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
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.
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.
are a service industry. I know that doesn't sound sexy today.
Nevertheless, at bottom, ALL hospitals are just that.
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,
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.
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.
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
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!
community hospitals have now been leased to large corporations that
manage and operate hospitals for profit all over the country.
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
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
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: http://en.wikipedia.org/wiki/Hospital_medicine
Many patients attempt to avoid the hospitals employing hospitalists. I'm one of them.
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