Teaching Hospitals Are The Best!
We’ve all been there.. Whether it’s the ER, visiting a sick loved one, or getting a procedure done. No one looks forward to a health crisis, but these awesome tips will help you get the best medical care, cut bill costs, and get out of the hospital alive with some dough in your pocket.
If Possible, Avoid The Freestanding ER’s
Those freestanding ERs popping up all over? They typically don’t have anywhere near the resources of hospital ERs, yet they cost just as much. Go there for small bumps and bruises. For something serious (chest pain, a badly broken bone), get to a trauma center where specialists and surgeons work.
Don’t Pick The First Rehab You Come Across
If you’re being released for rehab, shop around for a place that has experience with your condition. We found that rehab facilities that handle more than two dozen hip fractures a year were more than twice as likely to successfully discharge seniors within a month as less experienced facilities were.
Sanitize Everything..Literally Everything
Superbugs live everywhere, and they can travel. Even if your doctor washed his hands, that sparkling white coat brushing against your bed can easily transfer a dangerous germ from someone else’s room. Ask for bleach and alcohol wipes to clean bed rails, remotes, doorknobs, phones, call buttons, and toilet flush levers. Wash your hands before you eat.
Talk To The Docs
Ask your nurses to do a “bedside shift change.” This is when they share information in your presence instead of at the nurses’ station. You can better correct any errors.
Don’t Distract Your Nurses Or Doctors
Ask What Is Going To Be Done
The surgeon who performed the best in our complication rate analysis said he and his partner drape their patients, do the whole operation, and close the incision themselves. He said, “I just know nobody is going to do it as carefully as I’m going to.”  Check whether your doctor will be doing your entire procedure and whether she will do your follow-up care.
Nurses Are Human.. They Get Overwhelmed Too
Hospitals often force nurses to handle more patients than they should—even though studies show if your nurse is responsible for fewer patients, they have better outcomes. California is the only state with hospital-wide minimum nurse-patient staffing ratios. Researcher Linda Aiken at the University of Pennsylvania found that each extra patient a nurse has above an established nurse-patient ratio made it 7 percent more likely that one of those patients would die.
Administrators Make A Lot Of Dough
Doctors Are Incentivized to Over Treat Their Patients
Make Sure You’re Paying For In-Network-Care
Even if you’re careful to choose a hospital and a surgeon that are in network, there’s no guarantee that everyone involved in your care at the hospital is also in network. The radiologist, anesthesiologist, pathologist, and even the assistant surgeon could be out of network, and—surprise!—you’ll be billed at a much higher rate.
If You’re Staying Overnight, Ask If You’re Being “Admitted”
Hospitals Side With Doctors
Specialists Add To Your Bill Very Fast
Less-well-trained physicians will call in an abundance of consults to help them take care of the patient. If those specialists check on you every day, your bill is being padded and padded. Ask whether those daily visits are necessary.
Ask If There Is Any Way To Recover Faster
Bring Your Own Medicine To Save Costs
It’s a lot cheaper—and usually OK—to bring your own medicines from home, but the hospital pharmacy will have to check them to verify they are what the bottle says. Just ask your doctor to write the order.
Triple Check Your Bill
Second-Guess Every Test You Have To Do
Fifteen to 30 percent of everything we do—tests, medications, and procedures—is unnecessary, our research has shown. It’s partly because of patient demand; it’s partly to prevent malpractice. When your doctor orders a test, ask why, what he expects to learn, and how your care will change if you don’t have it.
Hospitals Are Becoming More Luxurious
Hospitals worry about losing revenue to retail clinics, urgent-care centers, and private surgery centers. To attract patients, they try to appear like hotels. They have waterfalls, pianos, and big windows. Instead of hiring people with backgrounds in health care, they’re bringing in people with experience in retail and five-star hotels.
We’re Not Prepared For All Diseases
Hospitals Are Getting More Violent Every Day
There is more violence than ever before. Nurses have been attacked, bitten, spit on, and choked. It’s partly because hospitals are no longer prescribing pain meds to addicts, and addicts can get very aggressive. It’s also because our mental health system is broken, so some of those people are coming into the hospital and acting out.
We’ve Seen Everything… Seriously
We see crazy things. I had a patient naked into the ER waiting room. A patient asked me out while I was holding a basin, catching his vomit. We pull bugs out of people’s ears regularly.
Hospitals Cut Chaplains To Save Dough
Spiritual care is not a profitable area for hospitals, so it gets cut. The vast majority don’t have enough chaplains, and some U.S. hospitals today don’t have chaplains at all.
Doctors And Nurses Place Bets On Patients
Hospital staffers have placed bets on patients. Guess the Blood Alcohol is a common game, where money (or drinks) changes hands. Others try to guess the injuries of a patient arriving via ambulance. Surgeons have been observed placing bets on outcomes of risky procedures.
VIP Patients Can Affect How You’re Cared For
In many hospitals, VIP patients get special treatment. They may stay in special areas or have a VIP notation on their chart, which means that whenever their bell goes off, we are expected to make that patient’s request a priority, whether it’s “I need some water” or “Can you get me some stamps?” Hospitals don’t add more nurses; they just take away from the care everybody else gets.
Surgeons Multitask Major Operations Like It’s Nothing
Your surgeon may be doing someone else’s surgery at the same time as yours. We’re talking about complex, long, highly skilled operations that are scheduled completely concurrently, so your surgeon is not present for half of yours or more. Many of us have been concerned about this for decades. Ask about it beforehand.
We’d Rather Use A Pen And Paper..Old School
Most of us hate electronic medical records systems. We don’t like that we have to click off boxes instead of focusing on the patient. The choices they give us to click on don’t give the doctors a real understanding of what we’re doing. A lot of things get missed.
Our Priorities Have Changed Over The Years
Managed-Care Companies Take Over Our Time
The amount of time I spend on the phone talking to doctors working for the managed-care companies is, in my eyes, a complete waste of time. This morning, I spent 30 minutes explaining why I’m giving a patient a particular medicine. Those doctors don’t know who the patient is, yet I have to persuade them to allow me to do what I believe is in the best interests of the patient.
Be Detailed About All Of Your Medicine
Bring a clear, printed list of exactly what medications you take at home and when you take them. Don’t just say “daily”: We need to know if you take them at night with dinner or when you wake up.
Log Everything If Admitted Overnight
Keep a notebook. Write down your questions, log who’s coming into your room, and track conversations with different doctors. It’s easy to get confused and disoriented in the hospital. It will also be helpful once you get the bill to have a record of who saw you and when.
Bring Your Own Toiletries.. Ours Aren’t Very Great
Hospital toiletries are awful. The lotion is watery. The bars of soap are so harsh that they dry out your skin. There is no conditioner. The toilet paper is not the softest. Come with your own.
Bring A Pillow For Yourself So You DEFINITELY Have One
Want to be comfortable? Bring your own pillows. We never have enough of them.
Readmitted? Great, We Just Lost Money
Hospitals used to not care about you once you were discharged. But under new rules, they face financial penalties if you are readmitted within 30 days. So now you may get a call from a nurse case manager a day or two after you’re discharged asking if you have any questions, checking if you got your prescription filled, and making sure you have transportation to your follow-up appointment.
The Hospital Tracks All Data For Patients
Some places use big data to improve patient satisfaction. We take all the information we have on you—age, ethnicity, health conditions, ZIP code, profession—and cross-reference it to find similar patients who have already filled out satisfaction surveys. Based on what we know about those patients, we try to figure out your preferences: how often you want nurses to assess you, how much time you like the doctor to spend with you, and what you may want in your room. We’ve seen a significant boost in patient satisfaction.
Hospitals Can Monitor You From Pretty Much Anywhere
Hospitals try to lower the number of patients readmitted through remote patient monitoring. They may have you wear a monitor that tracks your vitals and alerts your team if they go out of range. They may ask you to download an app that reminds you to take your pill. If you don’t mark that you’ve taken it after a few reminders, a nurse calls.
Ask Questions If Being Transferred
If you go to a smaller hospital and it has to transfer you to a different medical center, demand that it ship you to the closest one that can handle your care. What’s happening is that community medical centers are sending patients instead to the big hospital that they’re affiliated with, even if it’s farther away. It happens even when a patient is bleeding to death or having a heart attack that needs emergency care.
Don’t Leave Your Loved Ones Alone
Don’t let loved ones spend the night alone in a hospital. It’s important someone is there if they get confused or need help getting to the bathroom or if their breathing pattern changes. If the hospital has restrictive visiting hours (many are eliminating them), ask if it will make an exception.
Just Because It’s There.. Doesn’t Mean You Should Eat It
Don’t assume the food is what you should be eating. There’s no communication between dietary and pharmacy, and that can be a problem when you’re on certain meds. I’ve had patients on drugs for hypertension or heart failure (which raises potassium levels), and the hospital is delivering (potassium-rich) bananas and orange juice. Then their potassium goes sky high, and I have to stop the meds. Ask your doctor whether there are foods you should avoid.
Request If You Can Have Your Pet Visit You
If you love animals and miss yours, inquire if the hospital has a program for service pets to come and visit.
Surgeries Earlier In The Week Are Best
On weekends and holidays, hospitals typically have lighter staffing and less experienced doctors and nurses. Some lab tests and other diagnostic services may be unavailable. If you’re having a major elective surgery, try to schedule it for early in the week so you won’t be in the hospital over the weekend.
Hydrate Before Surgery. Please.
Many hospitals say no drinking or eating after midnight the day before your surgery because it’s more convenient for them. But that means patients may show up uncomfortable, dehydrated, and starving, especially for afternoon surgery. The latest American Society of Anesthesiologists guidelines are more nuanced: no fried or fatty foods for eight hours before your surgery and no food at all for six hours. Clear liquids, including water, fruit juices without pulp, soda, Gatorade, and black coffee, may be consumed up to two hours beforehand.
Don’t Rest Too Much
Get up and move. Walk the halls, walk to the cafeteria, go outside. It will help you avoid blood clots, and patients see psychological benefits. One study found that older patients who get out of bed and walk around reduce their stay by an average of 40 hours.
Being Discharged? Take Notes
One study found that patients forget 40 percent to 80 percent of what doctors and nurses tell them, even if they’re nodding their heads. Have someone with you to take notes or tape-record what the doctor says on a smartphone. (Ask, “Do you mind if I tape-record this?”) The most critical time to record is at discharge, when you receive crucial information about medications and next steps.
Don’t Wait To Get Your Papers
Get copies of your labs, tests, and scans before you leave the hospital, along with your discharge summary and operative report if you had surgery. It can be shockingly difficult for me to get copies of those things. Even though I have a computer and the hospital has a computer, our computers don’t talk to each other.
Ask If You Can Get A Full Nights Rest
If you’re feeling good and you are stable, ask your doctor whether you can sleep undisturbed between midnight and 6 a.m. I can write a note directing the nurses not to wake you up to check your vital signs.
Schedule Follow Ups Before You Depart
Before you leave the hospital, demand that your follow-up appointment be already scheduled. I’ve found that is the single most effective strategy hospitals can use to reduce your chance of readmission, but it still rarely happens. Make sure you’ve been connected to the next person who will take care of you.
Try Your Best To Be Patient In ER
Emergency rooms used to have just curtains between the patients, so they could hear the chaos. As a result, I think they were a lot more understanding about delays. Now most hospitals have individual ER rooms that are very isolated. When patients get upset that it took me 20 minutes to come back to their room, I often wish I could tell them that I wasn’t sitting out there doing nothing. I was comforting someone who just lost a family member.
Devastating Moments Never Leave Us
My worst moment ever was on New Year’s Eve in 2008, when the code-blue pager went off. A baby we had operated on had stopped breathing. Ten of us were frantically doing everything possible, but we couldn’t resuscitate her. I had to tell her parents that their firstborn daughter had died. I was up all night grieving with them. Every New Year’s Eve, I think about them.
We Know You’re Overpaying For Treatments
One time, I ran into a patient I had performed a simple appendectomy on. He thanked me for saving his life, then told me it almost ruined him because he couldn’t pay the bill. Four hours in the hospital, and they charged him $12,000, and that didn’t even include my fee. I showed his bill to some other doctors. We took out an ad in the newspaper demanding change.