"Drive-through" medicine is about dollars, not sense… Over the years, I've heard some real horror stories about hospitals discharging patients too soon after surgery-everything from latent infections setting in to sutures bursting to massive blood loss from undetected post-op internal bleeding. I'm sure you've heard a few of your own. Why does this happen, you ask? Why don't hospitals simply allow patients to stay an extra day or so to make sure they're all right? Well, it's like this: We always tend to forget this fact, but the brutal truth is that almost all hospitals are BUSINESSES. And the vast majority of their income comes from insurance companies, also BUSINESSES…
And what's the cardinal rule of business? Time is money. It's obvious to me that hospitals and insurance companies structure discharge guidelines based not on what's best for patients, but rather on what's best for the bottom line. To them, it's probably just a simple question of risk assessment: Does the extra profit made by quickly "turning over" patients exceed the potential liability of lawsuits brought by those patients who experience problems relating to premature discharge? What's ideal for you-the patient-may not even enter into this equation! So how's it feel knowing that you're just a number in their eyes? Pretty disconcerting, isn't it? And what's really alarming is the fact that doctors-who often push for more hospital recovery time for their patients-seem to have less and less of a voice in the matter. Nowadays, the decision of when to release you (or kick you out) is likely to be made almost solely by the number crunchers. There's not much we can do about this. I certainly don't expect hospitals-or insurance companies-to stop worrying about the bottom line. What it comes down to is this: you have to look out for yourself and for the people you care about. If you're seriously ill or have had major surgery, hiring a private nurse who'll focus on your case alone and speak up for you in the hospital can be a life saver. And if the bean counters throw you out of the hospital (it's almost that brutal), you might want to try to keep her on a day or two at home until you're out of danger and on the mend. Getting my own two cents in,
William Campbell Douglass II, MD
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