Comments on: Here is the Problem

By: ED RN

ED RN — Wed, 21 Oct 2009 09:15:52 +0000

If the family want’s admission (esp if they have medical power of attorney) they can obligate the patient but not themselves.”

If the FAMILY demands an unecessary admission then the FAMILY should be obligated. Why should the family be allowed to obligate the patient when the patient isn’t the one making the demands?

By: ED RN

ED RN — Wed, 21 Oct 2009 09:12:41 +0000

People like you are the problem. you want to be able to DEMAND what you want but, you don’t want to be responsible for the cost. As much as I dislike Happy he’s right “the patient has to have some skin in the game”

By: Kate Allison

Kate Allison — Mon, 12 Oct 2009 11:43:17 +0000

I am an emergency vet, so have to deal with irrational people all of the time (most in situations that they could have avoided if they had been following the”rules”). I have to fight for the opposite: PLEASE let me admit your polytrauma dog who has 40% of his face smeared across Main St. But people see the price for hospitalization (it runs around $300-500/day once diagnostics have been done). They are horrified and say something along the lines of “but it doesn’t cost *me* this much to stay in a hospital. Of course it doesn’t, it costs a hell of a lot more, but the rub is, you are more likely NOT to pay it…hoping that the government will do it.

Personally, I have crappy insurance. Therefore, I pick and choose what diagnostics and procedures have to be done because of my high deductible. I cannot afford PT because it is $150/tx. I make about $300/week as a base pay (before 5 of production kicks in), so unless I want to really get behind the 8 ball, I cannot afford it.

By: Ted

Ted — Sun, 11 Oct 2009 19:19:13 +0000

Yeah, it certainly doesn’t work every time. But it is one more tool in the toolbox.

By: ERPA

ERPA — Sun, 11 Oct 2009 16:32:13 +0000

Why not just admit this person to observation and let the hospital collect something for occupying the bed? The patient will get stuck with a huge bill for all them medications, and if something is wrong with the patient that you missed with your 5 minute ER consult, then it can be change to a regular admission later on and the hospital will collect even more money for the admission. I am not sure why you don’t want the hospital to loose out on the payment for the admission????

By: Dan R.

Dan R. — Sun, 11 Oct 2009 16:26:08 +0000

Why would a family sign such a waiver? I can understand the patient signing it, but why would I as a son of a patient accept liability for a debt that I have no legal obligation for? If the patient want’s admission, that’s fine. If the family want’s admission (esp if they have medical power of attorney) they can obligate the patient but not themselves.

The end result being that unless the estate has resources (and most nursing home patients that I know don’t), then the hospital collects nothing.

By: Dr. Grumpy

Dr. Grumpy — Sun, 11 Oct 2009 16:00:45 +0000

And, I STRONGLY agree with what you did. Families in these cases are a remarkable waste of resources. I deal with this crap. Alzheimer’s patient brought in because the family is worried he’s been getting worse over the last 3 years. And, of course, they want the whole damn work-up repeated.

By: Dr. Grumpy

Dr. Grumpy — Sun, 11 Oct 2009 15:59:06 +0000

Never a good sign when they show up in the ER with packed suitcases.

By: Doc99

Doc99 — Sun, 11 Oct 2009 15:21:47 +0000

ERP would be a “disruptive physician” at my hospital.

By: DreamingTree

DreamingTree — Sun, 11 Oct 2009 14:36:27 +0000

ERP — you would be a rock star at our hospital for doing this.