Wednesday, April 28, 2010
A New Form of Health Care
A New Form of Health Care
From the beginning of time there has always been a form of a health care system or those who have cared for the very sick, the week and disable. Through out time, men and women worked, treated and studied with a common goal to develop there knowledge in what we know today as Health Care.
I presently work in health care and have for the last 28 years as a Surgical Technologist. Primary in the field of Neuro Surgery and now all services of the operating room.
When I started DRG's were coming into light. I can remember how all of us shuttered and mumble about how conflicting this was going to be when taking care of a patient.I mean lets face it"We are going to get paid what?"and " I can no longer do it this way"? Yes that was just the beginning!The computer had just crept into our operating room as well as the rest of our Hospital so our sleepy little Hospital was now shaken to wake and discover that medicine was at its turning point and change was on the horizon
Back in 1982 Congress decided that hospital base in-patience would only receive a certain amount for what the procedure would actually cost. So codes were invented to help in the aid to determine what a hospital would be paid and for the amount of time a patient would be allowed to stay. For example it used to be that a patient having a surgery for a brain tumor the patient would have to be admitted 24 hours before surgery or in some cases even earlier. Now most of not all Brain Tumors are day of surgery admits or what we call Am admissions. I remember on one of our Brain Tumors I was mumbling to myself that how on earth are our patients ever going to be ready for such a surgery this is crazy! Now it is the norm.
Doctors are now having less and less say on how their patents care can be administered and the length of there stay in hospitals. Yes this is a double edge sword why because there are patients that do not need to have 24 hour admits prior to there surgery's and there length of stays have been reduced by reimbursements thus pressing forward with the birth of the Surgery Centers. No longer does a patient have to have there Gallbladder out by a open procedure most if not all Gallbladders are done Laperscoptic and going home that day.Only the few are having a longer stay and trust me it has to be explain and documented for hospitals to be reimbursed for such cases
Now that DRG's are here to stay lets talk about Medicare. Insurance by the government for our senior citizens. Now this can be a controversial l topic epically in states that are largely populated with senior citizens. Hospital and Doctors across the nation have suffered major cut backs Thus cousing significant changes in how health care is being govern. For example, A patient goes into a hospital who is of medicare age and has to have a Total Hip or Knee. Medicare will only reimburse a hospital for the entire procedure lets say 5,000 when in reality it has cost the hospital more money with the stay and cost of supply for the surgery and The actual implant that the patient receives is very costly for a hospital to purchase. But Medicare will only pay a small amount so it has forced hospitals to make the company that supply the implants to reduce their fees or so to speak go with the lowest bidder.Thus forcing Doctors to possible use a implant from company that they are not comfortable with.
There has been a change in Health Care that has sawed away at the spirit and core of Health Care today.
The most costly item to a Hospital is a Employee. Why? Because Nurses, Technician and other staff are paid in benefits as well as a salary and this becomes a burden to a Hospital.
Hospitals are now forced to higher PDM staff which is not committed on either side to work a 40 Hr week and has no benefits.
Hospitals are forced to cut staff to the bare minim which can cause a impact on patient care. Nurses are forced to work with less and have more patient load. This follows suit with management as well. It use to be that you had a charge nurse and a director now you have several charge nurses and a director over several departments.
Now with the most recent cut back Doctors across the nation are starting to stand up and speak out and with our new Health Care reform this has everyone in a tail spin. Everyday I here topics on this Health Care and how terrible medicine is going to be . Well on some parts I have to agree. Why? How I see it is, Government Insurance Company's and Drug company has forced Health Care to become Big Business. Hospitals are popping up everywhere and are no longer community base Some have become Private cooperation's.Community Hospital are now Medical Center. And More and more Doctors are becoming employees of a Hospital or Medical Center and have less say on how they are going to be able to practice So the Marcus Welbie M.D does not exists.
Health Care has been a heavy topic for a very long time at least strongly for the past 16 years every President is trying to make it better But are they? I do say that Health Care Givers have had a chance in the past to change health care but there Insurance company and drug company and Hospital were making money and lets not forget the Lawyers. So only a few saw the future and they had not the power to make a change.
I think that anytime Government has to step in there are problems and not everything is thought out. So what about Socialize Medicine? Now that is a hot topic among many Doctors. Don't we have a form of it now? Lets brake it down We have DRG'S Medicare and one more Medicate. This is state govern which is reimbursed by the government. Each state is awarded so much moneys for there indigent care. The largest is Women's Health. Yep Having Baby's. Women's Health is one of the larges and most costly in Indigent care. Why is that? Well Lawyers!! I once was able to sit in a court room and watch a trial which involved a bad baby. All the Lawyer had to do was bring that baby into the court room and walk this child in front of the jury and presto a huge check was written to the family even though everything was done correctly it doesn't matter a bad baby was born and it became the Doctors and hospital fault.
Woman's Health can and be the most dangerous of all in the indigent care not all patients register with there local health care provider to get medicate and if they do they don't always show up for their appointments. Some have drug and achole problems and very poor health in general so they are very high risk And lets not for get the many teen pregnancies . Most Doctors that work in this setting are employees of Hospitals and those that are receive a salary from the hospital but there are some that are not and volunteer their time and services for a clinic or Health Department and are paid a small amount from the government or state for this. Hospitals that have Doctors for W omen's health pay a high cost for their Medical Mal Practice. Which brings back to lawyers Hmm I wonder why government has not placed any control on court room drama.
So many changes have happened and many are about to happen the days of hands on patient care seem less and less and Nurses and Doctors are working harder and longer and with sicker patients.and little rewards we should be a lot further with our cures and less worrying about who's going to make money as I have found and believed greed as put us at a stand still. and such deceases as diabetes and cancer are still on the top of no cure list but have made fortunes for the drug company's however we always seem to be hearing we are so close but never seem to cross over for a cure. Sometimes I have to wonder?
With everything that I have discussed in hopes that you have a greater understanding of your Health Care provider and have patience and understanding of what we are faced with.
I still today great my patience with compassion. And respect my patient for what they are going through knowing that I have and will delivered the best form of Health Care that I am allowed to do.