Self Help Now: A community blog

Dr. Jacqueline B. Sallade offers ideas for maintaining your mental health.

VA and Other Hospitals-Mismanagement

Written by Dr. Jacqueline B. Sallade, Community blogger | May 30, 2014 3:25 PM

So, you think only the VA hospitals are negligent, corrupt and unable to deliver? Believe me, there are stories after stories of trauma and death caused by not scheduling appointments, long waiting lists, overbooked doctors, incompetence, and corruption in private nonprofit and for-profit, faith-based, and government hospitals and clinics.

There was a nineteen- year old boy, a patient of a psychiatrist I know, who commited suicide while a mental health facility slowly looked into his family's finances to see if it could collect payments. There was a sixty-nine year old man who bled to death on a hospital floor after he fell because no nurses or doctors were available to pay attention when he rang and rang. He had been operated for a shoulder injury. Remember the case of the man whose healthy foot was amputated, not the dying one? How about all the people who had the wrong operation, which is why they now ask your name over and over?  On the more positive side, there are some patients who get well while waiting for their appointments, like back pain which subsides with rest. Lucky for those patients.

 Sometimes the doctor wants to see you in two weeks and doesn't know that the hospital has her booked eight weeks ahead, so you can't get in soon for the appropriate protocol. Breast and other cancer patients in some hospitals have long waits to hear their diagnoses, get their biopsies and have their treatments. Every moment counts for them, not statistically but personally. What a nightmare!

Don't think that socializing medicine will change the horrible situation. The VA is socialized medicine. Keeping people employed regardless of performance, sticking to a budget, and general administrative debacles happen everywhere, though. There are nightmares and malpractice in the best of healthcare centers.

Usually, doctors do well when nurtured in an environment in which they can and do choose to spend time knowing and caring for patients, rather than just making money, gaining fame, teaching and doing research. All of those tasks are necessary but should be compartmentalized away from direct patient care or, at least, subservient to patient care. Keeping statistics may be important, for example, to determine best practices, but really seeing each case as individual and holistic is even more key.

You can't imagine the time in meetings, repetitive record-keeping beyond what's helpful, silly grand rounds which don't really study cases but vague research power points, which could have been read in ten minutes. Comraderie and teamwork are fine but let team-building coincide with helping people.

I wish I had a solution. I do think that more well-trained doctors and nurses, less time doing busy work which doesn't relate to patient care, better supervision and double-checking/quality control, and willingness of hospitals to spend more and profit less, perhaps building fewer fancy buildings and hiring more staff, endowments and donations better spent... Hospitals shouldn't be like corporations or imperialist countries, caring more about expanding than doing a good job with the population-at-hand and rewarding executives and stockholders, growing pensions, and stockpiling investments. The artwork in the lobby is nice but spend more on the patients, please. 

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