alt Hacker NewsHad a family member recently go through unexpected major surgery.
One thing I would mention:
You are not dealing with a monolithic entity with regards to a hospital.
There are really multiple groups with oftentimes competing interests e.g.
- case manager wants you out and home b/c that is the best "score" for the hospital. They also DO NOT want you to qualify for Medicare if you are a senior b/c, again, "score" gets dinged if Medicare gets involved
- surgeons want you out as they don't want you to pick up hospital infection. They want you to go to a rehab facility as that will more likely lead to a good outcome
- the hospitalist wants you to be stable in the short term so will pump you with whatever medications are necessary to get you "back to normal" without addressing any root cause
- the nurses generally care about you as a person as they deal with you the most but oftentimes have the least amount of say over your case
- in one of those perverse incentives/unintended consequences: if you do TOO well on a physical ability test, that might disqualify you from certain coverage even if you are below the threshold on other ability tests. That can have gigantic insurance implications.
This is prompting me to write my own version of the OP blog post.
Replies
I don't buy those medicare statements. What's the evidence for that?
Link to yours?
> - the hospitalist wants you to be stable in the short term so will pump you with whatever medications are necessary to get you "back to normal" without addressing any root cause
This really rings true with me after my experience having pancreatitis earlier this year. I ended up hospitalized THREE times in the span of a month. The initial hospitalization was for the pancreatitis (which became necrotizing pancreatitis, this is important). Then I was discharged after the pancreatitis pain subsided - I think at that point they had noticed that a psuedocyst had formed next to my pancreas but they didn't see it as an issue and wanted me to get it looked at outpatient.
A week later, back in the hospital, jaundiced face and eyes because it turns out the psuedocyst that 'wasn't a big issue' was compressing my bile duct, which were causing multiple issues. They did some tests, my liver enzyme tests went back to normal (briefly), they discharged me again.
Another week later and my liver enzyme tests had skyrocketed again, and I was instructed to go back to the ER again. This time we didn't take 'oh you'll be fine, deal with it outpatient' as an answer and insisted that they look deeper into it after the 2 previous hospitalizations, and they ended up being able to 'scoop out' the stuff in the psuedocyst and finally have it go away and stop causing issues