Tuesday, July 23, 2013

Here's Where Things Go Wrong

I'm duplicating some "Conditions of Admission" from an unnamed hospital.  This is the kind of stuff that patients need to be aware of because this is the start of things going wrong.

I understand it is the policy of the hospital to allow services to be performed by competent authorized personnel who are in education, training, or teaching programs.  Authorized medical personnel do include students of health professions as well as trained medical personnel."

Pretty self explanatory, however, you need to know that even if you strike this clause, you will still be subjected to ONLY medical trainees.  You will probably not see your real doctor, who can't be bothered with the likes of you.  You will probably be surrounded by nurses, phlebotomists and assorted mid-levels who are rookies.  You will be subjected to being asked the same questions over and over and over by different interns and residents.  It's FRUSTRATING.  Why do we patients have to pay exorbitant medical costs for trainees?  Shouldn't we get a cost reduction for being used as the living cadaver?  Why CAN'T we strike this clause and have it mean something?

I also want to point out that "authorized medical personnel" doesn't mean what it you think it means.  The hospital administrators also put this clause into the "Conditions of Admission" document.

Many physicians and surgeons furnishing services to the patient in the hospital, including the radiologist, pathologist, anesthesiologist, emergency room physicians and the like, are independent contractors and are generally not employees or agents of the hospital.  Some of these physicians will bill separately for their services."

This means that although the hospital CLAIMS that these people are "authorized medical personnel" it doesn't mean that they are in any way subject to any scrutiny by the hospital.  They are completely autonomous and the hospital is in no way accountable to the patients for allowing substandard people to perform duties within the hospital.  (Where's the part about the crna's hmmm?)  ALL of these people will bill you independently whether you wanted them or not.  They seem to be maximizing patient exposure to multiple billing for the same patient encounter. 

Here's another one.  (Keep in mind that if you can't stop the above from happening, what's to stop the next thing from happening?)

I agree to allow the hospital to take, reproduce and use photos, video tape, video monitoring/recording, or audio recording for the purpose of diagnosis, testing, medical evaluation, care, or treatment (including invasive procedures) patient safety or medical education, and to preserve clinical information.  I understand that this material may be treated as a part of the medical record and that the hospital's privacy policies apply to them."

How do you like them apples?  What is the hospital's privacy policy?  Practically non existent to start with, and then with all the exclusions, there really isn't one.  You know it and I know it.  You patient modesty people need to know this in particular.  Naked photos are going to be taken, used, reproduced, disseminated and serve as part of the "medical education" among other things. Even if you strike this clause, how are you to know how many people are photographing, taping, viewing you regardless of your wishes?  They certainly won't allow YOU to view these photos etc.  I DO NOT agree to this.  How do you stop them?  Are we CHARGED for this? 

I wish our elected representatives would actually look into this kind of stuff.  Why should we be terrified of getting ill or injured and being subjected to this?

I AM glad and grateful that the hospital at least put these articles in the admissions document.  I WAS allowed to strike the the "training" clause and the "photograph" clause without issue.  They apparently retained the right to reinstate them without my knowledge or consent.  So here we are.

PS  When I contacted the administration they apologized for the errors in my care.  They said that most people simply sign what's in front of them and they don't pay ANY attention to what you struck.  Even if you strike the clauses you disagree with right in front of the admissions clerk and include them in the conversation about what clauses you are striking and why.  *I* myself signed the "Consent to Treat" last time when a hospital asked me to sign a simple little admissions document.  At that time (ORIF featured in this blog) I didn't think that most of the items could possibly apply to anything that was being done to me at the time.  I was wrong.   In the future I'm asking the hospital to FLAG MY DAMN CHART!  They have it electronically on every single computer on every single floor.  There is no excuse for being unaware that the patient has declined certain unnecessary requests from the hospital.

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