Conscience?

What happens if your doctor feels that you are morally bankrupt? We under federal rules she may not be required to refer you for proper care. In this case the rules are specifically about reproductive care.

So what should you do?
1) If you even contemplate that you might need reproductive services- contraceptives, emergency contraceptives, abortion services or information then ask at the very first visit. More important, ask before the start of the doctor’s history. Don’t even let her start (the reason in a minute).

2) If you and your doctor are incongruent on the provision of these services leave imediately. Don’t think about it, just leave.

3) Here’s the reason you do this first. Because you cannot be charged for services the doctor does not render,. Therefore you cannot be charged for a history and physical if the doctor does not complete one. Othert charges may be appropriate but the $350 history and compete physical will not be.

4) Once you leave, phone your insurance carrier and tell the service rep the story. Make sure you get everyone’s name with whom you speak.

It’s your health. Take charge and take care.

Nursing Shortage

One of the questions you should ask (read, must ask) when you check out a hospital is “What is the nurse-to-patient ratio?” Hospitals across the country are suffering under nurse shortages. Actually, that’s not quite true. Patients suffer from nursing shortages. Hospitals, especially administrators whose compensation is tied to year-end profit love nursing shortages. The reason? Simple, a full bed brings in revenue. If there are fewer nurses to care for the patients then the bed brings in the same revenue at a lower cost.

What does this mean for you- you want a hospital with the highest nurse to patient ratio. You should also check to see what percentage of nurses are “agency” nurses or “travelers.” These “rented” nurses are often very good and they allow a hospital to have flexible staffing at a lower overhead and less long-term employment committment. But if rental nurse percentage is too high then it may be a sign that the hosital is underpaying and therefore only attracting inferior nurses to permanent positions. Inferior nurses equal inferior nursing care. Don’t forget your nurse is the first person who will assess you if you become acutely worse while in the hospital.

So, what should you do?
1) Ask what percentage of nurses, by shift, are hospital employees as opposed to “contract” or “rental.” Ask specifically about the ward to which you will be admitted.

2) Ask if the CEO or other administrative staff is paid a bonus based on hospital profits. This means that administrators have a financial incentive to keep nursing costs down.

3) Ask how long the average nurse has been at the hospital. Be careful to have them exclude nursing administrators.

It’s your health. Take charge and take care.