It used to be, years ago, that when you entered the hospital you were my patient.
But some years ago the terminology changed (as does all things) and you suddenly became my "client".
You are a health care consumer and make choices based on your needs.
But I... as an older nurse... have a problem with this terminology.
And no... to me, you are still my patient as opposed to my client.
And that is because this business of health care is indeed more than a business, particularly when viewed as a nurse.
That is why I have posted this photo of a cactus made up of budding fruit, prickly thorns and encompassed by a heart.
As a nurse... that heart symbolizes caring, and that is what nurses do.
This is far above and beyond a business.
Quite frankly, I don't care if you have been picked up off the street, are indigent,
if you are black or white, or if you are wealthy or on the board of my local hospital.
You will all be treated the same.
Nursing is a humanitarian service to those who are sick and in need of care. I cannot do otherwise.
Perhaps that's why I find the politics and financial aspects of health care so mind-boggling.
And I will be the first to admit that I do not understand it all.
Now in my mind, to be a health care consumer, you need to be on a level playing field and understand the rules of the game.
Just as you do when you visit your favorite fast-food establishment:
you walk in, look at the offerings and their cost and make your choice.
But can you, as a client, in a hospital, do the same?
Most people who are admitted to the hospital are in a crisis situation requiring medical or surgical care.
There is no list posted of costs of services, doctors fees, test fees, and the like.
And you are in no position to dicker over cost.
If you are lucky... you have insurance. And even then, it is a bit of a crap-shoot.
And this is where it becomes particularly complicated.
The insurance companies wield a lot of weight. Some things they cover and some they do not.
Some doctors are under that plan, and some are not.
Some procedures they will only cover a pittance of the cost.
Do you really know what is covered and what is not?
And when it comes to cost... we open another hornets nest.
You see... hospitals have a "hidden tax"... this is the hidden gap between costs and charges
as was reported in the Dallas Morning News by Jason Roberson, and I quote:
"That is why patients are charged $5 for an aspirin and $5,000 for a one-night stay."
The actual costs often are a fraction of their asking prices.
As a personal example... I was recently in the hospital for 12 HOURS (listed as "observation")
and my hospital bill came close to $9,000!!! Thank goodness I had insurance! (And what if I did not?)
And look at the charges... doctor's fee for less than five minutes at the bedside... over $1,000!
That bag of salt water intravenous fluid... over $100 dollars.
BASIC blood tests... over $1,000!
And the costs of medications... that's another story!
And the list goes on.
I understand that hospitals must be run as a business and in doing so, must look to cover their costs.
The amount charged is not actual costs but rather for the amounts not covered by
insurance, medicare, medicaid as well as the destitute who have no insurance.
It all gets spread around to stay in business. And yes, I do want a pay check for what I do.
I believe that's called the cost-to-charge ration.
These costs incorporate gross salaries, equipment, in-patient services, ancillary services, etc.
Like I said... this is a complicated business!
As a nurse... your caregiver... I am astounded at the costs.
I do not see these when I deliver care, but that would not change the care that I give.
I have a high standard to meet and I will do all in my power to give you that care,
protect you from harm, to prevent infection and to educate you and your family
so that you may return home as quickly as possible.
I often tell my patients... "I don't like sick people. I want you to get well and go home!"
The point of all of this... to make you aware that health care costs are through the roof,
that we all will need care sooner or later, and that it is difficult to truly be a health care consumer in making our choices,
as much of the decision making is out of our control.
And as far as all of those tests being ordered... much is driven due to litigation, and this is nationwide.
I do believe we all need health care coverage.
Even the most minor illness, particularly without insurance... can be devastating financially.
The more we understand, hopefully, the better decisions we can make.
But for now... you will remain my "patient", and I can only hope that in spite of the thorns along the way,
that you will continue to thrive and that your life will become more fruitful!
And I share this from my heart...