The healthcare system has a very distinct line separating hospital care from outpatient care. Hospitals are expensive and so they are the main target of cost containment. Here is where caregivers need to me the most vigilant.
They moved Dick out of the ICU after he received his most critical treatments–loading of the new anti-arrhythmia drug, a blood transfusion, and dialysis. He was weak still but doing much better.
Two nights later Mom tells me they will not perform the CT scan to better image his brain lesions. The hospitalist explained that he should not get radiation therapy so he did not need to have the CT. I reminded Mom about our visit with the oncologist just before this admission.
“He said if he had brain lesions then he would need radiation, and I asked him if that would be too harsh. He said Dick would only get five treatments and about the most that would happen is that he would lose his hair.”
“Half of it is gone anyway,” my aunt quipped, giving us all a chuckle.
“But the hospitalist said that was before he had the heart arrhythmia,” Mom continued.
“But he doesn’t have an arrhythmia any more, and they gave him a medicine to keep it from coming back.”
“Well if it comes back then he said Dick would need a pacemaker.” She told me that caused Dick to respond with some concern, but he is letter her make the decisions. “We can worry about that when and if it even happens. They are just trying to scare you out of treatment. I’ll be down tomorrow to visit Dick and talk with the hospitalist myself.”
Hospitalists are doctors that care for patients only while they are hospitalized. They change from shift to shift, even day to day. They have no personal relationship with patients, nor do they have time to form any. Patients do not get much information or input about their own care. Since hospitals get paid a set amount of money from Medicare for a particular diagnosis, the less the hospital spends caring for a patient then the more money they earn. And maybe that is why they are trying to talk Dick out of a CT scan.