A Tale of a Hospital "Visit"You should be so unlucky :-((
A family friend, lets call her "F", went to the Washington Hospital, Fremont, a local tax supported facility, for four days. "F" had so many misadventures that I'm going to tell our tale of woe.Our dentist, Dr Stewart, ran for, and was elected as, trustee of Washington Hospital. He is a good old boy. Part of the reason I am recording the tale is to amuse him. ;-))
It is too much to imagine that a mere trustee can influence a large institution.
When my time comes, I want to die in my own bed -
screw those medical screw ups -
This turned into a group of tales:
Medical Billing VS Medicare - Feb 28, 2017
- Medical Billing VS Medicare - Feb 28, 2017
- Maybe medicine is just a legal racket?
- Newspapers, 2014
- Update, 2011
- Life for Sale, 2008
- More Billing, 2008
- Original tale, 2003
The collection of images to the left are from my supplemental medical insurance, which (mostly) pays the medical provider the gap between the price that "Medicare Paid", and the "Medicare Approved Amount".
What is fascinating to me is the difference between the "Amount Charged" and "Medicare Approved Amount". It appears that the medical provider accepts as Paid in Full the "Medicare Approved Amount". I am assuming that the "Amount Charged" is the bill sent to Medicare (if you are under Medicare) or the poor victims (you and me) if not covered by Medicare or some medical insurance company.
I have heard Washington hospital talk about a "Negotiated Price" when talking about billing insurance companies. In any case, those not covered by an insurance company or Medicare seem to be billed three to ten times what Medicare and insurance companies "negotiate".
I think this dual pricing is grossly unfair !! Our beloved and high class medical establishment is screwing "the rest of you". And tried to screw me (and mostly did) when the wife was under 65 and not under Medicare.
Added Jan 16, 2014 - Study: Large Variation in Cost of Giving Birth at Calif. Hospitals
The study found that charges in California for:
- Vaginal delivery without complications ranged from $3,296 to $37,227; and
- Cesarean-section births without complications ranged from $8,312 to $70,908 ("State of Health," KQED, 1/16).
Anne McLeod, senior vice president of health policy for the California Hospital Association, said the study has a "major flaw" because it used prices before rates were negotiated between hospitals and insurers.
Why screw the people who would rather not pay the insurance salesperson's commissions and other insurance overhead and profits??
Update - Oct 14, 2011
"F" had about the same symptoms again - increasing pain in lower abdomen.
After a day "F" went to a local urgent care medical facility. "F" saw a doctor right away. Doctor pokes about and listens - granted its a tough call. "F" mentioned that she had been treated for diverticulitis a few years ago. You could see the Dr. get less tense - and figure it is probably the same thing again.
Dr. prescribes two medicines, and says firmly "If pain is worse tomorrow, come back !!. And if pain isn't better day after tomorrow, come back !!. In any case, keep taking the medicine until it is gone."
"F" paid $64 for the visit, and about $30 for the pills. (Total is about 1/2 a single IV at Washington Hospital.)
The pain got better slowly, completely gone in 4 days :-))
No fuss, no lost records, no patient ID screw up, no IVs, ... :-))
Motto: - avoid Fremont's Washington Hospital -
Life for Sale, 2008
Added Oct 9,2008 - I heard of the movie "Life for Sale" a movie describing a hospital using discrediting as a method of keeping complaining doctors in line, apparently using Washington Hospital as an example. Our story below is of gross uncaring incompetence.
Hot Flash - a local theater, Century Capitol 16, was threatened with a lawsuit by Washington Hospital, and decided not to show the film - "Life for Sale" - good thing I checked before going tonight -
Image from the August 30, 2009 Argus - The Washington Hospital administrator, Nancy Farber, apparently was paid $876,831 last year, and she can't even read the teleprompter. On the Washington Hospital TV, during board meetings, she reads statements in a mumbling unsure voice. Like reading a script someone else has written. Note that 3 more Washington Hospital employees are making in the top ten of this multi-county government salary survey. (expanded image is 106 KBytes)
More Billing, 2008
Update, in the spring of 2008, "F" was feeling bad, a change of hormone prescription, and went (again) to the Washington Hospital Emergency Room - in four hours they did an EKG and an IV, then sent her home - walking, in hospital slippers, at 2 AM, billing $4,600. For example, they are billing $580 for the use of a $6,000 EKG machine, not including 15 x mark-up for supplies, and plenty for application, and interpretation - just the use of the machine. "F" fought this silly billing this time. Like why not bill "F" $46,000? or thinking big, why not $460,000? Seems to make as much sense to me. - "F" finally settled for about 40% of the billing - She got tired of fighting the blood suckers. She is now using other medical facilities.
Original tale, 2003
One Tuesday morning in June 2003
Wednesday morning -
- "F" has been suffering pain in lower abdomen all night, goes to doctor and gets pain pills (? and an antibiotic?) and sent home - things get worse -
- Tuesday night - About 6:00 PM, after checking with her doctor, "F" goes to the Emergency Room at Washington Hospital, here in Fremont, California.
- About 7:00 PM, "F" goes to the CAT scan area, and I am permitted to photograph the activities :-)) (My pictures are pretty good but "F" does not want images of her insides published.)
- Things were going OK - until they lost us in the emergency room system.
- About 8:25 PM, the doctor gave us the CAT scan report
- - diverticulitis of the sigmoid colon -
and said that he was prescribing
- - a strong antibiotic
- - a liquid diet
- - a strong pain killer
and said "F" was being admitted to the hospital.
- About 9:30 PM I started bugging the nurses about when anything was going to happen - like where is the medicine?.
- About 10:00 PM a nurse agreed that something was amiss, and started to search for our records
- About 10:20 she found them, she said that the doctor had placed them face down somewhere.
- About 10:45 the IV and medicine arrived. IV is "Intravenous" - signified by the bag of clear fluid that hangs over your head in a hospital, connected to a needle in a vein in you, used as a convenient method of getting fluids, medicine, nutrients, etc. into a person. But "F" has very small veins - nurses 1 and 2 failed to get the needle into a vein for the IV.
- Finally about 11:15 male nurse 3 did the job, and the antibiotic and pain killer started to flow into "F".
- About 11:45 PM "F" arrived at the general nursing room Third Floor, West Wing, Room 8 Bed 2 (of 2).
- About 12:15 AM I am finally able to attract a nurse to come to the room and meet the new guest. Honest to God, they really don't seem to give a *@ -
- Soon some Officious Person comes in with forms to fill out, like allergies, phone numbers, medical history, age, ...
- "F" had just filled out similar but not identical forms in the Emergency Room.
- I try to tease the Officious Person that the Emergency Room does not talk with the West Wing (where we are now, 2 floors above the Emergency Room).
- Officious Person is not amused.
- "F" starts to fill out the forms, leaving out stuff about "Pain Management Counseling" and "Community Help Counseling".
- Soon Officious Person starts telling "F" about the use for the above Counseling -
- "F"'s identification wrist band was coming off, so they made and installed a new one.
- The past two days have been long, it is well past midnight, I head home ( about a mile away).
- I got back to the hospital and "F" about 9:00 AM. "F"'s doctor had already been there.
- I notice that the name and age on the ID tag on "F"'s wrist are for a different named woman about 25 years younger than "F".
- A nurse agrees that the wrist band is incorrect and has a correct one made up and installed.
"F" was told that is no problem as everything is by Room Number and Bed Number anyway.
- A few minutes later, Tina (the 33 year old roommate) says that this morning a nurse had tried to give her "privara" or something like that.
- Tina told the nurse that "privara" or something like that was for much older women, and refused the medicine.
- The nurse said that it was for Room 8 Bed 1, but Tina refused it anyway saying there must be some mistake. The nurse took the stuff away.
- Lunch comes - it is chicken and rice -
- Hmmm "F" thought the doctor in Emergency said something about a liquid diet.
"F" asks the nurse - nothing about a liquid diet.
- - OK - what the hell does "F" know? -
- I get there about 8:00 AM and meet "F"'s doctor - Dr. Veronica Watson, a very short plumpish very alert looking oriental appearing lady. She seems an interesting person.
- "F" asks about the liquid diet -
- OH Yes - "F" should be a liquid diet!
- I guess such minor details don't get from the Emergency Room doctor to the West Wing, two floors up.
- "F" is put on a liquid diet.
- I get there in time to see Dr. Watson again, and later leave to walk the dogs and wrestle with a sick computer and Fry's
- I get back about 2:30 PM, and "F" is *NOT* connected to the IV system.
- There had been considerable swelling at the needle site and the nurses had pulled out the needle but could not re-insert it another of B"F"'s veins.
- Several had tried, and given up. 3:30 PM is shift change time, and by 2:45 they all seemed too busy to try to get "F" connected up again.
- About 3:45 the new nurses seem available and "F" tries several times to attract a nurse about the disconnected IV system. It seems low priority -
- About 4:00 Rosa from the Philippines explains that since the other nurses had tried and failed, she did not want to turn "F" into a pin cushion and calls for a anesthesiologist nurse to install the needle. (They are reputed to be more expert.) About 4:15 he arrives -
- About 15 minutes later he succeeds in a vein in the bend of the right elbow. (An immobilizing place but that was the best he could do.)
- Rosa reappears and says that she will start the 6:00 antibiotic IV bag early since the 2:00 antibiotic bag had not been given because of "F"'s small veins.
What The Heck
- - the big deal about being in the hospital is to get the damn powerful drip antibiotic into "F" - and the day shift just couldn't/wouldn't do the job !!!
- The day shift just didn't seem to give a damn. (Screw the small veins and antibiotic, let the afternoon shift do it!!)
- About 7:00 P.M. I head out for dinner and dog walking.
- About 10:30 P.M. "F" calls and wants me to fix something. I get to the hospital and the nurse in the hall tells me she is calling Dr. Watson because "F" wants to get off the IV.
- I go into see "F" and she says her arm is really painful, and I see a little red line going up her arm. she wants to get her antibiotic by mouth or injection instead.
- A bit later the nurse comes in and says that she is pulling out the IV system. "F" is delighted and we talk about bending over for the injection.
- The nurse says "No" - "F" will be getting antibiotic pills.
- They have been fighting the IV system for three days, missing the afternoon dose, and "F" could have been popping pills instead of this whole *&^%$#@! stupid IV nightmare? ???? ????????
- Then the nurse says the reason the IV hurt so bad is likely the potassium. (The label on the bag of IV fluid they were using indicated 0.5 % NaCl and 0.15% KCl . )
- I assume that a person can live a few days without a shot of potassium. ( And since "F" is active - like eating and going to the potty by herself, I presume that if daily potassium is necessary, and enough is not available in the normal food - the staff could have given her half and half salt (Half KC1) (I'm willing to concede that if a person is totally dependent on IV for a month or so, balanced electrolyte might be important - but 3 or 4 days - come on - )
- I ain't no medical doctor, but I do try to fake that I got at least half a brain!
- About 1.5 hour after the IV got pulled the second time, the antibiotic pills hadn't arrived in the West Wing. I volunteered to go to the local 24 hour pharmacy and get them but the nurses said they are not allowed to give medicines [with unknown history].
- It is after midnight - the pills haven't arrived. I went home - shaking my head, a sinking feeling in my stomach.
- This is worse than fighting city hall!
- - It is too pathetic to get mad!!
- - When my time comes, I want to die in my own bed !!
"F" leaves the "hospital" - "F" feels much better - and we have survived the hospital staff.
Ya know what - the high school kids working at the local veterinarian's office seem more capable and caring than the nurses we saw at Third Floor, West Wing of the Washington hospital. - And the nurses in the Emergency Room didn't shine much either - .
What is the score?
- Emergency Room - long delay (three hours) after diagnosis and prescription before treatment started ("F"'s records got lost and they didn't realize it until I bugged them a lot)
- West Wing - not being interested in arrival of new patient
- West Wing - have to fill out the same info into forms already filled out in emergency room (it is the same hospital? or is it? see billing below)
- West Wing - replacing failed ID band with wrong patient name and age, OK, they got the sex correct -
- OK, OK, You're correct - same chance as a coin flip -
- West Wing - fed standard food to patient on liquid diet -
- West Wing - lost and totally screwed up the IV battle, then gave up and went home leaving the antibiotic unadministered.
- General - it seems the whole IV business (in this case) was based on high billing incentive rather medical need. (In the time delay of getting the IV installed, oral antibiotic would have been completely absorbed anyway.)
- Patient survived in spite of the above
- Hospital got lots of cash flow
EpilogueThe hospital bill(s) totaled $14 thousand for 4 days stay. (They use three different billing centers - maybe to confuse themselves as well as patients and insurance companies.)
I figured that the CAT scan would be a big part of that, but the CAT scan was only $2 thousand for the half hour.
But I did figure why the hospital loves IVs :-))
On the other side, hospitals in California have to take everyone whether they can pay or not - maybe this krazy billing is just a socialized medicine tax and should be acknowledged as such?
- - the wholesale price for standard solution IV bag is $13 per dozen - lets say a buck a piece - OK?
- we were billed $84 per IV bag - as a material object
- we were billed $81 per IV bag - labor to install
- including the bag that they couldn't/didn't install.
Stanford Hospital, across the bay, gets caught about every ten years double or triple billing - bill the patients, and the state, and the feds, and who ever. Each time they say they will review their practices ;-))
- Shortly after "F"'s stay, the local newspaper reported that the hospital administrator's salary was raised to over $350,000/year and that she also got a bonus "for meeting business objectives".
- In May 2004, the California Public Employees' Retirement System, CalPERS, removed Washington Hospital from its approved list - citing excessive billing.
- Blue Cross is requiring a higher patient co-pay from about 20% of the state's hospitals - including Washington in Fremont.
Maybe this is the reality of the hospital business?
If insurance had not paid for "F"'s hospital stay, Washington Hospital would have had to take me to court to get paid! That way I could have broadcast what a high priced, low service place it is! Talk about "your day in court" - I bet we would have settled out of court for a good deal less to save Washington Hospital from getting a public black eye.
- just dreaming of course -
Ya know - after re-reading the above tale, if a hospital treats me like that, and if I am conscious and mobile, the hospital might have to call 911 - They might have an insanely "mad" old man on their hands
- I'm old and don't have a salary or reputation to protect - Why the hell not give it a go? ;-)) - yell, scream, throw stuff, ... - On the Third Floor of the West Wing of Washington Hospital, they might not even notice :-| - probably have to pee on a nurse to get attention.
On the other side of the coin, my next door neighbors at the time were a cop and his wife, an obstetrical nurse at that very hospital. My neighbor the nurse was the very model of nurse of the year, caring, cool under fire, observant, (attractive), seemingly highly medically informed, ... , could move quickly carefully in touchy situations, just about every possible positive adjective. A wonderful person, you would trust her with your wallet and life.
(I didn't have the heart to tell them the above sorry tale. They moved to another area shortly after the above misadventures.)
Another Epilogue - Friends and e-mailers who have read the above, report similar things at their local hospitals.
Maybe I'm sensitized to hospital failings. One of my father's sisters, Rose, died in a hospital (in 1934 I am told) due to some medical screw up with a "minor" operation. Uncle Will, a brother of my father, was doctor in that hospital at the time and was in a position to know.