So my normally healthy 94 year old neighbor had a pain in her side and in her back for several days. The pain was severe, so she decided to drive herself to the urgent care center. She's actually still OK driving but probably should have had someone go with her. She's fiercely independent and doesn't want to ask anyone for help with these kinds of things. Plus she has an iron constitution, so she rarely has health problems.

At urgent care, she tells them about the pain and that she hasn't had a bowel movement for some time, something that's unusual for her. They tell her she has afib and they send her to the emergency room at the hospital. She's still in pain so they give her morphine. CT scan of abdomen shows nothing. She's admitted to the hospital overnight because of the afib.

She has an EKG and echocardiogram, and the two cardiologists that get called in determine from those tests that the afib diagnosis is a false alarm.

Meanwhile, she's still in pain and getting morphine. The GI guy gives her a couple of different drugs to get her to pass her stools. Nada.

Finally, he prescribes the really strong stuff: Two glasses of prune juice.

Success!

24 hours after leaving home, she's back and feeling fine.

These have to be the most expensive two glasses of prune juice known to man. Not to mention that morphine is constipating and contributed to the original and actual problem....

I can't tell you the number of times my wife has seen patients in pain come in thinking the worst, only to have her get an X-ray and tell them ... they're plugged up.

Have a heard of that.
The husband of my former sister-in-law did
not know what was wrong.
He will never live that down.

I spent a week and a half in the hospital in November-December with a nasty skin infection. My experience as very much in that same vein.

Hugely expensive, butt-covering incompetence on the part of the physicians to the point of me telling them what they needed to do and bringing in my PCP (who is very influential in this health system) once they had screwed it up and fluid overloaded me.

I will tell you this - it is more imperative than ever that you be an informed consumer and your own advocate. The hospitalist system may save them money but it does not work in your favor.

quote:

Originally posted by Mikhailoh:

I will tell you this - it is more imperative than ever that you be an informed consumer and your own advocate. The hospitalist system may save them money but it does not work in your favor.

What is the hospitalist system? Is it something new?

Interesting. It certainly sounds like a good idea, particularly for someone like me who doesn’t really have a primary care doc. In practice maybe not so much.

Thanks.

In practice you don't see the same doc twice from day to day. Orders change without explanation or your knowledge.

Add to that these docs have a very full schedule. They do not have time to fully read your chart and they skim. In my case they could not see the visual changes that were happening day to day, which meant they were essentially unable to determine whether or not the treatment (IV antibiotics) were making any difference at all.

It is not good medicine.

I first encountered the hospitalist system about four years ago when my Mom was in the hospital. At this hospital, the hospitalists are on call for seven days/off for seven days and once they start seeing a patient they continue to do so until the patient is discharged, or until their weekly shift is over, when they turn the patient over to the next doctor.

The hospitalist who took care of my Mom during that time was fairly competent and had a full picture of her health because I filled him in, but I completely disagreed with his approach and told him so. I made the key decisions. He told me my Mom would be dead in two or three days if she didn't have a resection of her perforated colon. I opted for medical rather than surgical treatment because of what the surgeon outlined as risks, benefits, and likely outcomes. The surgeon was a healer in every sense of the word.

She went on antibiotics and her white count came down dramatically within 24 hours.

When I told her PCP the whole story of what happened, he was horrified.

The system needs work.

Sorry to hear about your hospital stay, Mik.

Are you feeling better?

Re the fluid overload, that seems to be a preventable problem that keeps cropping up. You're not the first person I've heard of who has gone through that.

Yeah, I am much better now, thanks, although full healing is going to take some time. What I am now insisting they rule out is bone infection.

There is a lot more to the bad part of the experience with the hospitalists, but that’s too much writing for me right now. I will save that for my letter to the system’s CMO.

The MRI is closed on New Years Day? WTF?

Milking us for another day it seems to me


And yeah, we haven't seen the same doctor twice since being in the ER, yesterday.

Our health care system sucks. It makes me hate this country.

Is there any benefit to her continuing to be in the hospital? That is, if the CT scan didn't show anything that requires her to be in the hospital for close monitoring and they're just keeping her because it's convenient, might she be better off at home?

Maybe she could get the MRI tomorrow on an outpatient basis? Might be cheaper, too, if you have it done at a facility rather than the hospital.

How is she feeling?

Wow, I'm so sorry to hear of your situations, Mik and Mark. Hoping for a quick and simple resolution to both.

I'm surprised (OK, shocked) that the MRI is closed at a hospital, especially on New Year's Day. I'm guessing that New Year's Eve is one of the busier times of the year for problems that might require imaging (drunks, car accidents, falls, fights, etc.), and to have an MRI unavailable on NYD is just crazy.

I guess I've been an inadvertent hospitalist consumer for years now. My primary medical care (other than urgent care for things like sore throats) has been in teaching hospitals. All my doctors now, including my family physician, are associated with our local teaching hospital. I really like the system--no shopping for specialists, no waiting for referrals, and (one presumes) no closed MRIs! I've seen a fair amount of turnover, but it's on the order of a doctor staying for 3-4 years, not 3-4 days. In other words, I have "my" doctors until they leave the institution.

I totally agree that our healthcare system needs a major overhaul.

Reminded me of what happened to my neighbor last week.

quote:

My pager emits the same urgent beep no matter the occasion. That afternoon, it was the local preoperative clinic to say my 80-something patient, Lily, had been given an electrocardiogram (EKG) “just to be safe” before a minor office procedure.

The EKG was a little off, the page went on. Could I take a look? Lily (I’m identifying her by only her first name at her request) felt fine. No chest pain. No trouble breathing. But now that the irregularity was out there, the procedure would be delayed until we had answers.

Flash forward one borderline blood test result, several phone calls between myself, Lily, and the anesthesiologist, 14 emails, an office visit, and a completely normal stress test. Lily (and her heart) were in no better health, yet she was slightly less well off and more than slightly distressed by all the trouble she went through. I was disappointed that I’d failed her.

And this was a relatively good outcome.

https://getfitwinnipeg.com/hea...more-harm-than-good/