Yes, people often don’t realize that there are different levels of care available - including the equivalent of an adult babysitter who provides general supervision , possibly prepares a meal and will remind someone to take their medication , but not administer it. This level of care is much less expensive than someone who is able to assist with toileting and bathing and who can administer medications.
Making it an inpatient procedure with an overnight stay won’t happen- but I had a procedure done in the hospital which required monitoring afterward. They still may not have allowed me to take a taxi home- but I was discharged 10 or 12 hours after the procedure was done. It wasn’t overnight. I’m not sure why this can’t be done more often in a hospital - I understand why it can’t be done for procedures being done in a doctor’s office.
Or just have insurance cover the $16/hr companion care person for anyone who needs it. It seems advantageous for insurance to do so, so that the insured can get the test, which the insurance company should want, for the same reason that preventive care is often covered completely.
And the provider should just have a packet of info for folks who say they don’t have anyone. Like, “Some people ask a friend, neighbor, or coworker, or, here’s a list of places where you can arrange for someone to help you. It usually costs about $X.”
For a while I had a friend staying with me who was able to provide the needed transport when I had to go in for an endoscopy. However, this meant that she had to take the day off work, and due to her own health issues this started putting her job at risk. So I looked into other options, and ended up having to spend $60+ to hire someone to drive me to the hospital, stay there, and then drive me home. This required having to re-schedule the endoscopy for a date and time when the driver was available.
This year, I’ve had to go in for two endoscopies (and have a third one scheduled for next month). Fortunately, my friend retired late last year, so she’s now available to drive me without risking her job. There is a new twist: Because of Covid-19, she can’t wait at the hospital while I’m there. Instead, she drops me off and I give her phone number to the staff. When I’m ready to be picked up, they call her. Since I only live about a fifteen minute drive from the hospital, she goes home to wait for the call instead of having to wait at the hospital parking lot and then pay the parking fees.
Funny how rules that were non-negotiable, “necessary for your safety” written-in-stone absolutes actually turn out to be not necessary at all when push comes to shove.
For those who think there are always services available if one simply looks: The first time I was told I had to have someone take me back to my hotel and settled back into my room, I was at my wits’ end. I knew nobody in that city. I told the hospital this. They were sympathetic, but the policy was firm. Here’s what I tried:
Hospital social worker: No list of resources. Suggested I “call around.”
Home Health Aides. My insurance wouldn’t cover them. I couldn’t afford one OOP.
The Lions Club. They’re a great group, but nobody answered the phone.
Churches: I tried a couple of churches, but while sympathetic, they couldn’t help. There are liability issues for churches and charities. (And remember, they didn’t know me from Adam…or Eve.)
The Lupus Foundation (another good group): I have lupus. The LF didn’t provide that service, but a kind employee volunteered to drive me on her own time. Had she not been there, I’d have been SOL.
The fact is, services to help patients having same-day procedures simply aren’t available in many–maybe most–areas. I completely understand the reasoning behind the policies, but often there simply aren’t alternatives.
Except that insurance companies are NOT your friend and it would cost them money.
An enormous amount of care and work is dumped on relatives in the US for those two reasons.
What cheeses me off is when the doctors office makes an appointment for me with a secondary provider [MRI/orthopod/whatever] instead of telling that office to call me to vet scheduling.
Look, I am juggling several medical conditions, each with their own medical office and scheduling. I just had an MRI scheduled for the exact time I was to be visiting my orthopod, the appointment for whom I had for about 4 months. I am not willing to get bumped out of a difficult to get appointment for one that if the office had called me to set an appointment for, I wouldn’t have had any conflict.
The sucktastic thing is they are both in the same provider network, and should have been able to see my schedule - my oncologist can see all the in network appointments when I am standing there setting my next appointment … lazy.
Note the bolded part. Of course they aren’t your friend. But they do know that routine screening tests catch things early, and they know it is to their advantage to cover such tests and other screening and preventive care, which is why there are often incentives or advantageous treatment of such procedures
Having had 7 of them… this is not an unreasonable concern. I’ve had sessions where I had to run to the restroom repeatedly while in the waiting room.
In all seriousness, one might purchase a package of Depends or similar for this purpose. I’ve considered it myself.
As far as transportation: yeah, there are medical transport companies. My provider says “must have someone with you, you cannot take a taxi” but also says “here’s the name of a company if you need it”.
Part of the “have someone with you” concern is that if you get home, then start to hemorrhage or something, the friend will be looking out for you and can call for help. I doubt a medical transport company would do that, so I don’t 100% follow how the clinic reconciles that.
They’ve never actually spoken to my “+1” before a procedure, though they do always ask “do you have someone with you?”. This last time around, my original ride fell through and I had to wake up my son - and I sent him to buy himself some breakfast when he dropped me off. They asked if I had someone with me, I said “My son is out getting breakfast and he’ll be back before we’re done”. They didn’t check - and when I walked out at the end they didn’t verify that someone was there - I could have lied and gotten away with it.
To clarify the “no taxi / Uber” rule: that means you cannot leave and take such a ride solo. Part of this is that the driver has no medical training and couldn’t handle it if you got sick, part of it is that if you’re still reeling from the sedation, the driver could get up to some mischief. When a friend of mine had a procedure a couple years back, I was her +1 - but I’d had surgery and was not able to drive. We took Uber to and from the hospital and the staff had no objections at all.
BTW - I’m DC metro as well. I have stated in the past that I will be the “plus one” for anyone in the area who needs a colonoscopy. PM me if this crops up any time soon.
Not allowing people to go home with just taxi drivers is fine, IMO, not just due to liability issues, but because it’s not fair on the taxi driver. They’re just a driver, not a medical worker, and they’re not even your friend. In a lot of areas they might not even speak English well enough to understand if you tried to tell them that you were experiencing post-operative problems. It’s unfair to expect them to take on the responsibility for someone post-surgery for the cost of a taxi fare. (If they happen to be a taxi driver, and they’re also your friend, that’s different).
In my area there are whats app groups that help support people or put them in contact with groups that can support them. If I couldn’t find someone to travel with me or collect me, and so far that’s not been a problem, then there would be an organisation that would happily do it.
Of course in rural areas that might be more difficult, but there might be more support out there than you expect. There are tons of people out there desperate to do good deeds.
Amarinth - it might be different where you live, but you don’t walk to the parking garage alone. You’re picked up by your friend or a taxi at one of the specific exits to the hospital that have places to pick up patients, where you can be observed leaving the premises safely. In any case I doubt many people actually live closer to the hospital than to the hospital’s own parking garage because they’re usually all on the same lot.
How does a medical facility have that kind of power? They won’t let you take a taxi? What are they going to do if you tell them to fuck off?
These kinds of rules are very onerous and are probably preventing a lot of people from seeking treatment who need it.
I’ve seen it go wrong so I understand how facilities can be so strict.
A friend was having knee surgery in the morning. I decided to stop by the hospital early afternoon to see how his recovery was going. I found him out in the parking lot, knee well wrapped up but not even crutches to help him get around. In his still drug influenced state he told them he was leaving against medical advice and decided he would driver himself home!
I wrangled him into my truck and called his brother to arrange to pick up my friend’s vehicle. We made a stop at a pharmacy to at least get a pair of crutches and took him home. I took him inside and left him in the care of his aunt.
If he had someone actually waiting for him in the hospital perhaps they could have talked some sense into him so he wouldn’t leave.
IME the motivation for the requirement to have somebody waiting to pick you up (vice calling someone in) is simple: They need to detail an employee to watch you every second you’re on their property post-procedure. So letting you call an Uber or a friend who’ll arrive 20 minutes later means they just spent another 20 worker-minutes babysitting you.
None of which you or your insurer is paying for. Medical care is a business whether we or they like to think of it as such.
They probably do insist on it for their convenience, but it’s not because they would otherwise have to assign someone to do nothing but watch you. When I have a procedure done, there is no one detailed to watch me and do nothing else while I am getting dressed afterward. Is there someone in the general vicinity? Yes - but they aren’t just watching me so it’s not additional worker minutes. And when I have had to wait a few minutes for my ride to return , I am simply put in the waiting room - where the reception desk is. They do not stop answering phones or checking other patients in , so again, not additional worker minutes.
Yeah, I’ve been there. Where I live, there’s a Faith Based Volunteer organization that drove me to and from medical appointments and grocery shopping every 2 weeks during my recovery/rehab from having a stroke. Now that I’m driving again I only need them for outpatient procedures where I get “twilighted” or my eyes dilated.
After the 7th time I had one procedure requiring “twilighting” (the 1st procedure and then checkups every 3 months) the Dr wanted to do this in a different office. I checked with the new place and they wanted either a family member or a nurse so I arranged to go back to the first place where they were familiar with and ok with the FB folks. They still ask me if anyone will be waiting there for me and I tell them what time my pickup will be arriving.
Contact a local Community Health Care organization or maybe your Drs office has a Case Worker (social worker) who can help you find the transport you need.
You could look at care.com under “errand helpers.” They listed (for my area) a lot of people who do private transportation.
Depends of course on the procedure, any anaesthesia or similar, and on the facility. Another factor I didn’t mention: Fall risk and mobility in general.
My wife has intermittent mobility issues. Sometimes she can readily walk a couple miles and other times she needs a walker to go 10 feet. Going to a facility for a treatment in the first condition is as you say: nobody is specifically watching her at any point. Going to the same facility for the same treatment in the second condition she is met at the door and put into a pusher chair. And isn’t left alone for a minute until she’s loaded from the pusher chair back into my car afterwards. Which does tie up a worker.
Pre-COVID of course it was often a volunteer during the time just spent sitting around waiting. Volunteers may be free, but they too aren’t in infinite supply.
When I’ve had my recent endoscopies, I was just kept in the recovery area until the doctor came by to discuss the results and they were sure I wasn’t having any aftereffects from the anesthesia. Then they told me I could get dressed and they called my friend to come get me. Per hospital policy, once I was ready to go they they had someone from “transportation” take me in a wheelchair to the entrance and stay with me until my friend arrived.