I Felt Like I Was A Hostage…I Didn’t Have Any Clue How Much They Were Going To Bill

We all go to the doctor, the ER or are admitted to the hospital without asking what it will cost.

A New York Times article started with this vignette:

“Kim Little had not thought much about the tiny white spot on the side of her cheek until a physician’s assistant at her dermatologist’s office warned that it might be cancerous. He took a biopsy, returning 15 minutes later to confirm the diagnosis and schedule her for an outpatient procedure at the Arkansas Skin Cancer Center in Little Rock, 30 miles away.

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Hospitalized Patients Cannot Assume Their Regular Doctors Will Check On Them Daily

In the recent past a hospitalized patient expected to see one’s primary care practitioner making rounds, examining patients and writing “orders.”

An article in Newsday addressed the question: “Do you know if your primary care physician will manage your care if you are admitted to the hospital?”

“Reflecting today’s changing medical practices, some primary care doctors don’t set foot inside their patients’ hospital rooms at all — leaving their care to physicians called hospitalists.

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Courteous Bedside Manners Are Associated With Improved Patient Recovery And Satisfaction

An article in Becker’s Hospital Review reported that hospital interns generally failed to use “five key communications strategies, including introducing themselves, explaining their role in the patient’s care, touching the patient, asking open-ended questions such as ‘How are you feeling today?’ and sitting down with the patient. The five actions are components of what is termed ‘etiquette-based medicine,’ as described in a 2008 New England Journal of Medicine article by Michael W. Kahn, MD.”

“With internal medicine in particular, especially these days, it’s about chronic medical problems and chronic care, where much of what we need to do is motivate the patient to provide self-care and self-management to improve their health over the long term … You can’t do that if you’re not connecting with the patient very well.”

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Cancer Patients May Learn That Some Of The Best Cancer Hospitals Are Off-limits

The New York Post reported “An Associated Press survey found examples coast to coast. Seattle Cancer Care Alliance is excluded by five out of eight insurers in Washington state’s insurance exchange. MD Anderson Cancer Center says it’s in less than half of the plans in the Houston area. Memorial Sloan-Kettering is included by two of nine insurers in New York City and has out-of-network agreements with two more”

“Doctors and administrators say they’re concerned. So are some state insurance regulators. In all, only four of 19 nationally recognized comprehensive cancer centers that responded to AP’s survey said patients have access through all the insurance companies in their state exchange”.

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“Would You Rather Your Doctor Won The ‘quality’ Contest By Doing Good List Management … Or Spent That Time Listening To You?”

An article in the Wall Street Journal noted “Quality” has been the buzzword in health care for a decade, but the worthy goal is driving health-care providers to distraction. All stakeholders—insurers, patients, hospital administrators and government watchdogs—are demanding metrics to ensure that money is spent wisely.

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Tell Your Doctor About Your Travel History

A recent Modern Health Care article noted “The key is getting that travel history right up front when you’re interviewing the patient and then as soon as you suspect MERS—even before you do the testing—you should make sure you have that patient on isolation precautions so they don’t spread to any other patients or healthcare workers.”

The major lesson from this first MERs experience in the U.S. for other healthcare providers is “to think about MERS you really need to get a good travel history…”

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Often “primary Care Doctors’ Appointments To Be Scheduled At 15-minute Intervals.”

“Some physicians who work for hospitals say they’ve been asked to see patients every 11 minutes.”

A Kaiser Health News article noted “Patients – and physicians – say they feel the time crunch as never before as doctors rush through appointments as if on roller skates to see more patients and perform more procedures to make up for flat or declining reimbursements.”

“Doctors have one eye on the patient and one eye on the clock…”

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If You Go To The ER And Stay In The Hospital, Don’t Assume You Have Been Admitted

Not so! You can be in a hospital bed for several days without actually being admitted with personal financial consequences.

The New York Times article “ noted: “ But it turns out that even though you are receiving treatment in a hospital bed, you may simply be under observation, and technically are still an outpatient. That can cost you money if you are covered under Medicare, the federal health plan for older Americans.”

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Why Don’t Patients Remind Medical Professionals To Wash Their Hands?

I ask this question to every clinician examining me, doing a procedure on me, or drawing blood from me. Physicians. Dentists. Phlebotomists. Radiology techs. PTs.

And I prefer they wash their hands in front of me. Proper hand washing is the single most effective preventive medicine measure.

Bloomberg News article explained why it is important to remind clinicians to wash their hands. “Physicians shouldn’t take offense. We all can benefit from reminders about the basics. Years of education and expertise don’t mean that medical professionals aren’t human, and may sometimes forget a step in even routine procedures.”

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