June 18, 2007

Hospitals try to stay competitive with promotions

Posted in Medicine at 5:12 pm by The Lizard Queen

I’ve only been to the emergency room once since I became a legal adult, and I was lucky — I was just the driver, the college senior who was lucky enough to have a car and thus ended up driving lots of other people around. I’d been playing football with a bunch of friends, and one guy’s head hit the ground pretty hard when he got tackled, and he ended up with a concussion. We went to the nearest hospital, checked in, and waited. Then we waited. After that, we waited some more. There was a television in the corner playing Headline News; after about an hour I was familiar with all of the day’s top stories. After two hours I was sick of those stories. After three hours I had just about committed them to memory. The young man with the concussion finally got to see a doctor after nearly four hours had passed. An article on Yahoo describes how some hospitals are dealing with such backups:

With competition for healthcare dollars tight and complaints about care on the rise, hospitals from California to Virginia are trying to cut wait times. They pitch “quality care at a moment’s notice” and “door to doc” treatment in minutes.

For those who do endure long waits, hospitals offer meal vouchers, baseball and movie passes and written apologies.

“If someone has to wait a long time it is less likely they’re going to come back,” said Deborah White, spokeswoman for Carondelet Health, which owns two acute-care hospitals in Kansas City that launched a “30-minute guarantee” program on June 1, even as a competing hospital chain pledged to see patients within 15 minutes.

Tickets to a ball game or a movie might have been a nice gesture after the mind-numbing boredom of four hours in the waiting room, but there are too many situations in which trying to make up for slow service in an emergency room with such a gesture is simply not good enough. The Yahoo article brings up one such situation:

Last month a 43-year-old woman died in the waiting room of a Los Angeles-area hospital emergency department after a perforated bowel was not treated swiftly.

Of course, that’s rather an understatement of the situation:

A woman who lay bleeding on the emergency room floor of a troubled inner-city hospital died after 911 dispatchers refused to contact paramedics or an ambulance to take her to another facility, newly released tapes of the emergency calls reveal. . . .

Relatives said Rodriguez was bleeding from the mouth and writhing in pain for 45 minutes while she was at a hospital waiting area. Experts have said she could have survived had she been treated early enough.

This is not a situation that meal vouchers can fix — makes me think of trying to put a band-aid on the gaping wound in your thigh you got in what your relatives will henceforth refer to as “the chainsaw incident.”

And furthermore, how often do people choose which emergency room they go to based on anything other than proximity? I can’t remember which hospital I took my acquaintance to, but I know the only reason we went there is because it was the closest. In the case of an emergency, if I or a loved one for whom I’m providing transportation is bleeding or seizing or what have you, I might consider which hospital might be able to see me/them soonest, but mostly I’m going to be thinking of simply getting myself/them to an emergency room as quickly as possible. As a result, the idea of emergency rooms competing for patients strikes me as somewhat ghoulish.

Of course, there’s also the question of being able to afford a trip to the emergency room, but that’s another issue for another time.



  1. Cara said,

    Having been stitched in a few different places in Boston, I wish wish wish I had taken the extra time to go to Mass General instead of Beth Israel (the closest) the 2nd time. I wasn’t dying, so I could have chosen. Mass General was awesome…. meanwhile, after I’ve already waited for several hours, tightly gripping the towel holding the big chunk of flesh down on my hand, the stupid intern/medical student at Beth Israel tries to make me stand over a sink so he can a) pull my cut flesh away from the rest of my hand (while I’m standing there feeling it and watching it, with my dinner I didn’t get to eat sitting half cooked on the stove back home) so he can rinse it out with some saline. Jack ass. When I said no, at least they had the decency to send someone else who first gave me the local anesthesia and then let me sit on the bed while she rinsed my hand (which I could no longer feel).

  2. *shudder* Jackass, indeed.

    Yeah, quality of care definitely comes into the equation, too, which I wasn’t really thinking about when I wrote the post. And I think your story further illustrates the ludicrousness of the offers the Yahoo article refers to — if Beth Israel had given you a pair of movie tickets in an attempt to make up for your experience, would that change your mind about going back there the next time you needed to be stitched up and had a choice of where to go? I don’t think it would change my mind, personally.

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