Wednesday, December 12, 2007

Hospitals and patients and ethics....

Earlier this week I spent most of the day in the outpatient department of a local hospital with a family member. There were some things that bothered me when I had been there in the past and it was reinforced with this visit.

Possibility for Identity Theft:
In this day and age when identity theft is a rampant problem for American society, the hospital does not seem to take that into account. From the time a patient shows up to the time they leave, their name, address, and date of birth are read out loud so the patient can identify himself ... information that could easily be overheard by an unscrupulous person.

Arriving at the check-in desk, the first question was, "Name please?" After orally stating his name, the patient was then asked to sign in. Why not sign in first and then the clerk can see the name instead of having to speak it out loud in front of a room full of people?

Next, in the "office," another clerk filled in insurance information including name, address, date of birth, place of work, insurance info, and more. While the room has a door and appears to be private, the back opens into a hallway, and all "offices" open that way. While working with us, our clerk called out loud around the wall to the next clerk to ask a question about something. Info is easily overheard by those in adjoining rooms and by those passing in the adjoining hallway.

Lack of Privacy:
Once the patient is prepped for surgery, he is parked in a cubicle on the surgical hallway with much activity as employees rush back and forth working with other patients. There is a curtain to partition off the cubicle but it is usually not pulled unless a family member does so. People off the street walk by going to other cubicles; patients are wheeled past; employees walk by.

Another round of personal questions happens at that point. As I sat with my family member in the cubicle waiting for him to be wheeled into surgery, the nurses worked with the man next to us (I could not see him) and I heard the responses to every question. He had no privacy.

On the other side was a young person in for knee surgery. I heard it all ... questions and answers.

There is no privacy. There is no protection from possible identity theft. At a time when people in a medical situation need more privacy than at any other time, they do not receive it. I realize hospital personnel take these things in stride; one backside is the same as the next. However, there are patients' feelings to be considered and, again, identity issues to be considered.

Even the waiting areas are not private. I was sent to a hallway with sofas and chairs and, while comfortable, people constantly passed by traveling from one part of the hospital to another. A lady in a seating area beyond me was softly crying (it was 6:00 in the morning) and I could not help but think how sad it was that she had nowhere private to be with her emotions. While the person I was with was there for non life-threatening out-patient surgery, there are times when family members receive bad news from doctors about their loved ones ... cancer, terminal illnesses ... devastating news to absorb in a public setting.

Bedside Manner:
When surgery was completed on the person I was with, I was called by a clerk to the phone to talk with the doctor. He did not even come out to speak with me personally.

In the waiting area, sitting near me, was the mom of the young man who had knee surgery. The doctor who performed the surgery came out after he finished, sat with her, and explained the surgery (again, I could overhear everything), and he took the time to answer her questions ... he had an excellent bedside manner ... and then told her to let him know if they needed anything or had any other questions, and then said, "God bless," as he turned to leave.

I made it a point to ask the identity of that young doctor ... an orthopedic surgeon that I would call on if I ever needed one. I had seen him in action and was impressed.

Charge for Filling Out Insurance Forms:
The insurance form needed the doctor's signature and information filled in. When I stopped by his office to leave the form, I was told there would be a $15 fee for filling it out. I was surprised and somewhat offended because the cost of surgery should easily have covered any additional cost for the time necessary to sign the form.

I was told they have many forms from many insurance companies, a point I could understand. However, in a pre-surgery visit to the doctor, the doctor charged $325 for a 20-minute visit (that did not include charges for surgery). The insurance form would not have taken longer than 15 minutes to fill out. If a clerk was paid $20 an hour, that would have been $5 out of the overall cost. I suppose I am offended that the doctor felt it necessary to charge an additional $15 instead of including that cost as part of the overall procedure.

This is not meant as a criticism but, rather, a questioning of procedures and whether there are better ways ... or perhaps I am being too sensitive. I have worked in a hospital in the past and tried to be careful and aware of patients' feelings and privacy. I must add that all the personnel and volunteers in this case were extremely friendly and helpful.

Have others encountered such situations? Feedback?


Mosquito said...

There are definitely better ways. All the Doctors I know (I used to work in a large, well-respected, non-profit hospital, and all the folks who have had their insurance fail them (if you've ever had a serious, EXPENSIVE illness then you are in this group) are praying for a single payee national health insurance policy in America. Nothing else makes sense...The major things wrong with the system can be traced back to insurance companies and/or corporate greed.

American health care is number one in a negative category--COST....and number 37 in quality.

Funny thing...I had a friend who recently had to visit a Canadian emergency room....the ER was crowded yet it only took them 20 minutes to get to her and she didn't have a major life threatening condition....she was twisted her ankle....Talking with my Canadian friends I found that's an average ER wait....Have you been to an American ER lately....I've heard of folks having heart attacks having to wai an hour or more before they were seen in a local ER. So much for long lines and quality of care issues.

A family friendly country would guarantee free health care and a free education (up to a Ph.D for students who have the ability....and vocational training schools for those who don't).....That would take two major stressors off parents....

If you haven't seen SICKO you should...They got their information and facts straight in that documentary....No one (not even folks with insurance) are safe in our insurance industry health care system.


Lynn R. Mitchell said...

Nice try, Mosquito, but no go. Nationalized health insurance would make matters worse in the medical field, and the issues I talk about in this post do not need government interference. They need common sense on the behalf of hospital administrators, doctors, and personnel. We do not always have to turn to Big Brother to solve our problems.

Michael Moore is about as big a propagandist as I have ever seen whether it's talking about health insurance or the war in Iraq. I pay him no heed.

Part of the issue with medical insurance is that no one asks questions. There is little oversight from the consumer, partly because of the red tape, partly because of a lack of understanding, and partly because of laziness. As long as someone is taking care of it for us, we often don't care.

I have family in Canada. Their "free" health system is in shambles so that is not a good example to use with me of a properly run system. I will take the American health system anyday of the week -- and most of them would like to, too.

Bottom line: There is no such thing as "free" health insurance. Insurance is not a right; it is a privilege. There are priorities to be decided and, in some instances, the cost of paying for insurance should override the want for a big-screen TV or other material goods. It happens.

There are numerous free clinics nationwide, and no hospital can turn anyone down anymore for treatment so almost anyone can receive health care.

We do not need socialization in this country. But thanks for bringing your points to the table ... it gives more insight into the liberal thinking of everyone deserves everything to be given to them....

Anne Taetzsch Fitzgerald said...

I have to admit that I don't find that AMC protects patients privacy very well. The staff is great(you always have 1 or 2 that aren't) but patient information is not very confidential.

There are HIPPA laws out there--but there are humans administering those.

This is a small regional hospital. Try even getting into UVA--that place is a fortress! Yet at AMC there is access to almost every section except the OR and ICU.

But they are friendly people.

And PS nationalized healthc are?? Yeah right shorter waits. In the meantime it can take 6 months to get a biopsy or schedule necessary surgery. The costs are astronomical. We can barely support Medicare/medicaid now we want to add socialized health care??

Lynn R. Mitchell said...

I totally agree, Elle. We do not want national socialized health care.

The people working at the hospital were wonderful so there were no complaints there. The volunteers, many of them retired folks, who help out and transport patients in wheelchairs to their waiting vehicles, etc., are extremely friendly.

The identity issues are something the health care industry should look into because I have noticed it in doctors' offices, too. The entire waiting room should not be able to hear contact information for a patient. In some cases I've even heard the SSN read loud enough that people waiting can overhear....

Dirk van Assendelft said...

As always, I love reading your blog, even if I never agree. Ok, sometimes I really agree, sometimes I don't agree. Just wanted to mention that your label is mis-spelled (hsopital).

I don't have any answers to the health issues in this country, but I have to remind myself that I pay over $10,000 per year in insurance costs, and I wonder where it all goes....

My solution is to stay healthy - very healthy. And keep my kids healthy.

Just a few days ago I was visiting a friend in the hospital, and as nice as AMC is, I was left with the feeling that I would not want to spend a night there......

Dirk van Assendelft said...

Sorry, I should have put this in the first comment. Recently took my daughter with a broken thumb to AMC after a bike wreck. Was treated very quickly; I was surprised. We did not have any of the privacy concerns. It may have helped that I have a background in emergency medicine.....

Lynn R. Mitchell said...

Thanks for the comments. I am interested to hear experiences from others.

This is by no means a slam on the hospital but, rather, a wondering about experiences from others.

As to my misspelled word, it has only been 48 hours since the surgery described in this post ... it has been busy here with not much time to work on posts as I usually do.