Friday, May 24, 2013

Just a Name on a Chart ... J. D. Longstreet

Just a Name on a Chart
A Bar Code on a Wrist Band
A Commentary by J. D. Longstreet

America's medical community is in a state of severe decline.  The way medicine is practiced and care given to America's medical patients has dropped to a level I have never experienced before in my lifetime and I have been hospitalized at least eighty times since the mid 1960's. 

I blame two things:  Government and computers.  There are other reasons, to be sure, but these are the two most prominent to me, at least.  Combine the two and you have something akin to chaos in a medical facility.

Understand:  When a chain of computers is used in any process, that process is only as fast as the slowest computer user within the chain.  Some people's computer skills are excellent.  Others are not. 

RN's now have those little roll around computers they constantly roll from one patient's room to another.  Everything they do -- to and for the patient -- is entered in the patient's records on that computer. 

In the good ole days, before computers, patient care was a hell of a lot faster and, in this semi-professional patient's opinion,  way more efficient.

Like nearly all businesses, and that's what hospital's really are, these days they are trying to do more with fewer employees. 

The recent recession affirmed something in business's collective mind.  The fewer employees you have the wider your profit margin -- if you can maintain production at a sufficient level. 

Of course, it's a bit more complicated than that.  The staff must be able to do more, to work harder, and in some cases work longer hours.  They will do it because the number of unemployed people waiting for their job is staggering.  (High unemployment is a boon to business.) The employee knows his employer will have no problems replacing him immediately.  So he produces to the maximum for the boss. 

For the company, production goes up, payroll comes down, and the profit margin grows wider -- all good for business. 

I expect the above will be the new normal in American business -- if not in global business.
Hospitals are a service industry.  I know that doesn't sound sexy today. Nevertheless, at bottom, ALL  hospitals are just that. 

Operating any service industry at the bare minimum will, over time, reduce the services and the quality of the services administered by that business.  That's bad for both the consumer of those services and the business, itself.

Many hospitals have cut their staffs just as other industries have done. In my opinion, there is no way a healthcare facility can avoid reducing the quality of care the patient receives when they don't have enough people to keep the operation running smoothly and efficiently.

To all of the above -- add government regulations -- and you have a nightmare. And it will only get worse, much worse, under Obamacare.

You know, one of the great inventions in America was the community or county hospital.  They were a source of pride for the citizens of that community.  Admittedly small with limited resources, they were, however, staffed with people from the community whose families would be receiving care in the institution in which they worked.  These small hospitals did yeoman's work in their communities.

In small communities patients knew the individual members of the staff and vice-versa.  Doctors were referred to by their first names, because the patient went to church with them, attended PTA meetings and Little League ball games with them.  They, too, were an integral part of the community. 

Usually the community hospitals were run by an administrator who answered to a board of trustees, who answered to the county commissioners, who answered to the citizens of the community. 

Across much of America that has now changed -- and change is NOT ALWAYS GOOD!

Many community hospitals have now been leased to large corporations that manage and operate hospitals for profit all over the country. 

Suddenly that community (or county) hospital becomes a regional healthcare facility.  At this point, two steps have been taken away from the community where the hospital was born. It is no longer a community hospital and it is no longer answerable to the citizens who ultimately own it.

Then the company running the facility brings in staff doctors.  Some are known by a relatively new title -- "Hospitalist."  They may be great doctors but they have nothing in common with the community and do not have the bond or the trust of the patients they see.

If you are not familiar with the term hospitalists, you're not alone.  Even my thesaurus didn't have it.  Turns out the term hospitalist was first coined by Robert Wachter and Lee Goldman in a 1996 New England Journal of Medicine article.  Hospitalists' activities may include patient care, teaching, research, and leadership related to hospital care.  SOURCE: 

Many patients attempt to avoid the hospitals employing hospitalists.  I'm one of them.

We have gone from being greeted in the admitting office or the emergency department by our first names to this: "Please give me your full name and date of birth."   During my most recent visit to a medical facility I reckon I was asked to provide my full name and date of birth several times and hour.  It was even required just to receive my food tray from the hospital kitchen.

In my opinion, we are observing a massive make-over of the healthcare delivery system in America and, frankly, I don't like it -- at all.

Patients are now only a name on a chart or a bar code on a wrist band.  It's just one more thing about this new America that I don't like.

© J. D. Longstreet

1 comment:

  1. yet another sign of our times...sigh
    Have an awesome holiday weekend my friend!:)