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Published by dinesh22180

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Published by: dinesh22180 on Sep 04, 2008
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1. "Emergency? Take a number."
Earlier this year Thelma Gundlach felt her arms go numb and her vision turnfuzzy. She sensed a stroke coming on and had a friend rush her to theemergency room at a hospital near her home in Modesto, Calif. Gundlach, 67,expected to be seen right away. Instead, she waited four hours in an emergencyroom jammed with other patients. Gundlach survived (her stroke was a minor one), but now says, "It's unnerving to think about going back there."Lots of other patients feel exactly the same way, Thelma. A 2000 studyconducted by the National Center for Health Statistics revealed that patients withnonurgent problems (where life or limb are not at risk) wait an average of 68minutes to be seen, up 17 minutes from 1997. "Generally, if you come in with achest pain, you'll get seen quickly," says Robert McNamara, chairman of emergency medicine at Temple University Hospital in Philadelphia. Otherwise,"you'll wait hours -- as many as 12, based on what I've seen."While it's no fun thinking about getting hurt, McNamara suggests you do someplanning ahead for an injury or illness. For instance, scout around for anemergency room with a fast-track area that will address minor complaints quickly."Also, if your emergency is not life or death," he says, "take a few minutes to calland find the hospital with the shortest wait." And avoid getting seriously ill onMondays between 2:00 and 10:00 p.m. That's often the busiest time foemergency rooms.
2. "We'll misdiagnose you to pad your bill."
 Making patients wait in line is one thing. Purposely inflating the level of carerequired to treat an illness (and jacking up the bill) is downright criminal. Just askRick Newbold, a Center Bridge, Pa.-based physician turned high-tech whistle-blower. Newbold employs a self-devised software program to reveal billinginconsistencies. So far he's uncovered more than 100 hospitals he accuses of hyping patient illnesses. He brought his findings to the attention of the U.S.Attorney's office for the Eastern District of Pennsylvania, which to date hashelped recoup more than $15 million for Medicare, the usual victim of thisparticular scam.But it's not only insurers that suffer from this fraud. Jim Sheehan, an AssistantU.S. Attorney based in Philadelphia, says such shenanigans by hospitals have "areal impact on the public. It increases the expenses people pay, in taxes and inhealth insurance." Unfortunately, patients and their families often have littleindication they're being used in this way.
3. "Our surgeons get confused."
Did you hear the one about the Florida woman admitted to a hospital with a brainhemorrhage? The surgeon operated on the wrong side of her brain. Or howabout the Brooklyn hospital where an ophthalmologist mistakenly operated on apatient's good eye?These O.R. goof-ups would be laughable if they weren't so awful.Euphemistically referred to as "wrong-site surgery," such mishaps have risen
from 16 nationwide in 1998 to 58 in 2001. To protect yourself from becoming avictim of a directionless doctor, your first defense is avoiding incompetenthospitals. The Joint Commission on Accreditation of Healthcare Organizationsdoes qualitative studies on health-care facilities across the country and posts itsresults on its Web site, www.jcaho.org. Second, don't cut your surgeon too muchslack. Before you go under anesthesia, discuss with him exactly where -- andwhy -- he wants to make incisions. Don't let him make a cut unless you'recompletely satisfied with his answers.
4. "You're not welcome here."
Hospitals should be egalitarian places. Exclusivity does not belong in theoperating room. Everyone deserves the best health care possible.Sound reasonable? Perhaps, but patient advocates say it's not uncommon for hospitals to delay or deny service if your health-insurance coverage fails to meetits pricing standards. "If you have a major illness -- like heart disease or cancer --you want to go to what I call a 'center of excellence,' a place with the best careand most experience at treating your condition," says Ron Pollack, executivedirector of Families USA in Washington, D.C., an advocacy organization for health-care consumers. "But the first thing a hospital will do is biopsy your walletin order to figure out how you plan on paying. And if your insurance plan won'tpay everything they want, then the hospital will want you to put up the remainingdollars."Though hospitals are legally obligated to treat patients at risk of life or limb, noneare required to treat you after you have stabilized. Longer-term treatment -- at thehospital of your choice -- with the wrong insurance policy will require apersuasive argument. "Sometimes the insurance policies have appeal rights, sounder extraordinary circumstances, you can get yourself treated at a hospital thatdoes not seem immediately [welcoming]," advises Alwyn Cassil, spokeswomanfor the Center for Studying Health System Change, in Washington, D.C. "If thephysician responsible for facilitating your care says that you can't get appropriatetreatment within your existing network, that physician can be a powerful advocatefor you. Remember, it's best to know your appeal rights before you need to usethem."
5. "We partner with your doctor -- to commit crimes."
Physicians are expected to send patients to the hospital that can best treat their conditions. In Kansas City, Mo., though, a pair of brothers, Drs. Ron and RobertLaHue, were found guilty in 1999 of violating the Medicare Antikickback Act. Theyaccepted payments for regularly sending patients to Baptist Medical Center. Inaddition to the brothers, a hospital official was sentenced to prison time.Hospitals use more than money to induce doctors to send patients their way.Some require physicians to bring a certain number of patients into the hospital just to remain credentialed with them. "Some hospitals are giving kickbacksrather than the best care," says Sheehan, the Assistant U.S. Attorney. He addsthat kickback crimes showcase an even more insidious element: "Your doctor tells you that you need a certain treatment, you trust him, and you go for thetreatment. Most patients don't expect the hospital to pay him to make decisionsthat may not be in their best interest."
6. "Don't trust us to keep your private life private."
Patient records are packed with sensitive information that you'd expect hospitalsto keep hush-hush. Tell that to a woman the courts call Jane Doe. Her uterus toreduring an abortion at Hope Clinic for Women in Granite City, Ill., in June 2001.She was treated at Saint Elizabeth Medical Center. Days later her snapshot andhospital record appeared on a pro-life Web site. Doe is suing Saint Elizabeth inIllinois state court for failing to protect her medical records. "Somebody gave her hospital records to [pro-lifers]," contends Doe's lawyer Mark Levy. (An attorneyfor Saint Elizabeth declined to comment on the suit.)While patients can usually request that information not be shared on internalhospital networks or that a specific person be blocked from accessing reports,hospitals "may or may not agree with your request," says Joy Pritts, senior counsel of the Health Privacy Project at Georgetown University. While in office,President Clinton issued rules that will require hospitals, starting in 2003, to get apatient's written consent before releasing information to insurers, doctors andpharmacists. The Bush administration, however, wants to change the Clintonruling so that hospitals would not need prior consent.
7. "And you thought you were coming here to get cured."
In the spring of 1998, Jill Cahill was admitted to a Syracuse, N.Y., hospital after being brutally beaten by her husband, James. Six months later he went to thehospital and finished the job (poisoning her with cyanide). Or consider this: InApril 2001, at Savannas Hospital in Port St. Lucie, Fla., a patient allegedly beatto death three other patients and a nurse.Such lowlights highlight the sticky middle many hospitals find themselves in whenit comes to security. "Most people like to see hospitals as an open environment,"says Tony W. York of Hospital Shared Services, a Denver-based health-care-services firm. "I like to see visible security people walking around on patientfloors." He also wants to see both employees and visitors wearing identificationbadges at all times. Worried that an unwanted guest may pay a visit to your room? York says, "The hospital should be willing to accept" a list of people whomyou don't want admitted. How well the hospital enforces it, he adds, is "a wholeother issue."
8. "Our skin banks get depleted -- just when you need them most."
In 1999 Sadie Nolan underwent a dozen operations at University of WisconsinHospital and Clinics (UWHC) in Madison after being severely burned in a car accident. Sadie was in constant danger of not getting the lifesaving skin sheneeded. Two months later she died. Afterward, her mother, Kate, began towonder why there was such a shortage of donated skin. She says she wasshocked to learn that skin donated to Allograft Resources, the tissue bankaffiliated with UWHC, was unavailable. "It had moved on to a for-profit tissue-engineering company," according to Kate. But Allograft President and CEONancy Holland says, "We never received a call to help Kate Nolan's daughter."

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