medicine

TRX
January 14, 2013
2:
Money isn't always the deciding factor. A few years back several large US hospitals admitted to refusing to perform major surgery on patients who had a high probability of dying because of it... even though they were terminal already. Why? Because if the patients died, it would adversely affect the numbers used by various hospital rating systems, primarily those used for determining malpractice rate.

An acquaintance of mine ran into that. He had some serious heart problems, but other problems made his chance of surviving surgery low. After five expensive trips through testing, evaluation, and rejection, he killed himself. Perhaps not the most logical solution, but despair can make you do that sort of thing.

TRX
January 14, 2013
24:
Last year, the newest of the local hospitals went "paperless." A couple of months ago my Dad spent two weeks there as a patient. The only people who weren't shackled to a PC were the janitorial and foodservice staff.

Each time someone came into the room, they were pushing a modified IV stand with a laptop screwed to it. They swept the barcode reader over the band on Dad's wrist, scanned every pill, blanket, or paper cup, then scanned his wristband again when the left. His doctor came in a couple of times; I think he glanced up at Dad once, otherwise, he was working the computer.

Back in the mid'90s I wrote a pharmaceutical tracking package. Ironically, for the corporate overlords who own the hospital Dad was at. As such things tend to do, it expanded into a general patient information system, and as such, crossed the lines of multiple departments. This was before HIPAA; not all departments were computerized, and those that were, were on totally different systems. They didn't even all speak ASCII...

Anyway, at one of the higher-level meetings, I made the point that they were wanting to make the physicians into data-entry operators. Considering what the hospital was paying them, was this a good use of their time? The physician time was billed by the minute, and few of them were computer-literate.

A few quick checks showed that it would save money to hire someone to accompany the physician to handle the computer... which would cost nothing extra, since most of the physicians already had a nurse or secretary following them around already, taking dictation and carrying folders.

It was interesting to see all that went away. If anything, there were more staff around than the last time I was at a hospital, but other than pushing a mop or dinner trolley, all of them were playing "keyboard monkey."

TRX
January 15, 2013
65:
> weeks

Same here, for a long time. At least I have an old-time GP (nearing retirement now) who is a real, albeit somewhat outdated, doctor who runs his own practice, not affiliated with anyone. Most people have to settle for "Primary Care Physicians", where you wait a week or more to get a referral to a "specialist", which takes another week or more, who might send you to yet another specialist, at which time you're either recovered or dead without any professional help.

Hospitals and insurance companies screech about "people who use the emergency room as their doctor", but in some places in the USA, that's the only way to get any help in a timely fashion. It's not like you can just go to any doctor you want; most of them want credit checks and referrals from your previous doctor...