Virginia Hospitals – the good, the bad and the ugly
According to the New York Times, “Not all hospitals are created equal, and the differences in quality can be a matter of life or death.”
I didn’t need a national Newspaper to tell me this and likely, you didn’t either.
Every community I have worked in knows what hospitals are good, which are bad – what nursing homes are terrible, and which are better.
“Fundamentally, there is sort of an implicit assumption that every hospital is the same,” said Dr. Barry Rosenberg, the study’s lead author and a partner at the Boston Consulting Group in Chicago. But if someone has a heart attack, the closest hospital could have a death rate of 16 percent, compared with one a little farther away, where the rate was 4 percent, he said.
The study cited by the NYT studied facilities based on Medicare admission records and results. The study reflected hospitals that treated a high volume of cases were generally more successful than those that treated a low volume, with some exceptions.
But what happens when you live in a rural community and you don’t have any choices between a larger volume facility and small regional hospital?
What happens in an emergency, when the ambulance needs to find the closest facility to treat a stroke, or heart attack? What do expecting Mothers do when they have extreme pain, or bleeding but the local hospital doesn’t have an OBGYN floor?
All hospitals are not created equally, and in an emergency you don’t have a choice. But when an elective procedure is recommended, often we chose convenience over expertise. Or, we just flat out trust that local doctors wouldn’t be offering care if they didn’t feel comfortable and expert at giving it.
But that is just not true anymore. In a health care system where compensation is often based on procedure numbers, providers are tempted to undertake care they have little experience in providing.
While it may be uncomfortable to ask questions – and keep asking when you don’t get the answers, your life may sometimes depend on knowing what your physician’s experience level is. Some questions you should ask before a procedure, or surgery is agreed to.
1. Are you board certified?
2. Where you trained to do this procedure in residency or fellowship?
3. How many do you do a year?
4. Have you encountered any complications for patients like me?
5. Is there a doctor in Virginia, considered an expert – who does more? Or writes about this? Would you refer me to him or her?
6. How many of these procedures are done in the hospital each year?
7. Who helps you? Can it be done with without a resident or student helping?
If your physician does not do this procedure ALL THE TIME – then find someone else. We’ve always known this to be true, but now studies are confirming it. Not all hospitals are created equally.