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Hospitals across the country are facing the following issues and more:
– Nationwide nursing shortage.
– People using emergency rooms as their primary care provider.
– Homeless / elderly checking into hospitals for “free” room and board.
– Same staffing issues that employers are facing in every industry post Covid.While some issues are systemic, others reflect the populations the hospital serves.
the issues you raise affect many hospitals… good hospitals do a better job managing this than bad Hospitals
So, Yidden with medical degrees should go work in areas where Yidden live, and Yidden in areas where there are not enough doctors, should go get medical degrees.
A homeless/elderly person cannot simply check into a hospital unless they have a condition that warrants it. The hospital won’t get paid.
and in related items,
TSA screening wait times are long
Traffic jams are awful
Parking in NYC stinks
Crime in the big cities are off the charts
We have the highiest inflation in 40 yearsThis is what is called stating the obvious
Anonymous Jew,
If the hospital accepts medicare they are required by law to asses and stabilize every patient that presents themselves to the hospital for help.
AJ: Anyone, including those with no insurance and no money, can walk into any Emergency Room in the United States and receive service.
Wait times vary by both demand and staffing, as well as the care needed by the patient.
I type this while sitting up all night (for the 10th consecutive night) in Mrs. CTL’s hospital room.When we arrived outside the ER in the driveway I lowered my car window and yelled to a nurse who was discharging a patient that we needed a wheelchair and staff to get Mrs. CTL out of car and into triage. Within 2 minutes 3 staff and a wheelchair were at the car. It took ten minutes to transfer her. I locked the car where it sat and followed them inside. Immediately they started taking vitals while I dealt with quick registration. In 5 minutes we were in our way to an ER room and exams and treatment began. It was 2:30 in the afternoon on a weekday. We had passed through the ER waiting room and it was virtually empty. Only half the ER treatment room were in use. At 10 pm I left the treatment room to move my car to the hospital garage. By then every treatment room was in use, I counted 14 patients on gurneys in the hallway being treated. The large ER waiting room was full. At 2 am she was admitted and sent to ICU. 8 days in ICU, half the rooms empty but no bed was available on a medical floor so it took an extra day til she was moved.
Since arriving on the full medical floor, I walk the corridor to stretch my legs. Tonight I counted 3 empty rooms for the first time.
What it will be in an hour? I don’t know and couldn’t guess.
Your timing depends on many variablesRefuah Shelaima!!
Oy ctlawyer,
She should have a refuah sheleimah bkarov
FYI to anonymous jew,
If a person comes to the hospital drunk or drugged up they will admit him
Anyone who has been to Maimonides will have similar experiences…the ER is packed with beds in the aisles. No chairs for family cuz it’s a fire hazard. Drs aren’t available. Nurses are overworked. If you need x ray or sonogram you need to wait hours. When you get said test it needs to be read tomorrow cuz dr who reads it went home for the night.
On the main floor the doctors are great. Service is horrendous. Nurses are too busy with other patients. Try tasting the food. Come on, the whole hospital has to suffer with no salt to accommodate people with high blood pressure! Can’t they make a salt free menu for those who need it?Refuah shleima to Mrs. CTL.
But it seems most large urban areas are more predictable and to the worse side…
And then you have patients who complain for the lack of salt. You should know if you overuse salt, then you stop tasting normal amounts. And also know this is one of the first questions a (good) cardiologist will ask – do you have a salt-shaker on your table.
I live in an area that is well serviced by a medical monopoly that covers 3 counties. Tues, I called to make an apt for what I believed was a minor issue. I was given an apt for later that day. During my intake the PA found an abdominal mass. I had a CAT scan that afternoon, before I got home, the DR called me with the results (after 5pm). By the time I got home the CT scans were posted to my electronic medical records and available for my viewing. Two days later I had an MRI, I got my results within one hour and was able to view them on my patient portal once I got home. This Tuesday I meet with the surgeon to discuss my options.
I think that a lot of problems with medical systems across the country have to do with densely populated urban areas, and some underserved rural areas. In my case I was spared a trek to Ptlnd. for second opinions. This was effortlessly completed with the seamless electronic transmission of medical records and imaging results. In most areas there also much difficulty in retrieving medical records and history and transferring them to other offices. My electronic medical records are delivered seamlessly via an online patient portal. This portal makes my electronic records available at any time. I can look up previous office visits, meds, request prescription refills, see billing and charges, see test results, Drs notes, notes of others called in on a consultation basis, vax records etc. The monopoly also covers chiropractic, nutritionists, PT, OT, and acupuncture. Locally there are still Drs. not a part of this system, typically these are physicians and surgeons who deal in elective cases.
Amil, I take it that you’d oppose the government taking antitrust action against the monopoly?
Reb CTL, wishing your wife a refuah shlayma, and wishing koach to you and your family.
What I may call a monopoly doesn’t meet the legal test for one. Your premature assumption is just that UJM.
UJM my use of the word ‘monopoly’ is would not withstand a legal test.
CTL,
ERs tend to become busy later afternoon, when people are more available to check in.
Ujm and 2cents, let me be clear. Yrm reffered to homeless and elderly checking into hospitals for free room and board.
I agree that anyone can walk into an ER and must be triaged ( assessed for illness/injury). However, you won’t be admitted unless the condition warrants it. If a Medicare patient falls and fractures a hip, and, mris etc determine that surgery is not needed, only bed rest, Medicare will deny that patient’s admission.
In addition an ER is not a bakery. People don’t get treated in the order they arrive, but by how seriously sick or injured they are. You could be number 5 when you arrive but number 14 three hours later.
One more note. If you’ve been sick since Monday, don’t be surprised if your insurance co refuses to pay for your outpatient visit on Thursday. Why? Because it’s not an emergency. The ER is obligated to treat you, but an ER is the most expensive place to seek outpatient care and the ins will say you had several days to seek out your dr or an urgicare centerI think this meets definition of a monopoly. Not all industries are easy for competition, but less and less so. We used to have phone monopoly. At&t produced wonderful phones that attached beautifully to the wall and always worked. Nobody wants them anymore somehow/ Do you think if AT&T stayed a monopoly we would have phones in the pockets, sending pictures and messages around, for better or worse? Similar problems are in defense. In all cases, if you focus on market solutions, you can always find some ideas to try, and from experience, there is “nothing to lose”. For example, there is an idea of having insurance work across state lines. Who can be against it? (except the monopolists).
Our health care system is collapsing before our eyes and we don’t seem capable of responding. My regular physician (who was board certified in cardiology and internal medicine) closed his group practice, “fired” about 2/3 of his patients and started a “concierge practice” with two colleagues that doesn’t accept insurance and only the more affluent could afford. They are accessible 24×7 thereby avoiding some ER visits and in true emergencies, assist in arranging “expedited access” to one or two local hospital ERs.
We always had a two-tier health care system based on income and education but in a post-Covid world, the differentials are even more extreme as thousands of traditional independent family and primary care practices are bought out by the big hospital chains and converted into assembly line medicine. Even those, however, are better than those with NO primary care who use the ER as the last resort. Instead, we are celebrating new legislation that will give certain seniors lower drug costs beginning in 2026 on only a dozen or so commonly used generic medications out of over 1800 in the Pharmacia listings.It is now the Twelth Night (sorry Shakespeare) that I am sitting in a chair by Mrs. CTL’s hospital bed.
Here in CT, two hospital systems own/run 90% of the hospitals, including all in our area.
Her doctor is in a practice owned by Group A, she is in a hospital (our preference) owned by Group B.Group A only makes the latest records available instantly to Group B, otherwise request and wait 24 hours. As the ICU doctors ask questions about condition over time, I sign into her records on my smartphone and let Grouo B specialists see what they need
We also see a lot of retirements that started earlier during covid and still continue. It is understandable that those close to retirement chose to shift a couple of years earlier than risk daily exposure. Still, some of them might be hesitant at 60, but might have worked till 80 otherwise. Lots of people contemplate retirement every year but still continue. A possible contributing factor is decrease in private practices as government regulation forced them to sell to big hospitals, and a need to spend most of the time typing in the computer instead of looking at the patient.
“One more note. If you’ve been sick since Monday, don’t be surprised if your insurance co refuses to pay for your outpatient visit on Thursday. Why? Because it’s not an emergency.”
Interesting story. Many years ago, I was playing with my kids outside, and my oldest accidentally kicked me in the center of my chest. That night, I had some chest pain, and I couldn’t get comfortable – couldn’t lie down, couldn’t sit, couldn’t fall asleep. Finally, around 2:30 in the morning, I woke my wife, and said I was having pain in my chest, and I thought E broke a rib. I was going to drive myself to the hospital. My wife’s famous line to me: “You know, if it’s not an emergency, the insurance won’t pay.”
My wife woke the next morning, and I still wasn’t home. She got the kids off to school, and went to work – at the hospital where I was still in the ER. I had suffered a heart attack, and a few days later I had 4 bypass grafts. It was an emergency after all!
(BTW, my hospital stay between diagnosis until the day of the surgery was over a weekend. I found out a few months later that the insurance company wanted me to go home over the weekend, over the strong objections of my cardiologist. I stayed in the hospital, and I don’t know if the insurance covered those few days or not.)
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