A hospital is driven by the goal of saving lives. It can range in size and service from a small unit providing general care and low-risk treatments to large specialty centers offering dramatic and experimental therapies. Your choice of hospital may be limited by factors beyond your control, including insurance coverage, your doctor’s hospital affiliation, and the type of care available.
Before entering a hospital, you need to know the possible dangers. Well-known hospital hazards are unnecessary operations, unexpected reactions to medications, harmful or even fatal gaffes, and terminal hospital infections. The Institute of Medicine recently identified three areas in which the healthcare system, in general, and hospitals and their staff, in particular, often fall short: use of unnecessary or inappropriate care (too much antibiotics), under-used of care effective (too few vaccinations or Pap tests) and deficiencies in technical and interpersonal skills. The greatest danger posed by a hospital is infection, which is largely preventable.
What can lay people do to ensure proper and safe care while in the hospital? The following guidelines should be observed.
If you have a choice of hospitals, ask about their accreditation status. Hospitals are subject to inspection to make sure they meet federal standards. Policies implemented in 1989 require disclosure of information upon request to state health departments regarding a hospital’s death rate, its accreditation status, and its major deficiencies.
Before checking into a hospital, you need to decide on your accommodation. Do you want to pay extra for a single room? Do you want a non-smoker for a roommate? Do you need a special diet? Do you need a place to store refrigerated medications? If someone is staying with you, will you need a crib? You should try to avoid going on a weekend when few procedures are performed. When you get to your room, you should speak up immediately if it is unacceptable.
You must be familiar with your rights as a patient. Hospitals must provide an informational brochure that includes a Patient Bill of Rights. The brochure will inform you that you have the right to considerate and respectful care; information about tests, medications and procedures; dignity; courtesy; respect; and the opportunity to make decisions, including when to leave the hospital.
You must make informed decisions. Before authorizing any procedure, patients must be informed of their medical condition, treatment options, expected risks, prognosis of the condition, and the name of the person in charge of treatment. This is called informed consent. The only cases in which hospitals are not required to obtain informed consent are cases involving life-threatening emergencies, unconscious patients when no family members are present, and / or compliance with the law or a court order, such as examination for illnesses. sexually transmitted. If you are asked to sign a consent form, you must read it first. If you want more information, you should ask before signing. If you are skeptical, you have the right to postpone the procedure and discuss it with your doctor.
Authorization for a medical procedure can be given non-verbally, such as an appearance at a doctor’s office for treatment, cooperation during the administration of tests, or lack of objection when consent can be easily refused. This is called implicit consent.
You must weigh the risks of drug therapy, x-ray exams, and laboratory tests against the expected benefits. When ordering tests or treatments, you should ask about their purpose, possible risks, and possible actions if a test finds something wrong. For example, the injection or ingestion of X-ray dyes makes body structures more visible and greatly facilitates the physician’s ability to make a correct diagnosis. However, dyes can cause an allergic reaction ranging from a skin rash to circulatory collapse and death. Lastly, you should educate yourself on prescription drugs. You should avoid taking medications, including pain relievers and sleep aids, unless you are confident of their benefits and are aware of their dangers.
When you are scheduled for surgery, prepare for anesthesia. In rare cases, general anesthesia can cause brain damage and death. One of the causes of such catastrophes is vomiting while unconscious. To reduce your risk, refuse any food or drink that may be offered to you by mistake within 8 hours of surgery.
You need to know who is in charge of your care and record the office number and when you can expect a visit. If your doctor is transferring your care to someone else, you need to know who it is. If your doctor is not available and you don’t know what’s going on, you can ask for the nurse in charge of your case.
You should keep a daily record of procedures, medications, and doctor visits. When you receive your invoice, check each item against your written record. Insist on an itemized invoice.
You must be active within the limits of your medical problem. Many bodily functions begin to be affected by just a few days of inactivity. Moving, walking, bending, and contracting muscles help to eliminate bodily fluids, reduce the risk of infections (especially in the lungs), and cope with the stress of hospital procedures that add to the depression and discomfort of hospitalization.
You should be alert. During your stay, you can keep asking questions until you know everything you need to know. According to some experts, the biggest improvement in health care has not been technological advances; have been patients asking questions. The more questions, the fewer errors and the more power patients have in the doctor-patient relationship.
Selecting a healthcare professional
Choosing a doctor for your general medical care is an important and necessary duty. Only physicians are discussed here, but this information applies to the selection of all healthcare professionals. You should select one that listens carefully to your problems and diagnoses them accurately. At the same time, you need a doctor who can lead you through the modern medical maze of technology and specialists.
For most people, good health care means having a primary care physician, a professional to assist you as you take responsibility for your overall health and guide you when specialized care is needed. Your primary care physician should be familiar with your complete medical history, as well as your home, work, and other settings. You are best understood in periods of illness when your doctor sees you during periods of well-being as well. However, finding a primary care physician can be difficult. Of the 700,000 physicians in the United States, only 200,000 (less than 30%) are in primary care.
For adults, primary care physicians are often family physicians, formerly called “general practitioners,” and internists, specialists in internal medicine. Pediatricians often act as primary care physicians for children. Obstetricians and gynecologists, who specialize in pregnancy, childbirth, and diseases of the female reproductive system, often serve as primary care physicians for women. In some places, general surgeons may offer primary care in addition to the surgery they perform. Some osteopathic physicians also practice family medicine. A doctor of osteopathy (DO) emphasizes manipulation of the body to treat symptoms.
There are several sources of information for the names of doctors in your area:
State and local medical societies can identify physicians by specialty and provide you with the basic credentials of a physician. You need to verify the doctor’s hospital affiliation and make sure the hospital is accredited. Another sign of prestige is the type of societies to which the doctor belongs. A surgeon’s qualifications, for example, are enhanced by a scholarship to the American College of Surgeons (abbreviated as FACS after the surgeon’s name). An internist fellowship at the American College of Physicians is abbreviated F ACP. Membership in academies indicates the special interest of a physician.
All board certified physicians in the United States are listed in the American Medical Directory published by the American Medical Association and are available from larger libraries. About a quarter of practicing physicians in the United States are not board certified. This may mean that a doctor failed the exam, never completed the training, or is incompetent. It could also mean that the doctor just hasn’t done the exam.
The American Board of Medical Specialists (ABMS) publishes the Compendium of Certified Medical Specialties, which lists physicians by name, specialty, and location. Pharmacists can be asked to recommend names.
Hospitals can provide you with the names of staff physicians who also practice in the community.
Local medical schools can identify faculty members who also practice privately.
Many colleges and universities have health centers that maintain a list of physicians for student referral.
Friends may have recommendations, but you should consider the possibility that their opinion of the doctor is different.
Once you have identified a lead candidate, you can schedule an appointment. You should check with office staff about hours of operation, availability of emergency care at night or on weekends, back-up physicians, procedures when calling for advice, hospital affiliation, and the procedure for payment and insurance. Once you’ve seen your doctor, reflect on the following: Did the doctor seem to be listening to you? Were your questions answered? Was a medical history taken? Were you informed of the possible side effects of the medications or tests? Was respect shown for your need for privacy? Was the doctor open to the suggestion of a second opinion?