My health care is killing me
Uberblogger Glenn Reynolds shares some of the frustration of being a patient or relative of a patient in a hospital today:
Being in the hospital is an exhausting, draining experience even if you aren't
sick. I spent a lot of time, and a couple of nights, there, and I felt like I
had been run over by a truck. Imagine how I'd have felt if I had been, you know,
a patient with something actually wrong with me.
As he notes, and I've said before, a lot of the problem comes from health care being organized for the convenience of doctors (and to a lesser extent nurses and other staff), not patients. This manifests itself in a myriad of ways, from inpatients being woken all night, to inconvenient hours.
I had knee surgery during graduate school and it was a real eye-opener. I remember being put on a PCA (Patient Controlled Analgesic) pump, where you can inject your own morphine for pain control, subject to certain built in limits No one told me how to use it, so, being the stoic type, I tried to use as little as possible. A nurse from the pain control team came by the next morning and gave me instructions in its use. She nicely informed me that by giving yourself a little bolus when you first started feeling the pain you ended up with better pain control and less total morphine use. Nice thing to learn, one hour before the PCA was disconnected and I was sent home.
In my practice, the earliest available appointment is 8:30 and the latest 4PM, and the 4PM is only for return patients. The latest new patient slot is 8. Would you take your car to a dealer who could only fit you in for service between those hours? Of course not, you'd find someone else.
What makes it worse is that our practice, a major children's hospital, thankfully has a commitment to care for the underserved. Therefore, our allergy/immunology practice is one of the few to see kids who are on Medicaid. So the single working mom with little job flexibility has to take off time to bring her kids on our schedule. Crazy. I'd actually be happy to do an evening clinic to free up a half day during the week, but at this point the system is so ossified it is almost impossible to organize something like that.
Andy Stedman also had a recent post about his experience in the ED. He makes the following observation
Restaurants and tire stores, like emergency rooms, never really know how much
business to expect. However, it is unusual to have to wait hours for a meal or
new tires, whereas in emergency rooms it seems to be the norm to wait hours for
treatment. They’re not full, either, they’re just woefully understaffed
I'm not so sure I completely agree. I have spent a lot of time waiting in car dealerships, although they seem to have gotten much better about scheduling appointments for all but the most urgent repairs (it may also be that now that I've gone more upscale in the cars I drive and so the quality of service provided by the dealer is better). I suppose most tire centers can get you in and out quickly, but I suspect they benefit some from people who either schedule appointments or leave their car for the whole day.
Restaraunts are about the same. While you can always get served at McDonalds if you are willing to wait a few minutes, I don't think you'll have much luck walking in to, say, Charlie Trotter's or The French Laundry on a Saturday at 7, no matter how long you are prepared to wait.
But I do agree that healthcare is not organized for patient convenience (or even benefit). I think there will be a lot of opportunities going forward for doctors and firms that cater to patients: botique practices, expanded clinic hours, open scheduling, "consults" via cell phone camera, email, etc.
UPDATE: My colleague (and fellow ultrarunner) Geoff Kurland wrote a book about his own experience with leukemia. It is on my to read list.