Shouldn’t patients be more important than the fact that a place closes at 4:00 p.m.? I wore a heart monitor for 24 hours, dropped it off at 3:10. Well, they close at 4:00 so they weren’t going to do anything with it until Monday. Meanwhile, I have been uncomfortable for a week now and trying to get someone to help me all week. The first heart monitor was put on me on Monday, but they couldn’t get it to work with the computer (alternate question: shouldn’t a doctor’s office have a computer with something more recent than Windows 98???), so they sent me to another office that couldn’t take me until THURSDAY to give me the heart monitor. So I have to go the weekend with the weird heartbeat thing. (Skips about two beats a minute.)
When my m-i-l was in rehab after having a brain aneurysm, and was still semi-conscious, they would not take out her feeding tube because she had to be tested to see if she could swallow. Well, she wasn’t drooling. That was good enough for me. But it was Friday. They couldn’t possibly test her for swallowing until Monday. Meanwhile, they forgot to tie her arms down so she pulled it out in the middle of the night.
People having the weekend off was more important than my m-i-l’s well-being and comfort. I know, it would have cost more to have the expert come in on Saturday to do the test. So what? What’s another few hundred or a thousand when she was in ICU for two weeks? Who the hell cares? I never found out what the total bill was, but I’m sure it was over $100,000.
I’m really sorry to hear that you are experiencing this frustration. 
If you’re very worried about spending the whole weekend waiting for answers, maybe a trip to the ER would provide some peace of mind? Good luck to you.
Well, that’s been a debate in medical circles for a long time: 24/7 availability of non-emergency service. Or at least make it available 12 hours a day, 7 days a week. Some say it would cost a tremendous amount, more than a 50% increase in our current health-care costs. Others say that the savings in health prevention and avoiding time off work for the patients would make it a money saver in the long run.
Either way, our society lacks adequate trained staff to do this at the present time. Nursing assistants, nurses, physician assistants, respiratory therapists, pharmacists, etc etc etc would all be needed to cover the evenings and weekends. And right now, there’s a shortable of most of the above-mentioned professionals just to do the current job. Emergency rooms are under-staffed in many areas of the country, and many populations are being deprived of life-saving interventions because of lack of trained personnel.
So it’s a good idea, and it sure would be nice. But I don’t see how it’s going to happen.
QtM, MD
It would be wonderful if all doctors’ offices were staffed as they should be, if we could take care of our patients the way we want to, (and, trust me, we DO want to) and if we could afford the latest technology, including Windows XP or the equivalent. Unfortunately, the costs have to get cut somewhere, and most doctors prefer to pay their employees a living wage and benefits, and let the technology slide a bit.
Lilith, I’m sure your MIL’s hospital charges came to well over $100,000. I’m also certain the payment came to about 1/4 of that. If that. See, the medical/health care profession is the only one I know of that contracts with companies to LOWER their prices…significantly…in order to make sure their patients don’t get stuck with the bill. Think I’m exaggerating? Okay. Take a look at your benefits. Have they taken a significant rise in premiums? While the benefits aren’t as comprehensive? Here’s what happens:
Your company pays those benefits. Not your insurance company. Your company decides which benefits you get, and pays the insurance company to administer them. Basically, the insurance racket is a win/win situation. For them. Not so much for you or the doctor who accepts assignment on your insurance.
I could go on and on…in fact I am. Sorry. But, after working for an insurance company for a year and seeing the way they treat their “members,” I’m convinced they are a tool of Satan. 
They get their cut no matter what happens. And then still manage to say that it’s the doctors that are greedy bastards. :rolleyes: I know doctors who drive 5 year old Toyotas because they cant afford a newer car. Yes there are doctors who are doing well. But…well…most primary care doctors aren’t.
They also can’t afford to pay overtime. I work for a dialysis unit. We accept most insurances, and the doctor is a really sweet man who believes that his patients are going through enough hell, and don’t need to be pestered for money on top of all the other problems. Which means I work for a comparatively low wage, but I love the company, the people I work with, and what I do.
Don’t even get me started on administrators who think cost cutting is more important than making sure there are enough nurses and CNA’s on staff for a ward of 40 patients.
sigh…I’m sorry. I didn’t mean for this to turn into a rant. But, really…there are a lot of reasons what’s happening is happening. Not caring isn’t one of those reasons.
I know the way things are set up just isn’t right. I had a procedure done a few years ago and the charge was more than the insurance company would pay, so they just had to reduce the charge. I didn’t have to pay for it. I know that really isn’t right.
I just feel very frustrated that because my problem is not an emergency there is no urgency to figure it out and help me. I keep wavering about going in so they give me medication or shock my heart back into normal rhythm. I think it would be okay to do it, but no one has told me to do it.
I have a friend who is a nurse who works for an insurance company. They got a nice bonus at Christmas. She knew it was because they denied care to people and she felt bad about it, but she accepted the bonus. On the other hand, she needs to have breast reduction surgery that is not for cosmetic reasons, and the insurance company will not pay for it, so she can’t afford to have it done. So she suffers from the same thing the rest of us do.
Back in the olden days I had to have my wisdom teeth out. This was in 1978, I think. Can you imagine…I went to the hospital and SPENT THE NIGHT before the surgery. I think I even spent the night afterwards, too. I can’t remember. But this is one of the reasons things got so messed up in the first place. Doctors could do whatever they wanted and people were in the hospital when it was not necessary.
Now we have people being sent home way too early sometimes. NOT RIGHT!
Um. No. What you are describing is the common line used by insurance companies to deny services. “Fraud and Abuse” is the favorite tag line. “Doctors hike up their claims by over charging for whatever procedures they want and thus scam the system.” BS. Insurance companies are not your benificent uncle, looking out for your well being from the big bad doctors. They’re looking out for their stockholders and their bottom line. Period.
Hysterectomies are major surgery. There was a time it was a required 3 day stay for recovery. There are several legitimate medical reasons for that. Not just “gee, here’s a way for us to get money.” Sepsis. Reaction to anesthesia. Actual recovery for the patient. Now, it’s a same day procedure. Why? Because that’s what insurance companies will allow. Pacemaker? Overnight stay. Can’t have those doctors bilking the insurance companies by saying a healthy person needs to be monitored to make sure their pacemaker doesn’t fail, now can we?
Your friend needs a reduction and it’s medically necessary? Excuse me, but medical necessity is the main reason cosmetic surgeries are denied. If she can get a second opinion proving it’s medically necessary, then it will be approved. If she works for an insurance company, she should know that.
You have a medical problem? Get involved in your treatment. Ask your doctor what the exact problem is, and what testing is available to find out more. Find out what options are open to you. Find out what your benefits are. Most people don’t even know what their coverage includes, and what it doesn’t cover. Call your benefits department. Fight to get what you need. Because that’s what it takes now.
There have been so many complaints from doctors saying they are going to have to go out of business because of the insurance companies.
Isn’t the bottom line that interest rates are down, therefore insurance companies are making less on their investments? But they blame the doctors and high costs.
I have had two nurses (friend and aunt) tell me to wait until Monday and see if the doctor calls by 1:00. If not by then, call him. Unless the skipping a beat happens 10 times a minute. It is happening 1-2 times a minute. No pain or anything like that.
There was a protest in Chicago not long ago by doctors. One OB-GYN said she was leaving the business because she just had a malpractice insurance premium hike, and couldn’t pay $130,000/yr for the premium when she made $160,000/yr. Something does have to be done. I don’t think it’s entirely the fault of the insurance companies, or frivolous lawsuits, or whatever, but something has to be worked out.
I work in a medical center, and I also get my health care there. So I do understand the frustrations of parents and yet see the other side of the coin at work 5 days a week.
From the original post:
I hate to be a bitch, but yes, people having the weekend off WAS more important. People have limits. It’s okay to have limits. You have to remember that every weekend–and every night, and every early morning–there is someone’s well-being and comfort on the line–there is simply more need for care than there is care to go around, people are allowed to set limits to how much of themselves they are willing to give and still be good people: if nothing else, it’s awful hard to be the spouse or child of someone who is gone every single morning and night and weekend because every single morning and night and weekend some stranger’s health and well being is more important than the healthprovider’s relationships with his/her spouse and children.
I’m sensitive to this because while I don’t work in the medical profession, I am a teacher, and it’s a similar situation–you have to either make peace with the fact that you have to put limits on how much of your time you give, or you have to get out entirely. To do otherwise is to invite burnout and depression. What makes it harder is when you finally say “no” after a 60, 70, 80 hour week and someone makes a snide comment about how getting home early is apparently more important than someone’s health (or a child’s future, in my own profession). It brings back all the feelings of guilt and shame you’ve worked hard to talk yourself out of feeling, and makes you angry,
Unfortunately I don’t think it’s a case of primary care workers not caring, but in the end result, yeah, the patient loses out.
It’s probably futile, or at least headache inducing, to figure out where the mess started because there’s plenty of blame to go around: greedy doctors/lawyers, greedier insurance companies, a hellish bureaurcacy, unrealistic patient expectations re wonder treatments and drugs, etc. But one way or the other, the current system is a hellishly expensive, unresponsive mess.
Everybody has anecdotal impressions but here goes:
- When my mother died, after a scant week of hospitalization and with excellent insurance, the bills were still so exorbitant the only asset left was the house she worked all her life for.
- The nurses were wonderful but run ragged. After the second day my sister and I were working with them as unofficial front-line spotters for mom. God the poor people who didn’t have family right there becaue there weren’t enough nurses to go around.
- My own stellar, exhausted, hard-working doctor is struggling to 1. stay in business and 2. keep his own costs to patients reasonable enough so they don’t avoid seeking care they need.
- My city is losing more employees–and direct services–due mainly to the death spiral in health insurance costs. Forget wage increases; it’s the one area where cost containment is a joke. Fewer and fewer things are covered, co-pays have doubled, employee payments increased by 25% and people are either foregoing needed procedures or paying them out of pocket (or loans) due to insurance company stalling tactics. More “reductions in force” will come next year. More people unemployed, without insurance.
IMO the state of health care in this country is a bizarre Emperor’s Clothes example of mass denial. It isn’t working, not for patients or primary care providers. The capabilities of medicine changed. Duh! Then change the damned system to make the changes work on the front line already.
Its not just important getting home early, its getting home at all. When I worked in the hospital, they tried to keep every PT at 100% productivity. That meant that they tried to keep you in patients pre-scheduled in every time slot you had 100% of the time. If you had time slots opening up because of patients out to tests, ill, or low admissions, someone would be sent home early and your patients would be redistributed to other PTs. Whoever went home would have that time deducted from their accumulated vacation time, and your boss decided who went and when. So all Therapists would be busy nearly 100% of the time. But if something unexpected happended like a bunch of admissions or sudden new evaluations, everyone already had their hands full. Sure you could stick around and help out, we were salaried, there was no overtime. Of course if something else came up after the first incident, and you were now the only Therapist around… well, you were on SALARY, and patient needs come first. After you pull a couple of days like that, you either learned to keep a real low profile at the end of the day, or get used to 10 and 11 hour days 5 days a week for a lower middle class wage. Usually, after the the current newbie caght on, there would be new newbie to get hooked, because of the enormous burnout turnover. There was always more care needed than workers to do it, and they had to keep it that way, so productivity would be high, or staff would be cut further.
Oh, and my hospital is paying “bounties” for nurses. Both the referring employee and the newly hired nurse get a significant bonus payment for any nurses hired, paid in increments - up through a year I think. I’ve read about other hospitals that do similar things, or give even better stuff. That’s because nurses are generally worked like dogs, and yet they’re among the most important staff in a hospital. One doctor I used to work for said that hospitals could run longer without administrators and doctors than they could without nurses and other “support staff.” I’d tend to agree.