Five hospital secrets you should know
Going to the hospital for any reason is bad enough. But it can be particularly grueling if you receive substandard care, get stuck with a bill full of mistakes or wind up sicker than when you were first admitted.
While most patients check in and out without incident, there are plenty who haven't been as lucky. On average, one person at every hospital is harmed by a drug error -- every day, according to a 2006 study by the Institute of Medicine. It gets worse. The Centers for Disease Control estimates that roughly two million people a year get hospital-related infections, many of which are potentially lethal. About 195,000 patients die each year from hospital errors, according to healthcare ratings firm HealthGrades.
There are some little-known ways to protect yourself, however. Here are five hospital secrets you need to know.
Secret No. 1: Avoid the most dangerous month to be in the hospital
Be extra careful in July. Why?
Newly-minted interns start work that month.
A study of 200 major teaching hospitals in the United States found that during July, a large number of experienced employees leave, and less experienced ones arrive. That migration is "associated with roughly 1,500 to 2,750 accelerated deaths per year," according to the National Bureau of Economic Research.
It makes sense that inexperience coupled with the adjustment to unfamiliar surroundings and long hours might be a source of increased errors affecting patient care. However, this potential connection between new staff and poor outcomes is not without its detractors. Another study by researchers at the Iowa City VA Hospital in Iowa City, Iowa found no evidence that patients in the intensive care units of 28 hospitals fared any worse due to "the July phenomenon."
While the experts may not be able to agree, why tempt the fates? Just postpone any surgeries until August or, even better, September.
Secret No. 2: Checking a hospital's rating can save your life
What causes more deaths than diabetes, pneumonia, Alzheimer's disease or kidney disease? Preventable, in-hospital medical errors.
HealthGrades estimates that these types of screw-ups kill an estimated 195,000 people each year. That's the equivalent of 394 fully-loaded jumbo jets crashing and killing everyone on board.
The majority of medical-error deaths stem from an improper diagnosis or failure to treat a problem in a timely manner. Less common, but just as serious, are errors that include avoidable post-operative respiratory failure and pulmonary embolisms.
How can you protect yourself? Consider obtaining a ratings report for your hospital from the U.S. Department of Health & Human Services or from private providers such as HealthGrades or The Leapfrog Group. Another resource is the annual ranking of America's Best Hospitals by U.S. News & World Report.
We are discussing your life here. Doing a little due diligence can go a long way toward saving it.
Secret No. 3: During the most critical part of your surgery, you may be receiving less competent care
Before setting foot in the operating room, you most likely will conduct a background check on your surgeon. But what about your anesthesiologist?
While serious complications from anesthesia are rare, they can occur, and the consequences can be deadly. Patients who require general anesthesia and who have pre-existing medical conditions are at an even greater risk.
According to Dr. Bruce Fagel, a medical malpractice lawyer who is also a physician, most surgical patients know little or nothing about their anesthesiologists. Even worse, most hospitals outsource their anesthesiology services to a group that may just randomly assign an anesthesiologist to a patient, he says.
All patients undergoing surgery should insist on interviewing anesthesiologists prior to surgery. Here are some questions the American Society of Anesthesiologists suggests you ask:
• What are your qualifications? Specifically, are you a medical doctor trained in the field of anesthesiology?
• How many procedures like this have you done?
• Who else might be involved with my anesthesia care?
• Do you monitor my heart and breathing?
• Is an anesthesiologist on call to respond to the recovery room?
Secret No. 4: You don't have to pay for the hospital's mistakes
Minor infections, like urinary tract infections from catheters, happen all of the time in hospitals. Often, however, these infections are preventable. If that's the case, then you don't have to pay for cost of treating them.
Medicare has drawn a line in the sand. Starting in October 2008, it stopped paying for designated hospital errors. State medical groups, insurers and state agencies have jumped on the bandwagon, too. Now hundreds of hospitals have agreed to absorb the cost of their mistakes.
If you are the victim of a hospital error and are asked to pay for treating the ensuing problems, just say "no." There is a good chance the hospital has no right to bill you. Even if it is not prohibited from doing so, it is unlikely to pursue you for payment.
Secret No. 5: Your medical records are not as confidential as you think
If you think that gall bladder surgery is something that's going to stay between you, your doctor and the nurses, think again. The information you share at the hospital doesn't always stay in the hospital.
Celebrities have learned this the hard way. Hospital records of Britney Spears, Maria Shriver and Farrah Fawcett were reportedly provided to the tabloids by hospital employees. Believe it or not, you and I face similar risks. When put in the wrong hands, medical records can prove to be highly valuable. Earlier this year, an employee of the prestigious Cedars-Sinai MedicalCenter in Los Angeles was arrested and charged with stealing more than one thousand patient records, and then using the patients' identities to steal from insurers.
Even if your information doesn't get used to make a quick buck, it still gets around. Patients believe that HIPAA, the federal law governing the privacy of medical records, protects them from disclosure. But HIPAA has many exceptions. Here are a few of them:
• Disclosure to affiliated organizations. This can include many providers in different states. That may be fine unless your nosy Uncle Fred works in one of those entities.
• Limited disclosure for hospital fundraising (the hospital may use your name and demographic information to solicit donations). You can opt out, but few patients understand their right to do so.
• Disclosure for national security. This may not sound like a problem, but no court review or order is necessary prior to disclosure. The potential for abuse is huge.
If you are concerned about the privacy of your hospital records, you are entitled to request an accounting of all disclosures. Review the hospital's Notice of Privacy and follow the procedures.
Dan Solin is the author of the newly published book, The Smartest Retirement Book You'll Ever Read (Perigee Books 2009). His prior books include the New York Times bestsellers, The Smartest Investment Book You'll Ever Read and The Smartest 401(k) Book You'll Ever Read. See SmartestInvestmentBook.com. Read more about Dan Solin.
Be extra careful in July. Why?
Newly-minted interns start work that month.
A study of 200 major teaching hospitals in the United States found that during July, a large number of experienced employees leave, and less experienced ones arrive. That migration is "associated with roughly 1,500 to 2,750 accelerated deaths per year," according to the National Bureau of Economic Research.
It makes sense that inexperience coupled with the adjustment to unfamiliar surroundings and long hours might be a source of increased errors affecting patient care. However, this potential connection between new staff and poor outcomes is not without its detractors. Another study by researchers at the Iowa City VA Hospital in Iowa City, Iowa found no evidence that patients in the intensive care units of 28 hospitals fared any worse due to "the July phenomenon."
While the experts may not be able to agree, why tempt the fates? Just postpone any surgeries until August or, even better, September.
Secret No. 2: Checking a hospital's rating can save your life
What causes more deaths than diabetes, pneumonia, Alzheimer's disease or kidney disease? Preventable, in-hospital medical errors.
HealthGrades estimates that these types of screw-ups kill an estimated 195,000 people each year. That's the equivalent of 394 fully-loaded jumbo jets crashing and killing everyone on board.
The majority of medical-error deaths stem from an improper diagnosis or failure to treat a problem in a timely manner. Less common, but just as serious, are errors that include avoidable post-operative respiratory failure and pulmonary embolisms.
How can you protect yourself? Consider obtaining a ratings report for your hospital from the U.S. Department of Health & Human Services or from private providers such as HealthGrades or The Leapfrog Group. Another resource is the annual ranking of America's Best Hospitals by U.S. News & World Report.
We are discussing your life here. Doing a little due diligence can go a long way toward saving it.
Secret No. 3: During the most critical part of your surgery, you may be receiving less competent care
Before setting foot in the operating room, you most likely will conduct a background check on your surgeon. But what about your anesthesiologist?
While serious complications from anesthesia are rare, they can occur, and the consequences can be deadly. Patients who require general anesthesia and who have pre-existing medical conditions are at an even greater risk.
According to Dr. Bruce Fagel, a medical malpractice lawyer who is also a physician, most surgical patients know little or nothing about their anesthesiologists. Even worse, most hospitals outsource their anesthesiology services to a group that may just randomly assign an anesthesiologist to a patient, he says.
All patients undergoing surgery should insist on interviewing anesthesiologists prior to surgery. Here are some questions the American Society of Anesthesiologists suggests you ask:
• What are your qualifications? Specifically, are you a medical doctor trained in the field of anesthesiology?
• How many procedures like this have you done?
• Who else might be involved with my anesthesia care?
• Do you monitor my heart and breathing?
• Is an anesthesiologist on call to respond to the recovery room?
Secret No. 4: You don't have to pay for the hospital's mistakes
Minor infections, like urinary tract infections from catheters, happen all of the time in hospitals. Often, however, these infections are preventable. If that's the case, then you don't have to pay for cost of treating them.
Medicare has drawn a line in the sand. Starting in October 2008, it stopped paying for designated hospital errors. State medical groups, insurers and state agencies have jumped on the bandwagon, too. Now hundreds of hospitals have agreed to absorb the cost of their mistakes.
If you are the victim of a hospital error and are asked to pay for treating the ensuing problems, just say "no." There is a good chance the hospital has no right to bill you. Even if it is not prohibited from doing so, it is unlikely to pursue you for payment.
Secret No. 5: Your medical records are not as confidential as you think
If you think that gall bladder surgery is something that's going to stay between you, your doctor and the nurses, think again. The information you share at the hospital doesn't always stay in the hospital.
Celebrities have learned this the hard way. Hospital records of Britney Spears, Maria Shriver and Farrah Fawcett were reportedly provided to the tabloids by hospital employees. Believe it or not, you and I face similar risks. When put in the wrong hands, medical records can prove to be highly valuable. Earlier this year, an employee of the prestigious Cedars-Sinai MedicalCenter in Los Angeles was arrested and charged with stealing more than one thousand patient records, and then using the patients' identities to steal from insurers.
Even if your information doesn't get used to make a quick buck, it still gets around. Patients believe that HIPAA, the federal law governing the privacy of medical records, protects them from disclosure. But HIPAA has many exceptions. Here are a few of them:
• Disclosure to affiliated organizations. This can include many providers in different states. That may be fine unless your nosy Uncle Fred works in one of those entities.
• Limited disclosure for hospital fundraising (the hospital may use your name and demographic information to solicit donations). You can opt out, but few patients understand their right to do so.
• Disclosure for national security. This may not sound like a problem, but no court review or order is necessary prior to disclosure. The potential for abuse is huge.
If you are concerned about the privacy of your hospital records, you are entitled to request an accounting of all disclosures. Review the hospital's Notice of Privacy and follow the procedures.
Dan Solin is the author of the newly published book, The Smartest Retirement Book You'll Ever Read (Perigee Books 2009). His prior books include the New York Times bestsellers, The Smartest Investment Book You'll Ever Read and The Smartest 401(k) Book You'll Ever Read. See SmartestInvestmentBook.com. Read more about Dan Solin.
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Reader Comments (Page 1 of 19)
10-01-2009 @ 7:32AM
AMF said...
The Institute of Health and other Journalists are constantly publishing these bogus statistics about deaths in the hospital system. What they are not telling you, or anyone for that matter is that that statistic EXTRAPOLATED from a study done in the 1980"s and it included numerous ICU patients, many of whom had TERMINAL illnesses. If you don't believe me get the Institute of Health's publication and read how they got that statistic. I did. It's just sensational Journalism. That's not to say however that you don't want to stay away from Interns in July. That is a good idea.
Reply
10-01-2009 @ 9:31AM
Jay said...
BULL The AMA Stats tell the story. The say the number is well over 200,000 deaths per year from hospital mistakes.
10-01-2009 @ 10:57AM
Tom said...
You may want to look at the figures that Ralph Nader gave before a Congressional hearing concerned with these facts in 1993. The hospital kill numbers were higher at that time and he compared to the numbers to Viet- nam where soldiers were being killed by guns, tanks etc. The numbers were lower in Viet-nam on a yearly basis but we do not have the picket signs at Washington etc. and focused jounalism on this problem. Thank you Daniel Solin for having the fortitude to bring this to the open.
10-02-2009 @ 12:54AM
heather said...
you apparently must work in a hospital, because why would you defend it?
10-01-2009 @ 11:34AM
Michelle said...
I had a botched operation that could have been prevented, almosted died from internal bleeding, the hospital kept saying, I was fine, that it was just bruising. It was more than just bruising, I was dying and knew it, so we fired the hospital and the surgeron in charge of my care and went to another hospital.
They confirmed I was bleeding internally and I had lost so much blood, that I was with-in 10 hours of being dead. Best drug I have ever had in my life is someone elses blood, but I don't recommend doing anything to need it.
This type of stuff happens all the time, more that I knew when it happened to me. But I know better now. I got a second opinion before I had the surgery, but didn't check the rates of failure of the surgeron I was referred to. I know how to do that now, and before I ever have surgery again, that will be checked.
A surgery that should have had me back on my feet in 3 days, took me over a year to recover from physically. Too bad, this experience has made me fear doctors.
10-01-2009 @ 1:37PM
joann said...
until it happens to you, hopefully you will live to talk about the nonsense you spew.
10-01-2009 @ 1:42PM
Kolleen said...
Interesting. I understand writers want their articles published and for people to be interested in them, but to be misleading is just wrong. Readers want to be informed, but what is the point when the information is not accurate?
10-01-2009 @ 1:44PM
JoAnn said...
The article is accurate, things do go wrong, no one is perfect, and having someone with you is the best and most important thing you can do.
There are some people who are not lucky enough to be reading this article today because they died in a hospital due to lack of care.
10-01-2009 @ 4:32PM
Dang, king of the Chinese hillbillies said...
AMA? Nader? Are you people fucking high? Let's try getting our stats from someone without a political axe to grind.
Of the myriad reasons hospital infections are on the rise, somewhere near the top has to be over-regulation. I've been in healthcare for 21 years and as those years have passed there have been ever more hoops to jump through, care has become more costly, and insurance companies and regulatory agencies have become steadily more intrusive about the work we do. Our paperwork is ever-increasing, we're filling out forms to document that we've filled out forms, for Pete's sake. These many factors have combined to increase (needlessly, IMO) the cost of care, and the braniacs that run the hospitals have decided that cutting primary care staff is the "best" way to reduce the cost of care. Fewer staff for the same work means everyone runs all day, staff become stressed and tired, things are missed, and I mean things that require attention to detail- like infection control. Personally I'm sick to fucking death of it, so I'm hanging up my stethoscope.
10-01-2009 @ 5:31PM
wild irish rose said...
Kolleen 710-01-2009 @ 1:42PM, how about letting us know what your "accurate" info is, and where you obtained it? It's so easy to criticize without backing yourself up.
10-01-2009 @ 7:31AM
Lilly said...
Strories like these are why people are so anxious to sue their Dr.s. Which is part of the whole health care problem. Malpractice insurance is getting to be a rediculous levels and I should know, I married one and pay the bill. I worked in a VA hospital for years that was associated with a university. These interns are not just thrown to the wolves and expected to perform. They are monitored and work a long side of their fellow residents, chiefs and program directors. "Do no harm", it's in their oath and they take it seriously people. Obama saying tht doctors puposely don't treat diabetics so the surgeon, who by the way is a totally different doctor than the Dr. treating the diabetes, was RECKLESS and DAFAMATORY.
Reply
10-01-2009 @ 8:52AM
kathy said...
Being a nurse for over 30 years, I have seen ,more than you can imagine, doctor errors! This story is not fabricated. Doctors cover up for other doctors. When incidents are reported by nurses, it is swept under the rug. I have seen doctors come in completly drunk. I have had to get them away from the bedside, before the families could smell them.
One anesthesiologist told a joke in the OR, and forgot to look at his patient. She had brain death because of his negligence. This doctor is still practicing.
Get a patient advocate before you let any doctor preform any procedure on you.
10-01-2009 @ 12:12PM
gennie said...
I just hate people who do the spell check thing. However, you said you worked along side (although you spelled it
a long side) doctors for years. Then after telling myself that even an R.N. could make a typo, you spelled Defamatory incorrectly!! I doubt that you did the type work you described and I doubt even more that you married a doctor!
10-01-2009 @ 1:21PM
Dave said...
Hey Lilly, Stories like these are not what is making people sue doctors! Stupid, avoidable, life changing errors by medical "professionals" is whay makes people sue and that is what insurance is for. I am so tired of this right wing talking point that what is wrong with health care is mal practice insurance and lawsuits. Fix the root causes of mal practice and the cost of insurance will go down as there will not be reason for the lawsuits. If it is you or a loved one that is a victim of malpractice I would bet the farm that you would not say "oh well its too bad."
10-02-2009 @ 5:00PM
Dr. Karen said...
Do not limit your choice of anesthesia providers to MDs. Certified registered nurse anesthetists (CRNAs) have been providing anesthesia care for over 100 years, far longer than physicians. These are RNs who hold graduate degrees and have completed an extensive educational program in anesthesia after gaining competence as critical care nurses. CRNAs provide most of the anesthesia care in the US. Research clearly demonstrates that the care they provide is effective and safe. Do not allow physicians to intimidate you with untrue tales of anesthesia horrors.
Reply
10-01-2009 @ 10:06AM
bob said...
CRNA's have only 6 years of post high school education on average. MD anesthesiologists have 12. Also most states have laws requiring that CRNAs are supervised by physicians but Bill Clintons mother was a CRNA and he removed that requirement for Medicare patients the last week he was in office so beware, especially in small rural hospitals.
10-01-2009 @ 10:22AM
Carol said...
I would rather have an experienced CRNA doing my anesthesia over many of the anesthesiologists that I have seen through my years as an RN.
10-01-2009 @ 10:24AM
AV said...
Dr.Karen, That is so true! Out of my six kids, I had five epidurals placed by different CRNAs that were perfectly placed and numbed everything. I had one epidural placed by a MD which totally screwed up my back! The first placement he did missed the epidural space and he still pushed all the meds into my back. He destroyed multiple nerves in my lower back and I still have pain from it over five years later. Now I have to see another MD three times a year to get steroid shots in my spine.
10-01-2009 @ 11:55AM
Mike said...
Hm. Yeah, MDs might have more schooling, but that's sort of like saying a certified automotive engineer would be a better choice to fix your car than an ASE certified mechanic because the engineer has more years of education. When it comes to someone pushing a needle into my veins, I don't care how many years you sat in a classroom learning the theories behind multiple subjects - I want someone with some practical, hands-on experience.
10-01-2009 @ 11:55AM
Victoria said...
Amen Karen! BTW, Since MD's count their years in residency into their education, then CRNA's can count their years of experience as Critical Care Nurses which is where we get a huge amount of our valued experience!
That means that we have an average of 8-10 years of education, and not 6! IN ADDITION, MD's focus a heck of a lot of time learning the in's and out's of all aspects of medicine whereas, CRNA's are learning relevant information for a solid 8-10 years!
I would choose a CRNA anyday, studies (originally done by the AMA in an effort to attack the capabilities of CRNA's) actually backfired when they showed that CRNAs had better surgical outcomes on average when compared to MD's.
Look for Anesthesiologists to be phased out over the next 10 years, insurance companies and hospitals can't justify paying them to do the same job as CRNA's for way more money!