I think you were very patient....4 hours waiting for an ambulance? They initially told you "shortly".... after 30 minutes I would have asked for an estimate. At one hour I would have become very upset, and by 90 minutes would haev called 911 to get another ambulance to pick us up there. Luckily he was fine, but you didn't know that at the time and it could have been really bad. I would not have gone into a taxi though.
4
that was really very funny. I mean, sad but funny. Glad Herb made it or it wouldn't have been funny at all.
5
If only it had been Christine Quinn's appendix instead of poor Herb's.
4
Worth reading/knowing about this. I would not have thought of the private ambulance either. Perhaps asking how your friend was coded in the ER would have told you that a 4-hour wait was entirely possible? I don't know, and it's not a pleasant feeling.
3
Couldn't be more delighted to have Joyce Wadler back!!!
12
Worst health care money can buy. It's the insurance, stupid. Hospitals are merging, we treat social problems in sophisticated ERs, someone named Carol at an insurance conglomerate involves 20 people to slow down the process of admissions so they and the receiving hospital make as much money as possible.
10
I accompanied a friend to Duke University's hospital because he was having chest pain. They saw him immediately and determined he was not having a heart attack but did have a non-life-threatening arrythmia. They told him he had to wait in the waiting room until a doctor was able to see him. We found out that some people had been waiting 8 hours because every time a seriously ill person arrived, he or she "jumped" the queue. Many people waiting should not have been in an ER; some were there for upper respiratory infections. Hospital ERs need to to establish an urgent care section and a primary care section to which those not in an emergency status can be referred. This will free staff time to care for the true emergencies in a timely fashion.
9
So happy Joyce is back.
7
em,
Ms. Wadler, I am an ED physician. Let me ask you this:
If you had been on Omaha Beach in 1944, and had free rein (as family and friends do in today’s ED), would you have gone around, constantly confronting GI Joe, peppering him with questions and statements like: “How much longer is this going to take?; “Why aren’t things going according to plan?”; “Why isn’t the transporter truck on the beach yet?”; “Don’t you think that part of beach over there is more crucial than the part you are working on over here?”; “I demand that you stop what you are doing and call General Eisenhower now and ask him why securing this beach is taking so long”; and “I’m not happy with the way you are doing your job, I’m going to complain to my senator”.
If GI Joe had been confronted by an onslaught of civilians constantly interrupting him, criticizing his competence, holding him accountable for things over which he had no control, complaining about how long it was taking even while the complaint itself contributed to the delay, do you think we would have overcome the German defenses? Do you think we would have won the day?
Miss Wadler, for us in the trenches, it is Omaha Beach – every day. The difference is GI Joe did not have civilians in his face all the time constantly thwarting his efforts to do the impossible
Ms. Wadler, I am an ED physician. Let me ask you this:
If you had been on Omaha Beach in 1944, and had free rein (as family and friends do in today’s ED), would you have gone around, constantly confronting GI Joe, peppering him with questions and statements like: “How much longer is this going to take?; “Why aren’t things going according to plan?”; “Why isn’t the transporter truck on the beach yet?”; “Don’t you think that part of beach over there is more crucial than the part you are working on over here?”; “I demand that you stop what you are doing and call General Eisenhower now and ask him why securing this beach is taking so long”; and “I’m not happy with the way you are doing your job, I’m going to complain to my senator”.
If GI Joe had been confronted by an onslaught of civilians constantly interrupting him, criticizing his competence, holding him accountable for things over which he had no control, complaining about how long it was taking even while the complaint itself contributed to the delay, do you think we would have overcome the German defenses? Do you think we would have won the day?
Miss Wadler, for us in the trenches, it is Omaha Beach – every day. The difference is GI Joe did not have civilians in his face all the time constantly thwarting his efforts to do the impossible
14
You've missed the point. You think it is all about the exalted doctor and - it is NOT - it is all about the patient.
Other people got the point; it is an EMERGENCY - this hospital doesn't do emergencies - the patient should have called 911, and so should the proxy fairy. And so should that so-called hospital and its "doctor" have called 911 as they did not have the facilities. Where are the grown ups???
911 folks, for EMERGENCIES!
Just imagine; the appendix burst and the hospital is yawning and waiting for doctor-worship instead. "Oh just keep that patient quiet he keeps asking for treatment - doesn't he know we don't do treatment here?
Other people got the point; it is an EMERGENCY - this hospital doesn't do emergencies - the patient should have called 911, and so should the proxy fairy. And so should that so-called hospital and its "doctor" have called 911 as they did not have the facilities. Where are the grown ups???
911 folks, for EMERGENCIES!
Just imagine; the appendix burst and the hospital is yawning and waiting for doctor-worship instead. "Oh just keep that patient quiet he keeps asking for treatment - doesn't he know we don't do treatment here?
18
Certainly Dr you are doing your best, but I hope in your ER, patients are not dying in droves like the Omaha Beach GI Joes did. Or are they? Maybe your hospital should put up a giant billboard informing would be sick customers of the wait times and divert them to more efficient and appropriately staffed ERs.
10
Well said on behalf of the many doctors who are racing around, doing their well-trained, earnest best under difficult conditions.
But em must be aware of the silly and antiquated procedures (waking ill patients repeatedly from sleep to do tests because a doctor prefers to conduct rounds in the early morning), lax process controls (turning off 'inconvenient' monitors, refusing surgical checklists and enforcement of basic hygiene, from clean scrubs to washed hands to coffee in the OR) and apathetic support staff that kill tens of thousands of patients each year.
You want less oversight from patients? Then admit the readily observable problems and start fixing them yourselves, the way anesthesiologists did 30 years ago.
But em must be aware of the silly and antiquated procedures (waking ill patients repeatedly from sleep to do tests because a doctor prefers to conduct rounds in the early morning), lax process controls (turning off 'inconvenient' monitors, refusing surgical checklists and enforcement of basic hygiene, from clean scrubs to washed hands to coffee in the OR) and apathetic support staff that kill tens of thousands of patients each year.
You want less oversight from patients? Then admit the readily observable problems and start fixing them yourselves, the way anesthesiologists did 30 years ago.
7
Another triumph of the Manhattan NIMBY's!
St Vincent's was very clear: they needed to build above the hospital or they would go bankrupt.
The NIMBY's had their way and now, like the little kids they are, they are all screaming "Where did my emergency room go, Mom?".
70 blocks uptown, apparently.
St Vincent's was very clear: they needed to build above the hospital or they would go bankrupt.
The NIMBY's had their way and now, like the little kids they are, they are all screaming "Where did my emergency room go, Mom?".
70 blocks uptown, apparently.
17
I'm so glad you're back, Joyce. And as you so often do, you identify a real problem amid the humor. Though I am more likely to need a Super Proxy than to be one, I'm taking this lesson to heart. I'm glad your friend is better and I'm looking forward to lots more columns.
8
Welcome back Joyce!
6
Urgent Care in Greenwich Village, Manhattan, NY - The website Yelp actually has consumer reviews of urgent/emergency care centers in Greenwich Village. Based on the author's description of distance from the site in The Village to the Hospital you can most likely deduce the organization and facilities. The best course of action in this case and certainly for a 74 year old already on morphine apparently for another ailment would have been to call 911. The paramedics in mobile consultation with a physician at a hospital would have most likely diagnosed the appendix issue and would have taken the patient to a hospital emergency room where "hopefully" his condition would have addressed immediately. An alternative to having to wait a total of 12 hours before being transported would have been to threaten to call 911 or leave the facility and then call 911.
17
I know a man who had a stroke in his car. His wife drove to a nearby emergency medical center that advertised they had a neurologist. This was in the middle of the day on a workday. It turned out that there was no neurologist. With a stroke there is a window several hours for treatment. Because there was no neurologist they missed the window. He ended up able to move his eyes but nothing else.
11
Instead of going to what's left of St Vincent's your friend should have told the cab to take him to Beth Israel on the East Side @ 16th St. Or better yet, have called 911 and let the EMT's make the decision for him.
Without surgical rooms you can't designate a facility as an "Emergency" facility, it's an Immediate Care clinic at best, and there are other hospitals closer than 70 blocks from the West Village.
Without surgical rooms you can't designate a facility as an "Emergency" facility, it's an Immediate Care clinic at best, and there are other hospitals closer than 70 blocks from the West Village.
12
I'm reading this from my hospital bed in Toronto, Canada following a stroke st age 50, and I send my sympathies.
But once again I'm forced to reflect upon the fact that the self proclaimed "best nation on earth" has far from the best healthcare on earth for all citizens. It not only should; it realistically could.
My healthcare was awesome. I was in the hospital and being treated within 20 minutes, walking in 2 days and have made a full recovery. My total bill for 16 days in hospital including all tests, rehab and prescription medicines will be ZERO dollars. It's a right of citizenship here.
True universal healthcare is most efficient, significant lower cost (it consumes 9% of our GDP for all citizens vs 14% of your GDP, I believe, pre-Obama Care) and supremely effective.
There is a better way: just raise your eyes and look north.
But once again I'm forced to reflect upon the fact that the self proclaimed "best nation on earth" has far from the best healthcare on earth for all citizens. It not only should; it realistically could.
My healthcare was awesome. I was in the hospital and being treated within 20 minutes, walking in 2 days and have made a full recovery. My total bill for 16 days in hospital including all tests, rehab and prescription medicines will be ZERO dollars. It's a right of citizenship here.
True universal healthcare is most efficient, significant lower cost (it consumes 9% of our GDP for all citizens vs 14% of your GDP, I believe, pre-Obama Care) and supremely effective.
There is a better way: just raise your eyes and look north.
64
Agreed; I'm heart-sick of reading Americans' man-made troubles with their own health care, and the unbelievable road-blocks to getting care and getting better that then end with selling the house to pay for it all.
Americans will not listen to us, nor believe us; they believe Fox news' lies. The truth is that we are so lucky because we had Social Credit Tommy Douglas to do this for us back in the fifties; socialist ideas are what are needed to bring equality to us all.
Americans will not listen to us, nor believe us; they believe Fox news' lies. The truth is that we are so lucky because we had Social Credit Tommy Douglas to do this for us back in the fifties; socialist ideas are what are needed to bring equality to us all.
6
Americans and Canadians: Call 911. Please call 911.
Let's try it again: CALL 911. It could save your life. I worked in the Level 1 trauma center that serves 25% of the US land mass and I have seen the difference between calling 911 and going at it on their own.
All I can say is when I'm in Blaine, or Port Angeles, or San Juan Island, I look north and am jealous of the healthcare of the land I see that looks just like my country (and we might have been in the same country if not for Wilhelm I and a few earlier treaties). And what we have in central Puget Sound is pretty good (I understand) but the whole billing and cost structure (which can also be blamed on the state Insurance Commission--like facility charges separate from the cost of the procedure or care--what a crock!) defies reason.
Single Payer.
Let's try it again: CALL 911. It could save your life. I worked in the Level 1 trauma center that serves 25% of the US land mass and I have seen the difference between calling 911 and going at it on their own.
All I can say is when I'm in Blaine, or Port Angeles, or San Juan Island, I look north and am jealous of the healthcare of the land I see that looks just like my country (and we might have been in the same country if not for Wilhelm I and a few earlier treaties). And what we have in central Puget Sound is pretty good (I understand) but the whole billing and cost structure (which can also be blamed on the state Insurance Commission--like facility charges separate from the cost of the procedure or care--what a crock!) defies reason.
Single Payer.
5
It was inconvenient that the ambulance did not arrive when expected, but it sounds like Herb's appendix had already burst and he was receiving appropriate antibiotics and monitoring. From a consumer's standpoint I can understand how the delay in transfer to the hospital would be frustrating. But from a medical standpoint, it doesn't sound like this qualifies as bad medical care. There is no evidence that performing his surgery immediately would have been superior to performing his surgery a few hours later.
Putting him in a cab (without any medical monitoring available) would have absolutely been the wrong thing to do.
Also, I'm not sure that you can cite the letter of apology from the ER as proof of error. The ER was likely forced to issue an apology (whether they thought they were at fault or not) when they received an angry letter from a columnist from the NY times. (In this instance, NY times = yelp on steroids)
Putting him in a cab (without any medical monitoring available) would have absolutely been the wrong thing to do.
Also, I'm not sure that you can cite the letter of apology from the ER as proof of error. The ER was likely forced to issue an apology (whether they thought they were at fault or not) when they received an angry letter from a columnist from the NY times. (In this instance, NY times = yelp on steroids)
6
EK,
I was not writing this column when this happened this past November -- nor would I use the name of any publication with which I was affiliated as leverage when making a complaint. It's a violation of journalism ethics. I identified myself as a New York Times columnist after I had decided to write about this in order to confirm and clarify some information and make sure that the center has an opportunity to address the case.
-- Joyce W.
I was not writing this column when this happened this past November -- nor would I use the name of any publication with which I was affiliated as leverage when making a complaint. It's a violation of journalism ethics. I identified myself as a New York Times columnist after I had decided to write about this in order to confirm and clarify some information and make sure that the center has an opportunity to address the case.
-- Joyce W.
13
I wish influential people like you would run their articles regarding medicinal humor by a doctor before posting it. While I understand that the predominant intent was humor, you ended up giving the wrong impression that the ER was very callous. The truth is that acute appendicitis is not an emergency (like a ruptured aneurysm), rather an urgency. (Now studies are showing that surgery may not be even necessary in all the cases).
The ER did everything right in their power. Now it would have been totally different if the patient did not receive antibiotics or IV fluids or it was managing trauma without having an adjoining operating room. Allowing him to go anywhere in a private cab would have been the worst thing to do!
As is evident by the comments, people waste no time in concluding that the hospitals are evil entities who couldn't care less about patients, largely due to one sided articles like these.
However, I did very much enjoy your writing style and look forward to reading more from you.
The ER did everything right in their power. Now it would have been totally different if the patient did not receive antibiotics or IV fluids or it was managing trauma without having an adjoining operating room. Allowing him to go anywhere in a private cab would have been the worst thing to do!
As is evident by the comments, people waste no time in concluding that the hospitals are evil entities who couldn't care less about patients, largely due to one sided articles like these.
However, I did very much enjoy your writing style and look forward to reading more from you.
4
Having watched a family member suffer a stroke from heroic efforts by a small hospital, we all now sign the do not resuscitate request when checking into a hospital. Due to a severe infection - came from riding my exercise bike too much with poor fitting shoes - I checked that block.
Later an attractive lady showed up in my room and offered to supply verbiage for that request - FOR A FEE!
Being very familiar - it now says DNR on your info sheet - they used to put a round green sticker on it - well I just howled. Out to make a buck - how American!
If you have a complex case, make certain that you get to a large teaching university hospital. Beware of 200 bed local hospitals, particularly if you have very good insurance. This happened to my brother and we had to get a SHOW CAUSE order from a judge to get him out of there.
Good insurance draws all kinds of miscreants who are after your resources and they put their mistakes in the morgue.
Later an attractive lady showed up in my room and offered to supply verbiage for that request - FOR A FEE!
Being very familiar - it now says DNR on your info sheet - they used to put a round green sticker on it - well I just howled. Out to make a buck - how American!
If you have a complex case, make certain that you get to a large teaching university hospital. Beware of 200 bed local hospitals, particularly if you have very good insurance. This happened to my brother and we had to get a SHOW CAUSE order from a judge to get him out of there.
Good insurance draws all kinds of miscreants who are after your resources and they put their mistakes in the morgue.
11
Welcome back, Joyce! Nice to see your byline again. Sorry about what happened to Herb & glad he pulled through.
7
People like you are why I don't practice in NYC.
7
Hi,
The delay was doing an oral contrast CT. Nobody does those anymore of appendicitis....
Humbug!
The delay was doing an oral contrast CT. Nobody does those anymore of appendicitis....
Humbug!
2
yes, we still do contrast CT's to diagnose acute appendicitis
1
i'm a general surgeon who understands the frustrations of a long stay in the emergency room - the system is imperfect, understaffing is the norm, and emergency rooms are generally overburdened. as a surgeon i have my frustrations too. when they consult me and i request a CT scan or certain tests, they almost always get done slower than i would like.
from an actual surgeon's perspective, i think your friend's appendix probably did not burst from the delay caused by the ambulance. it actually is very likely it had burst at home when his pain skyrocketed. the ER did the right thing by getting a CT scan - in your friend's age group appendicitis is on the differential, but so are a host of other completely differently treated conditions. studies have found that the time from onset of symptoms to getting antibiotics started may be the most important factor in whether the appendix ruptures or not.
that said, the visit could have been better. the ER staff could have explained these things to you better (it sounds like you never got a satisfactory explanation about what was going on) and the ambulance snafu shouldn't have happened. these are things hospitals and ERs are constantly actually working on, as a patient spending unnecessarily long hours in the ED not only is poor medical care and leads to unhappy patients, but also is detrimental to hospital revenue. hopefully little by little, they realize this and we can make things better together.
from an actual surgeon's perspective, i think your friend's appendix probably did not burst from the delay caused by the ambulance. it actually is very likely it had burst at home when his pain skyrocketed. the ER did the right thing by getting a CT scan - in your friend's age group appendicitis is on the differential, but so are a host of other completely differently treated conditions. studies have found that the time from onset of symptoms to getting antibiotics started may be the most important factor in whether the appendix ruptures or not.
that said, the visit could have been better. the ER staff could have explained these things to you better (it sounds like you never got a satisfactory explanation about what was going on) and the ambulance snafu shouldn't have happened. these are things hospitals and ERs are constantly actually working on, as a patient spending unnecessarily long hours in the ED not only is poor medical care and leads to unhappy patients, but also is detrimental to hospital revenue. hopefully little by little, they realize this and we can make things better together.
25
Read more closely. Joyce has stated that the surgeon thinks the burst appendix happened at home when he passed out from pain. I would like to know what were the possible commercial reasons for a delay in the ambulance? Follow the money. Could it be there was pressure to get an ambulance that would go to the affiliate hospital not another? One never knows.
3
The story says they determined that the appendix
The story already says it turns out that the appendix burst at home.
2
I have to confess I'm a little puzzled by this story. I thought a health care proxy only made decisions for a patient who could no longer make decisions for himself. It sounds like you weren't serving as a proxy in this case, but more as a supportive friend.
15
Joe,
I was both. The legal wording of my friend's health care proxy allows me to make any and all health care decisions which he could make "while competent and possessed of health care decision-making capacity." I don't know that anyone is thinking that clearly on morphine. The most important thing, however, was that I had papers that gave me legal standing had I needed to make a medical decision. If you're a spouse or relative you don't need legal papers. With friendships, you do.
I was both. The legal wording of my friend's health care proxy allows me to make any and all health care decisions which he could make "while competent and possessed of health care decision-making capacity." I don't know that anyone is thinking that clearly on morphine. The most important thing, however, was that I had papers that gave me legal standing had I needed to make a medical decision. If you're a spouse or relative you don't need legal papers. With friendships, you do.
41
Ms. Wadler is absolutely correct.
4
In case anyone hasn't noticed, our health care "system" in the US is a mess. Our "national health plan" happened with the EMTALA law in 1986. The law dictates that anyone can show up and be treated in any ER without regard to ability to pay. And as other parts of the health system get more and more broken each year, more and more patients go the ER for more and more things. They cannot legally be turned away, no matter if they belong in an ER or not. And another important detail, when our government passed this law, there was no funding attached to it to cover the cost of emergency care. Most ER's in this country loose tons of money. They are staffed with lots of highly qualified nurses, radiology personnel, doctors and support staff, 24 hours a day, 365 days a year. And the staffing levels reflect the low payment and the financial losses that providing emergency care entails. So when you go to the ER, expect to wait, a long time in many cases. This is how the system was designed, perhaps not intentionally, but that is our current reality. Our health care system needs reform, and we need to give patients options that keep non-emergencies out of the ER, so that the patients who truly need emergency care can access that care in a timely fashion.
56
That doesn't address the no ambulance for four hours issue.
22
Super Proxy? In my life, I'm Super Translator. "The Dr. said 'this'? 'This' is 'that'. 18 hours in the ER with your sister, who had a vasovagal episode? No, she didn't have a stroke. She never had a stroke. Stop saying that. She fainted. No need to be concerned, no life-long fear that it might happen again and be worse. She fainted, and out of an abundance of caution (and because you had insurance to bill) they did a bunch of lab work over 18 hours. Yes, they would do that. She's fine." Now if I could just get them all to believe me!
6
I think that the author was more Medical Advocate than just a Health Care Proxy. They really are two different things. But I can tell you that without a Medical Care Advocate - it doesn't matter if this is ones spouse, a child or a friend - one is not well served in an ER or even in an outpatient facility. When one is too ill to speak up for oneself, one is pushed aside and the wheel that is squeaking the loudest, gets the care.
Over the years, one learns which ER's to go to and which to avoid like the plague. Level One Trauma centers have people who often work the fastest, but one is shuttled aside when a gun shot would comes in - it's a real trade-off.
Over the years, one learns which ER's to go to and which to avoid like the plague. Level One Trauma centers have people who often work the fastest, but one is shuttled aside when a gun shot would comes in - it's a real trade-off.
24
I would have signed Herb out AMA (against medical advice), gotten him into a cab, and headed for Beth Israel or what used to be Beekman-Downtown Hospital (the name has changed so many times since then I don't know what it's called now). I recently went to the Lenox Hill ER (near my office) with a swollen and apparently infected arm. After spending seven and a half hours there, I was sent home with a prescription for an antibiotic. Two days later my arm was much worse. I went to the ER at New York Methodist Hospital (near my home), was immediately hooked up to an IV, and admitted. Two days later I had surgery and spent another 48 hours waiting for the path lab to culture the fluid that had been drained from my arm so that I could be sent home with a prescription for the appropriate antibiotic to target the specific bacterium. Go with your gut, or in this case, Herb's gut!
27
This thread is quite entertaining. I hope you all are voting for BERNIE! Our Health care system is fragmented and needs to be revamped on every level.
Joyce- Sounds like your friend ultimately did ok.
Ann- giving a trial of oral antibiotics before admission for IV antibiotics sounds like a good first step. We tend to only admit, after people fail treatment. Don't be upset about that.
And I wouldn't be hard on ER Staff- they speak the truth.
I have a lot more to say, but let's just say, there isn't an easy fix, but socializing education and health care is a good way to start...
Joyce- Sounds like your friend ultimately did ok.
Ann- giving a trial of oral antibiotics before admission for IV antibiotics sounds like a good first step. We tend to only admit, after people fail treatment. Don't be upset about that.
And I wouldn't be hard on ER Staff- they speak the truth.
I have a lot more to say, but let's just say, there isn't an easy fix, but socializing education and health care is a good way to start...
31
I understand Joyce's dilemma, Ann. When you're not a medical person, it is very difficult to know if going against medical advice is the right thing to do or might result in a catastrophe.
13
" it is very difficult to know if going against medical advice is the right thing to do or might result in a catastrophe."
I believe that going Against Medical Advice also voids any insurance coverage so it might well result in a catastrophe, a financial one.
I believe that going Against Medical Advice also voids any insurance coverage so it might well result in a catastrophe, a financial one.
7
Welcome back, Joyce. You've been missed. Looking forward to your next column.
26
Horror story with dollops of black humor about the lack of a real hospital in Greenwich Village since St. Vincent's closed six years ago. Then, as now, you can only wish that Mike Bloomberg would put his billions to work for real people and build a new one so that people like the victim in Joyce Wadler's story don't have to languish for 12 hours before being transported by ambulance to reach a real surgeon. Amazing he didn't die waiting.
37
So glad you are back, Joyce!!!!! I think Super Proxy would also have told Part of a Hospital where to put that letter of apology.
14
Dear Super Proxy:
Did you help Herb? Or did you just ask a lot of questions of medical personnel, creating further delays for other patients? If everybody had a Super Proxy would they all brawl in the hallway?
As a healthcare proxy, your “job” is to make decisions regarding care among the options offered and to sign paperwork expediting the legal consent process when a patient is unable to do so for themselves. That’s it.
Would you have preferred Herb went to another busier hospital, where he might have waited 6 hours to be seen? Do you think there was a room of idle surgeons with no cases in the AM, begging the heavens for an appendix to relive their boredom?
If Super Proxy really wants to fix the problem she’ll dive into a career in hospital admin. Or maybe just become the most competent ambulance transporter ever, the Jason Statham, of inter-hospital transfers.
Surgical delays are common. Herb is fortunate to live in New York City, where there are an abundance of hospitals with 24 hour specialty surgery coverage. If Herb lived in a critical access area, he would wait for an ambulance to take him two hours to a hospital with a surgeon. And Herb, at the end of the day would still be okay.
Your sarcasm isn’t humorous to us who actually help people survive. We have to deal with the crushing hospital bureaucracy every day. That all those people you met who you see as obstacles to care pull overtime they don’t need to help with understaffing – there are your heroes.
Did you help Herb? Or did you just ask a lot of questions of medical personnel, creating further delays for other patients? If everybody had a Super Proxy would they all brawl in the hallway?
As a healthcare proxy, your “job” is to make decisions regarding care among the options offered and to sign paperwork expediting the legal consent process when a patient is unable to do so for themselves. That’s it.
Would you have preferred Herb went to another busier hospital, where he might have waited 6 hours to be seen? Do you think there was a room of idle surgeons with no cases in the AM, begging the heavens for an appendix to relive their boredom?
If Super Proxy really wants to fix the problem she’ll dive into a career in hospital admin. Or maybe just become the most competent ambulance transporter ever, the Jason Statham, of inter-hospital transfers.
Surgical delays are common. Herb is fortunate to live in New York City, where there are an abundance of hospitals with 24 hour specialty surgery coverage. If Herb lived in a critical access area, he would wait for an ambulance to take him two hours to a hospital with a surgeon. And Herb, at the end of the day would still be okay.
Your sarcasm isn’t humorous to us who actually help people survive. We have to deal with the crushing hospital bureaucracy every day. That all those people you met who you see as obstacles to care pull overtime they don’t need to help with understaffing – there are your heroes.
59
My goodness, someone seems awfully defensive.
6
"I write to Part of a Hospital demanding an investigation, and Herb receives a letter of apology, saying this care was not in keeping with their standards of care."
Sorry your feelings are hurt, ER Staff, but you should read more carefully. Somebody screwed up.
Welcome back, Joyce.
Sorry your feelings are hurt, ER Staff, but you should read more carefully. Somebody screwed up.
Welcome back, Joyce.
14
After writing to the emergency facility to demand a root cause analysis of the case I was informed that they had re-educated the staff about the ambulance dispatch system so yes, I do like to think I helped.
47
Not that funny, but it is true to my experience of relating to America these days. Behind everything is a faceless and impenetrable bureaucracy. If you have a problem call the office of your Councilperson, Assemblyperson or Congressperson as appropriate. If it is urgent you are out of luck.
12
Wouldn't it be great if there was a business that did this sort of thing? Could we get insurance to pay for it, too? Next, we need "Super Billing Proxy" to make sure we are covered for services and fix the bill when it is inevitably incorrect.
21
I hope you filed a complaint with the NYS Department of Health so others don't have to suffer while waiting four hours for an ambulance. Inexcusable. The hospital should be held accountable. Here's the number of the NYS hotline:
800-804-5447.
800-804-5447.
63
Calm down. Although the standard strategy is to diagnose appendicitis and operate promptly, several randomized controlled trials show patients do fine with delay. Here's the latest trial showing that antibiotics alone are pretty good instead of surgery, and those who got antibiotics and later needed surgery did fine.
Antibiotic Therapy vs Appendectomy for Treatment of Uncomplicated Acute Appendicitis
JAMA June 16, 2015 Volume 313, Number 23, pg 2340
Have a little respect for hospital processes. Not everything which deviates from expectation is an error. Often things are allowed to deviate from optimal when it is known that there is little or no impact. When it comes to things where sub-optimal care makes critical differences, we usually try not to let those things deviate.
Antibiotic Therapy vs Appendectomy for Treatment of Uncomplicated Acute Appendicitis
JAMA June 16, 2015 Volume 313, Number 23, pg 2340
Have a little respect for hospital processes. Not everything which deviates from expectation is an error. Often things are allowed to deviate from optimal when it is known that there is little or no impact. When it comes to things where sub-optimal care makes critical differences, we usually try not to let those things deviate.
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Haha.
Next they will be complaining that the ER doctor was not enough good looking or that no one was having sex in the closet!!!!
No use quoting literature to someone who has the complaint hotline on speed dial!!
Next they will be complaining that the ER doctor was not enough good looking or that no one was having sex in the closet!!!!
No use quoting literature to someone who has the complaint hotline on speed dial!!
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What a great pleasure to see Joyce Wadler back at the Times with a bi-weekly column.Would that it were weekly as before.She has been sorely missed.
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Are you back? I thought you went away. Please say you're back?
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Thank you CML and all. I'm back.
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