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January 27, 2014 at 12:39 PMComments: 0 Faves: 0

A Hospital Is...

By Jeffrey VanWingen M.D. More Blogs by This Author

This past week, my mom spent the night in the hospital after a visit to the emergency room and the next morning she left after an unsatisfying experience. Her original problem had improved for the most part. They made sure it was not something serious and her body had done the rest, healing like it often does. As she walked out of the hospital, however, her head spun from a poor night's sleep and side effects of the medications she was given. 

I hear this story too frequently not to take notice, but then again,  I do hear the positive stories as well. I have amalgamated these stories in order to give you an honest a view of the modern hospital. In this day and age, the hospital is...

...not a place to rest.

In days of old, hospitalization were measured in weeks not the average few days of a modern hospital. Back then they were seen as places which primarily provided rest under medical supervision. Today, hospitals are 24 hour day operations where patients go to have things done - tests, operations, etc. Nurses collect statistics on vital signs and urine output around the clock. Even bowel movements are tracked and accounted for. And so much for sleeping in when the phlebotomist shows up at 5 a.m. to take your blood! The results need to be ready for the doctor later in the morning.

...a business that provides an expensive service.

While a night at the hospital is only slightly cheaper than a night at the Ritz Carlton, hospitals struggle to survive amidst increasingly stringent government regulations and care for those who cannot pay. With all this stress over keeping the ship afloat, staff are focused on cost-cutting measures and accounting for services provided. Identification bracelets are scanned for charges with every procedure and process. All this concern over reimbursement and running the business has made a noticeable impact on quality and caring. And don't forget about the countless expenditures on advertising the business just so the public will know how much the hospital exudes that quality and caring.

...a place of many protocols.

Though the medical system has experienced a glut of data, much of this data has pointed us in the right direction. In the spirit of efficiency and progress, hospitals have devised tracks and protocols ad nauseam which in turn, provide government and other insurance payers with a means of measuring the "quality" or various measures. The conclusion they come impacts the endorsement money each hospital receives and while that helps keep hospitals running more efficiently it can sometimes mean we also lose track of more "outside the box" things. Truth be told, there is an exception to every rule and patients with their healthcare issues seem to meet these exceptions quite often.  When patients present with exceptions, hospital staff responds with bewilderment as any well-trained machine would "What do the government and big insurance companies want us to do about this?" " How can we deliver the best possible care for this patient without being punished?" As a result, patients with unique needs may end up feeling ostracized.

...a place where infections run rampant.

Hospitals have become breeding grounds for infections and these are more difficult to treat than the garden variety types. The infectious agents there have usually been exposed to, and become immune to, standard antibiotics. Now, when patients are put in the hospital with illness, wounds, and other issues that weaken an immune system, the consequences of any slip-up in hygienic procedures can become deadly.

...a place to meet new people.

Gone are the days where your doctor takes care of you in the hospital. Most hospitals these days "employee hospitalists" - doctors who work solely in the hospital. These doctors are members of a team who work a shift and then turn their care over to another doctor. Due to logistics, protocols and advancing specialties of hospital care, it is now rare for outpatient doctors to provide hospital care.

...a place where mistakes happen.

Iatrogenesis (eye-at-row-gen-e-sis)  n. the inadvertent induction of disease or complication from a medical treatment or procedure.  Iatrogenesis is right up there with cancer and heart disease in - in fact, it is the 3rd most fatal disease in America with a conservative estimate of 225,000 deaths per year. In hospitals, iatrogenesis runs rampant.  Lets face it - hospitals are staffed by humans performing high stakes procedures on individuals who are all unique with different responses and susceptibilities. In this sense, even hospital doctors are prone to human fallibility and mistake.

...a place where problems are solved more quickly under one roof.

I don't want to be all negative.  Hospitals, for their faults, do provide a valuable and necessary service in healthcare. They are places where testing is present and assessable under one roof.  Various medical specialties converge under this roof to give input, confer and provide services.  In this sense, things get done more efficiently and quickly at a hospital.

...a place where lives are saved.

And to end on a good note, despite some bumps, the road most often for patients leads to better understanding, better health and often preserved life because of hospital services. 

...a place with both strengths and weaknesses.

Our American hospital system has some real problems. Despite tremendous advances in technology, the hospital has faced some serious challenges, negatively impacting the health of those it serves. If you are faced with a hospitalization, prepare for and be aware of these potential stumbling blocks. Be patient with the system, that is, for the most part, staffed with caring people who are trying to help as best they can. 

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