As a veteran of many procedures at different healthcare places, I can clarify some of this:
Yes, the idea that you can’t just take a taxi or Uber is that they don’t want to get sued should your groggy self fall inside your home.
In the one hospital where the driver had to stay during the procedure, he was given a device that would alert them if he left the building and alert him when I was ready to go. And yes, they said they’d immediately halt the procedure (It was an ultrasound that involved putting a device down my throat.) immediately if he left.
I don’t have family living close to me, and COVID means none of them could get to me. My friends are all high risk. Even without COVID, it’s been a real issue when I was in remote cities getting surgery. I’ve had to rely on the kindness of strangers so many times, I should call myself Blanche. (“Hey, do you know anyone in Salt Lake City who could give me a ride to my hotel from the hospital?”)
There’s no good solution, and it SUCKS. You can try the hospital social worker and see if she has resources to suggest. Otherwise, you have to burden friends.
They said it repeatedly and firmly, and the driver/friend and I had to sign a paper acknowledging it. It may have been a bluff, but if so, they sure had us convinced.
Weird. I mean, it might sound like a good way to make people take it seriously, but I don’t get how it could be justified from the medical standpoint. Are the risks mitigated in any way by doing half a procedure, cancelling it, with maybe no follow-up caregiver (but that’s unknown), plus then having a rescheduled whole procedure later?
I’m not in any way advocating that people not follow the rules. It just makes no sense to me that that would be a real rule.
I think maybe it’s that they don’t want to get sued for letting your groggy self get into a car with a stranger. Because only once was I ever told (either as the driver or the patient) that the patient couldn’t be left alone for a few hours. Every other time, they were unconcerned with whether the driver dropped off the patient and left immediately. Maybe they wanted someone to keep an eye out for the time it gets to take home* but that’s it.
I wouldn’t rely on an Uber driver to notice if the passenger stopped breathing)
Stuff gets worded this way a lot, but, you know, they probably actually don’t want to put groggy people in cars with strangers, and actually are concerned about having someone fall and hurt themselves at home. They aren’t just worried about being sued for those things. They probably actually want their patients to be safe.
In another discussion, someone was complaining about their Church having rules about kids being near the parking lot, and they said, they’re probably worried about being sued if a kid gets hit. No. They are worried about kids getting hit.
It made no sense to me, either. All I could figure was that they must have had some people who dropped off the patient pre-procedure and didn’t come back on time…or maybe at all.
That’s true to some extent. But when they have a policy that the responsible adult cannot leave the facility during a multi-hour procedure and just come back afterwards, I think that’s more along the lines of doing what’s most convenient and foolproof for them, while valuing other people’s time and convenience at zero.
I agree, but they’re not mutually exclusive. Sometimes they don’t think to worry about something until it becomes a liability issue. For instance, I had several eye surgeries over a few years at a hospital that was fine with me taking a shuttle back to my hotel. Then one day when they scheduled me for another surgery, they said I had to have someone drive me to the hotel and get me into my room, and it couldn’t be a shuttle, cab, etc. They specifically said it was for liability reasons, and I had to state on a form the name of the person picking me up and taking me to the hotel.
They were nice people, and I’m sure they really did worry, but the requirement was definitely based on liability.
This is it exactly. Same with taxis or most medical or disability or elder transportation services. Understandably, the medical provider needs to release you into the hands of someone who will take responsibility for getting you home safely, all the way including accompanying you safely to your door. Few taxi/Uber/Lyft/transport drivers are allowed to do that by their employers. It is a liability thing all the way around.
It is medically reasonable however, given tests or procedures that used any kind of sedation, even the mildest, or that leaves stitches or incisions. Leaving an ER after a possible head injury would be the same.
The tea tray would end up being served by an “out of network” provider and 3 months later you’d get a bill for $2,000 for a “horizontal planar comestible delivery device” and insurance is not going to cover that.
I’ve never had this type of procedure - What if you’re in walking distance of the hospital - as in going to the parking garage and going directly home are going to take a near equal number of steps? Do they allow that?
The more I read through this thread, I’m thinking rentafriend might be the way to go!
Anyway, this isn’t urgent for me. I hadn’t gone to a doctor in 10 years and finally went last year (and thank goodness or else the COVID period would have been scary). Clean BOH, but they told me next time I’d be recommended a colonoscopy.
That, most likely is something you’ll need a friend for the approved ride home. A suggestion: keep this in mind when you make the appt time for one that you most likely can arrange a ride home for with a friend-their work hours, etc.
I worked as a colonoscopy tech for about 15 years. At our clinic, and at the hospital I worked in, we handled it in different ways depending on the circumstances. The only absolute was that the person picking up the patient had to sign for them, accepting responsibility.
Otherwise, they could hang around, or go home and wait for our call. We would frequently release patients to a medical transport. On rare occasions patients would get prior authorization and we would release them to a taxi driver.
Part of the issue is not wanting groggy patients to be taken advantage of by unscrupulous strangers. There’s been a bit of a scare around taxi/uber/lyft drivers the last couple of years.
There is also a difference between “medical transport” and being transported by a carer. You can call a companion care agency and just hire someone for the day, or the afternoon. Some agencies only do long-term placements, but look for sites that say “Respite” as that means they do place for one-day services. What you need should fall under the description “Companion Care” which is usually the cheapest option.
These are people who have been carefully vetted and who work for insured companies and have been trained in basic first aid and such. Not a bad idea to have them come in and sit with you for an hour or so after the procedures. Many will also make your dinner while you rest.
Yes, for decades the medical industry has largely expected patients and their families to meekly obey the rules of the bureaucracy and acted as if no one had anything to do or any responsibilities outside of whatever the particular day’s medical thing.
It may be medically reasonable but for those of us with little or no family left it presents a serious problem. I can’t magic up dead relatives out of the grave to drive me to and from medical procedures. My friends can take off work to help a relative, but doing so for a friend could cost them a job.
OK… but when you can’t get a procedure because you have no relatives left and the medical facility just shrugs its shoulders and says “well, if you don’t have that you can’t get the procedure you really really need, sucks to be you” I’m not sure how I’m benefiting - I’m being denied medical care because of the strict application of such a policy and there needs to be a mechanism to work with people who don’t have living relatives or extensive social nets of friends - exactly the situation more common among the disabled, chronically ill, and elderly than the healthy. Who are also the groups least likely to have the money to hire a professional transport company.
That said - many people are NOT aware of the resources that are available to them. When my spouse was dying of cancer we were, in fact, informed of medical transport services that were considered acceptable for transporting his increasing debilitated self to and from chemotherapy and other medical appointments, at no cost to us for a certain number of times per month. As it turns out, I was able to do this but it was definitely reassuring that the option was there. I also have ties to the local Jewish Federation who help people out with these situations. As mentioned upthread there is zero requirement to be Jewish to use their services and when I inquired I found out that 3/4 of those using them are not Jewish (the percentage of non-Jews currently using the food pantry is even higher than that). (I’m sure there are some exceptions to that rule, but in general such organizations view serving the local area to be their “mission”, not just their own little community)
That’s great! What if you don’t have the money to do that? Because for a procedure like colonoscopy for sure insurance isn’t going to cover that cost as it isn’t “necessary” even when it is.
That’s true. But it may be less than you are imagining. Last time I looked into it the cost (6-ish years ago) was $16 per hour. In my case, with traffic and distance, four hours cost less than a one-way taxi.
I’ve been on both sides of this. I’m an ER doctor so I frequently sedate people for painful procedures. I don’t refuse to sedate them if they don’t have a ride. I adjust the observation time to account for individual circumstances. A child going home with parents just has be “sober” enough that they don’t need active medical monitoring before going home with parents. A teenager needs to be sober enough to walk safely. A toddler being carried to the car doesn’t need to walk, just tolerate oral intake and protect their airway. An adult without anyone else at the bedside may have to wait hours for discharge until they can safely care for themself. Same thing for intoxicated and/or head injured patients. A safe discharge for a college kid who’s going back to the dorm with his friends is a different assessment from a person who has to navigate public busses getting to their home across town.
So I was somewhat annoyed when I had oral surgery in an office <10 minutes walk from my house and they told me that I had to have a buddy to not only drive me but stay with me for 6 hours afterward They use fentanyl/versed for their sedation, a combo I’ve used many times. I told them I would walk to and from the appointment since I figured they could just wait to discharge me until I was safe to walk by myself. And I could see no medical reason I needed someone to observe me for 6 hours. That was just them being ridiculously over cautious. When I insisted that I had no one to accompany me and they wouldn’t OK letting me take a taxi home they finally had one of the office staff drive me the <1 mile back to my house.
Bottom line: some restrictions to ensure patient safety after discharge are reasonable but some places are so risk averse that their parameters are unreasonably conservative.
Some clinic staff seem surprised that some people live alone, and don’t have friends or family nearby that they can ask for a ride home (or worse yet, to have the friend or family member sit with them for six hours after). And yet millions of people live alone. So you think there would be procedures built around this. If it’s so important that we be supervised after discharge from something like a colonoscopy, make it an inpatient procedure with an overnight stay authorized by the insurance companies.