We had a little meeting with the hospital after my mother finally had her hip replacement. They told us the same thing about xrays. They also delicately suggested that maybe Mom’s hip was not really broken, but the two orthopedists who told us it was were overtreating for economic reasons. As I say, it’s hard for non-medical people to figure out the truth. Bottom line is this: although I had issues with the way the consulting orthopedist treated my mother, I don’t think he was deliberately cruel or negligent. I do think he made a mistake. I think his mistake cost my mother days and days of torment and possibly shortened her life. As her advocate, I should have worked harder to get her problem solved. It’s hard for me to fault a family member who questions treatment a patient has received, particularly if it turns out later that the problem was greater than the doctor saw at the time.

hip fractures at your mother’s age are a terrible thing and, unfortunately, her outcome is not an uncommon one, even with optimal care. i’m sorry it happened.

And now that it influences reimbursement, it is beyond nutty and into truly psychotic. Patients and families don’t have a rodent’s rump of an idea of the care they are getting, only about who smiles more and has the prettiest “turrkee sammiches”. Will this EVER end???

The key is learning how to very politely say “no” to people. If you are rude or disrespectful, then they complain. If you are nice, then they don’t complain. Press Ganey doesn’t ask “did the doctor do the right thing”. They ask, “was the doctor nice”. Stupid, perhaps. But the sooner you learn how to play the game, the easier your life will be.

I ask because my mother, at age 77, fell and hurt her hip. My father called me while the EMTs were trying to get her on the gurney and I could hear her screaming. Everyone was sure the hip was broken.

Everyone except the ER docs, who told us the xrays showed a silent fracture from the past but nothing current.

She couldn’t walk on the leg and was admitted for two days for pain control. Then she was discharged with mild pain medication and a prescription for physical therapy.

She still couldn’t walk on the leg and the physical therapist urged us to get a second opinion. We took her to one orthopedist who said the xrays clearly showed a fracture, but he couldn’t get her on his surgical schedule. (It was Christmas Eve at that point.) We found a second orthopedist who also diagnosed a fracture and admitted her for a hip replacement.

Three sets of xrays. Three orthopedists (one the consult in the ER) and an ER doc. ER doc was evidently suspicious enough to call for the consult, but not sure enough to override the orthopedist. Consult orthopedist said it was an old fracture (which somehow my mother didn’t notice). Second and third orthopedists both said it was current.

It’s not always easy for patients to know how to evaluate medical care. But I’d have to give the ER low marks in my mother’s case (although we did not actually submit a Press-Ganey). Whatever the truth about the fracture, they released her in terrible pain and unable to walk. She went into a decline and died about 9 months later. I will always feel guilty about not fighting harder for her in the ER.

And I’d rather have disgusting food than a multi-star chef in the kitchen and a butcher providing the care.

Oh, and it would be nice if the administrators stopped hiring more administrators and used the money for people actually providing medical care. A truly novel concept, I realise that, and one that will require taking a pruning saw to regulatory agencies, Press-Ganey, and other, like, parasites. But the blood bath in the admnistration sector will be worth it on the medical side.