There are those in the medical profession who see the entire profession as saints and accuse me of making up things when I say that there are incompetents out there who misdiagnose and mistreat patients, and point the finger at one particular institution where the problem seems endemic, with illustrations that even other people I know have suffered at their hands; it’s not just me, and it’s not just limited to CFS patients.
One woman I know was totally ignored in their ER for hours as she got steadily worse; when she became so weak that she could not walk, she was scolded for throwing up on the floor instead of walking to the ladies room, but was not moved up the priority list, nor even offered a glass of water to combat her dehydration or a container to throw up in so it wouldn’t contaminate the floor. Finally, she had someone take her to a different ER, where she was given top priority because it was so obvious that she was in serious distress and couldn’t wait much longer. If the ER is so understaffed that they cannot cope with all the non-trauma patients, then either they need to have more staff on call for the rush periods, or they need to tell non-trauma patients upfront that they would be seen much sooner at another ER instead of letting them wait for 24 hours (or more). And in what nursing school do they teach that screaming at a patient for throwing up on the floor is "compassionate care"?
http://www.cnn.com/2007/US/06/13/hospitaldeath.probe.ap/index.html demonstrates that the problem of ignoring patients in ERs is widespread.
In a hospital at the other end of the state (not the one where my friends and I had problems), "Rodriguez was bleeding from the mouth and writhing in pain for 45 minutes while she was at a hospital waiting area. Experts have said she could have survived had she been treated early enough. ... My wife is dying and the nurses don't want to help her out," Rodriguez's boyfriend, Jose Prado, is heard saying in Spanish through an interpreter on the tapes. "What's wrong with her?" a female dispatcher asked. "She's vomiting blood," Prado said. "OK, and why aren't they helping her?" the dispatcher asked. "They're watching her there and they're not doing anything. They're just watching her," Prado said. Dr. Bruce Chernof, director of the county Department of Health Services, which oversees the facility, has called Rodriguez'sdeath "inexcusable" and said it was "important to understand that this was fundamentally a failure of caring."" According to CNN, when her boyfriend called the attention of the medical staff to the fact that she was vomiting blood, they told him "No, that’s chocolate" and walked away laughing.
Even those who see the medical profession through rose-colored glasses will be hard-pressed to explain why someone vomiting blood should have been ignored in the ER until she died. That’s one of the things that we learned in our First Aid classes should get immediate medical attention from someone with more training than we were getting in our First Aid class. Did the ER personnel not learn the same thing?
According to CNN, more people die in the US every year due to medical errors than car accidents, breast cancer or AIDS.
Just coincidentally, as that story broke, Michael Moore was in the state capitol talking about his new movie "Sicko" http://www.sacbee.com/111/story/219530.html
""There is no room for the concept of profits when taking care of people when they are sick," Moore told a crowd of nearly a thousand nurses who swarmed the west steps of the Capitol. ... "What kind of sick, cruel system is this?" Moore asked his audience. The crowd responded with: "Sicko.""
And therein lies the problem. When doctors are accustomed to receiving bonuses for limiting the number of tests ordered, profit takes precedence over patients. None of the doctors ever investigated whether my insurance would allow them to order the tests I requested; they were just so used to dealing with an HMO which gave them bonuses for keeping costs down that they automatically assumed it would cost them money to do more tests. In fact, under my insurance, it would’ve earned the medical group more money to have their lab do additional tests -- all the tests I asked for to prove that I had a neurological/immunological/endocrinological problem, not some psychiatric problem (for which I didn't meet the diagnostic criteria).
Now, it may well be that some doctors are ordering unnecessary tests on some patients. But if you’re the one patient in a thousand who really needs that test so that they can differentiate between similar symptoms and give you the proper treatment for what truly ails you, that test is not "unnecessary" and should not be denied just sothe doctor gets a cost-cutting bonus. Whatever bonus he got that year, it’s not enough to compensate for me being denied a normal life.
If the subject had come up, I would have told them "I will pay for the test myself, if that’s what it takes to convince you that my problem is not psychological"; but I was never given that option, and later doctors were astounded that these tests had not been done to verify that I truly had post-viral CFS and not a purely psychological problem. They kept asking me "why wasn’t this test done earlier?" and could not come up with a valid medical reason why it had been denied when I asked for it earlier. If I reported symptoms X and Y, it should have been done, period.
It’s a "sick, cruel system" that makes people sicker, even permanently disabled or dead, in order to maximize profits and bonuses.
The patient’s health must come first. Before profits. Before bonuses. Even before doctors’ egos. What’s sick is not the patients, it’s the system. And the system needs to be fixed, with bonuses for getting patients healthy and keeping them healthy, not for denying treatment.
1 comment:
http://www.sacbee.com/101/story/286510.html
15 years after I complained about excessive wait times in the ER (I had been told to plan on at least a 12-24 hour wait) and nearly 10 years after Lisa nearly died of dehydration while waiting an eternity to be seen for food poisoning, that ER has FINALLY figured out that people get worse if they're left without treatment: the ER "has established a "24-7 fast track" area for minor illness and injuries. Thirteen nurses were added to the emergency department staff" -- which is precisely what I suggested 15 years ago!
That hospital's medical group's standard response to any attempt to contact your doctor is that you can either wait 6-10 weeks for an appointment, or you can go to the ER, but the ER sometimes had people waiting as much as 48 hours. And as Lisa's experience showed, getting significantly worse while waiting didn't get you further up the triage list than your initial assessment.
Nurses who do nothing but deal with the small stuff avoids the problem of people who show up needing just a quick treatment but require hospitalization by the time they are finally seen days later. It avoids people with lowered immunity getting a smorgasbord of germs while waiting 24 hours to be seen.
Thankfully, I've always had options, including calling nurses at home to ask "is this serious enough to spend the whole weekend hanging around the ER"? But a lot of people don't have that option, and have gotten worse while waiting to be seen. In the big picture of the budget of the whole medical center, those 13 nurses are a drop in the bucket. But how many patients will suffer less because of that small extra expense?
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