Health Care Rant

This year did not start off in the best manner despite my being so excited about a new diet plan, workout goals and determination to live to the fullest despite chronic sleep deprivation. The working out was derailed when I pass out and fell at work early on the morning of 1/2/10. I apparently had a syncopal episode (I just remember not feeling too hot then waking up confused on the cold floor) and fell on the bathroom floor splitting my forehead open and injuring my ribs. I was at work - you know in a hospital - and I wasn't able to stand and my coworker said I looked white as a ghost and she couldn't get my heart rate to come back up. Before I really knew what was happening, I was in our ER getting a liter of fluids put in via an IV which blew my mind because they never manage to put IVs into any of the patients admitted to my unit ... but I digress. My care in our ER was not the best and I should mention that it was early in the morning, pretty close to shift change and they only had one other patient so it wasn't like they were slammed. They did an EKG, drew some blood, put in the aforementioned normal saline and after I had been in the room well over an hour, I asked if someone would wipe the blood off my face and maybe put a bandage over my gaping wound (which the resident physician didn't even touch when he "assessed me." The next thing I knew I was told that I had to go to an adult hospital since they only do children. Unfortunately this was now Saturday so my doctor's office wasn't open. My husband had arrived by this point but they REFUSED to let him drive me to another hospital that is less than 5 miles away. They said I needed to take an ambulance because, "we can't rule out a cardiac issue." I started to argue the point the best that I could in my weakened state, but the resident returned and said, "sorry you have to go by ambulance." I should have just told them to screw off and gone AMA (against medical advice) but one of my co-workers pointed out that insurance can then refuse to pay any of the claim. DAMN!

So I went in an ambulance to another ER and I should mention that my own hospital gave the paramedics hardly any report on my condition or let them know that labs were pending. I had asked the dayshift nurse if my electrolytes were back and got a breezy, "oh I haven't checked that" prior to my leaving. Once we got to ER #2 (after my hospital told me I couldn't go to my first choice of hospitals because "employee health says you need to go to hospital A or B"), the paramedic proceeded to give the new ER a report on my condition that was shockingly incomplete. I filled in all the pieces and the paramedic specifically said, "wow! Good thing you were paying attention, they didn't tell me ANY of that!" Wow, good to know that they give a good report during transfer of care. ER #2 did a repeat EKG, were going to draw labs when I reminded them that my hospital had already done that but failed to give me results. Saved myself who knows how much because they simply called my hospital and got the labs faxed to them (which should have been sent with the paramedic in the first place). After a very long wait because ER #2 was hopping, I saw the doctor for all of 5 minutes. He did a quick assessment and said the nurse would glue my laceration shut. They also insisted on getting a pregnancy test despite my COMPLETE ASSURANCE that I wasn't pregnant. I was on my period, I'm on the pill, I have a one year old at home, I am NOT PREGNANT. The ridiculous thing is that they weren't doing any x-rays or treatment that would have required a pregnancy status anyway.

Shortly thereafter, ER#2 nurse comes in and glues my head shut - now the nurse did this, not the doctor which is important for later. And then I had to wait, and wait, and wait. Turns out since it was at work and possible workman's comp, I had to wait for a third party to arrive to do drug and alcohol testing. This was finally done, and I was looking to get discharged because it's close to noon, I had worked all night the night before, I'm in a psych patient room with no TV or even handles on the doors, and I just want to get home. At this point all I needed was my discharge instructions but my nurse was busy with a trauma. I flagged someone down, had already pulled out my IV (and had to leave everything on the counter, because psych rooms also don't have trash cans), and managed to get the charge nurse. I told her I'm a nurse, I'm tired, I've been treated, can I please go home? She quickly gave me my paperwork and let me go.

So now the bills are starting to come in ... and man are they ridiculous! I'm lucky that I've never had to use an ER in my life. I've had a broken bone or two in my life, some ankle sprains, a couple of lacerations needing stitches, but I always received care at a doctor's office. Even waiting an extra day with my broken wrist because it was a holiday and I waited til my doc's office opened. Had I not been at work, on a weekend, there's no way I would have gone to the ER, and in NO WAY would I have used a stupid ambulance. Honestly, had I not felt so weak and miserable I would have gotten more bitchy and demanding. I had told my husband that I would NOT get a cat scan since I was not symptomatic and seriously they are REALLY expensive.

So here's how my bills currently stand:

My hospital ER visit = $1045
-This includes one IV placed, a liter of fluids, the tubing for the IV, an EKG, a lab analysis of my blood chemistries

Ambulance = $664
- This included a 4 mile ride and me having to give a report to the paramedic on my care at the ER since they didn't bother to tell him anything. Also, he was the first person to actually assess my laceration and tell me about it since I hadn't seen a mirror yet.

ER #2 = $1078
-This included an EKG, generic supplies, "laboratory" which I still haven't figured out what that includes and the care of the nursing staff.

ER #2PHYSICIAN = $794
-This is for the 5 minutes he spent with me and the interpretation of the EKG. Dude, he wasn't even the one who glued my head shut! That's ridiculous!!

EKG interpretation from my hospital = $29
Pregnancy Test = $18

Total Bills = $3628

All this for one forehead laceration, a liter of IV fluids, and one blood draw. WOW! That's steep!!

Interestingly enough, my employer required that I go to my doctor and have a note that it's OK to return to work. I actually wanted to see my own doctor anyway since he's actually ... well a good doctor. That visit included a consultation and x-rays of my ribs which were in excruciating pain by the day following the injury. For that visit and 2 x-ray?? I was charged a whopping $185

If people want to look at how broken the health care system is, they don't have to go far. Clearly there is a problem with healthcare costs. Why could one ER do so much many more procedures but charge me so much less - especially when you factor in the cost of the physician? Why could my own doctor do two x-rays and treat me and charge only a small fraction?

The kicker is that I do not quality for an employee discount at my hospital because you only get it if you are on THEIR insurance! We have decided to keep the whole family on Bryan's insurance so I lose a 20% discount because of that. Also, I've been totally jacked around by the workman's comp process. They conveniently lost my forms but never bothered to tell me. I'm almost positive they won't cover it but was encouraged to go through the process by our nursing supervisor. Makes me wonder how two of my co-workers had their injuries covered AND time off covered when they slipped on the ice and fell in the parking lots last winter.

Ok, I know that no one really cares about my rants, but I needed to express it somewhere. I just hate getting screwed, especially by my own employer and for truly substandard care in my own ER. Did I mention that my IV beeped for well over 5 minutes and I finally had to get up and stagger over to silence it myself because I didn't have a call light, and apparently no one could hear the blaring noise.

Oh well, on the bright side, we will be making our $2400 family deductible early in the year so I guess this is the year to have lots of random medical visits. Hopefully I can start to focus on the positive soon, because this whole process and dealing with billing agencies and workman's comp really has sucked the life out of me.