

Just before I saw this report on the news tonight, I spoke with my friend Priscilla. I believe I reported here last week that she had gone into the hospital for an operation.

It turned out that she didnít have an operation. Instead, the hospital nearly killed her.

A surgery date had been set and two days before it was scheduled, her neighbor went to the local homeless shelter to pick up meals for herself, for Priscilla and for one other person. Priscilla, who eats very little these days because the medications leave her unable to eat very much, had just a couple of bites of the food.

A few minutes later, she wasnít feeling well, stood up and lost control of her bowels. She wasnít able to make it to the bathroom on time.

She took her temperature and discovered she had a fever of 102.

She said she didnít remember ever feeling so bad and so she called for help and someone rushed her off to the Emergency Room. The diagnosis: salmonella poisoning.

As she explains it, she was lying in the emergency room with tubes attached everywhere, a raging fever, and doubled over in pain. The doctor came in and dismissed her! The nurse was incredulous. He told Priscilla that she would be fine, and just to be sure to call her own doctor when she got home.

And why did he do that? Because sheís a Medicare patient and hospitals these days donít want to admit Medicare patients.

She got home and called her doctor, who ordered her into the hospital immediately (where she spent the next 4 days). He has advised her that she may have a malpractice case against the emergency room doctor and the hospital. Her own doctor told her that had she not called him, he felt she would have died, the poisoning was so bad. She should never have been dismissed.

But this is common practice in these days of HMOs. Decisions about medical care are taken out of the hands of the physicians, who went to school to learn about medicine, and instead are placed in the hands of bureaucrats and administrators who may or may not have any medical background. I remember when I was checking for permission to do various procedures for our office, I would talk with some young thing who had no medical training whatsoever and was making decisions based on a protocol book. No knowledge of the patient, no benefit of an exam, no nothing. Just protocol.

One of our providers was very frustrated because her patient responded well to one kind of medication, but the HMO insisted she had to prescribe the generic, not the brand name. Problem was that the composition was slightly different. For most patients it wouldnít have made a difference, but for this patient, the difference made all the difference. But the brand name wasnít on the formulary, so the provider had to try to find something else that would sorta kinda work, but not as good as the brand name the patient responded to so well.

What is it with modern medicine? Donít we tell ourselves that weíre the most advanced nation in the world? Why these barbaric, insane medical rules? Why are we tying doctorsí hands and putting patients at risk? And why do the politicians then throw scare tactics at us, saying our insurance rates will skyrocket if we--heaven forbid!--are allowed to hold the HMOs accountable for their decisions.

Need surgery? Boy, donít hope for a hospital stay! I swear they do mastectomies in the fast food land and offer fries with it. You barely get to recover from the anesthesia before youíre on your way out the door and home.

Nurses used to get to know the new mothers after they delivered their babies. They got a feel for where they needed help and were around to provide that help. Now the nurses are doing paperwork and the mothers are being wheeled out the door as theyíre delivering the placenta. Patients? In a hospital? How silly. Weíll lose money if we admit you!

(One wonders if the tragedy in Texas might have been averted if Mrs. Yates had stayed in a hospital long enough for someone to recognize the symptoms of problems postpartum. Perhaps not, but the thought does cross my mind.)

I donít know how it all got so out of control and I despair of ever seeing it turn around in my lifetime. But the system ainít working now and nobody seems to want to take responsibility for bad decisions.

I just hope that they donít kill too many patients, like Priscilla, while theyíre trying to sort things out.

But if so, I guess itís all just....collateral damage.


One Year Ago:

Fiascos and other fun


Some pictures from this journal
can be found at
Club Photo


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Created 6/28/01 by Bev Sykes