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> Really seems like a "hey nurse did this patient have their fentanyl yet?" would have resolved this issue. You'd be surprised at how questionable hospital car

by nickjj 6y ago

> Really seems like a "hey nurse did this patient have their fentanyl yet?" would have resolved this issue. You'd be surprised at how questionable hospital care is run in NY, even with $450 / month insurance with a high deductible. To protect the privacy of the person I know, here's a story from 2-5 months ago: - Person A goes into doctor's office for something pretty common - Doctor requests cat scan or MRI (I forgot which one is which) based on symptoms - Person A gets the scan - Doctor evaluates results and says to book surgery in a hospital ASAP as it's probably cancerous - Person A books surgery - Hospital gives prep instructions to be performed by Person A 48 hours before surgery - Person A does everything and goes in for surgery - Person A is prepped for surgery and is put under anesthesia - Surgeon comes in and looks at the scan in the operating room - Surgeon says this scan is nothing to worry about and surely doesn't warrant surgery and it's not a tumor or cancer - Person A is wondering how the surgery went after coming to from being put out - Nurse says no surgery was done and even she was able to look at the scan and see nothing was wrong - Person A is told to go home and wait 4-6 weeks to self heal So let's ignore thousands of dollars in bills (deductibles). All of this could have been avoided if someone actually looked at the results of the scan before going through the motions of putting someone under anesthesia and a massive amount of stress. That's only 1 of many stories. In another case someone I knew had their blood drawn twice in the hospital because the 2nd nurse didn't believe them when they said they just got their blood drawn by another nurse 10 minutes ago. The vials were literally next to them, about 3 arm's lengths away.

noir_lord 6y ago
Over here in the UK they generally mean well, almost without fault every one of my specialists, doctors and nurses have been awesome. That said man do they fuck up, most recently was a fun one, I had a scheduled appointment, turned up for it, doctor was in his treatment room seeing patients, forgot to see me and went for lunch. I mean it's minor but I'd checked in, the computer had me as waiting but he'd looked at the list, not seen me and went for lunch - I spoke to the nurse told her I didn't mind waiting while he ate and she tracked him down, he was incredibly apologetic (unnecessarily so, shit happens). It's inevitable in a system as complex as healthcare that mistakes are going to be made but we probably should assess the proximal causes much like the airlines/plane manufacturers did to reduce the incidence.
- cameronh90 6y ago
  Almost exactly the same thing happened to me (also in the UK), except rather than checking me in, they had transposed a couple digits on my NHS number and checked in a random person. Not sure if the NHS number has a check digit, and if not why not, but I digress... Rather than going to lunch, after I sat waiting for 3hrs they closed the department. When I went up to let them know I hadn't been seen yet, they apologised profusely, called back the specialist - who had already left - and saw me after closing time.
sjg007 6y ago
That sounds like malpractice but I dunno.
Renaud 6y ago
I find it bonkers that the surgeon had no prior involvement in reviewing the case before the patient is brought into the operating room. That's really scary.
- boomboomsubban 6y ago
  Requiring a surgeon's consultation before scheduling seems like it would be a huge hassle to arrange, and greatly reduce the amount of surgeries they could perform. Beyond that, I'm not sure what benefit there would be to a surgeon independently reviewing the case early. Thinking about what they'll need you do in tomorrow's surgery would distract them during today's surgery.
  - wl 6y ago
    At least with the surgeons I know in the United States, they have days devoted to clinic and days devoted to surgery. They meet with nearly all their patients beforehand to evaluate their conditions and discuss the options. The exceptions are emergent cases or if a surgeon (resident, fellow, or attending) is assisting on someone else's case that was seen in clinic by the primary surgeon.
  - billforsternz 6y ago
    When I had cancer surgery, it was the surgeon (literally "the consulant") who consulted with me. He looked at the scan with me and explained my diagnosis and prognosis. We had at least one more meeting before the surgery, and I still see him every year for follow up (I think he's cutting me loose next year after six years - I will miss him he's a nice guy). Isn't this how it normally goes?
  - tsimionescu 6y ago
    My understanding is that (1) the patient has the right to be explained what the surgery will be, what is their prognosis, what are the risks etc, so they can give informed consent - not sure who other than the surgeon could do this; and (2) that surgery needs to be planned, the surgeon needs to know how many nurses they will need, whether they need any assisting surgeons etc. This is all medical knowledge, a surgeon is not waiting in an operating room and operating whoever they bring in. The whole story smells of very bad medical practices (and I'm speaking with the perspective of someone living in a formerly communist country, not some medical Mecca).
nobody9999 6y ago
>- Person A goes into doctor's office for something pretty common >- Doctor requests cat scan or MRI (I forgot which one is which) based on symptoms >- Person A gets the scan >- Doctor evaluates results and says to book surgery in a hospital ASAP as it's probably cancerous >- Person A books surgery >- Surgeon comes in and looks at the scan in the operating room >- Surgeon says this scan is nothing to worry about and surely doesn't warrant surgery and it's not a tumor or cancer This seems really unusual. I'd also say that (as someone who lives in NYC), I can't imagine things going this way. I have never heard of a surgeon not reviewing the radiology reports, preparing a surgical plan and consulting with the patient pre-surgery. If this is true, it's flat-out malpractice. Given the sheer number of people, resources and precious operating room time involved in ordering, prepping and performing surgery, your story stretches credulity well past the breaking point. To put a fine point on it, I call bullshit. I had surgery a couple years ago. I had specific symptoms and went to my doctor. He referred me to an actual surgeon who ordered an MRI. The MRI showed what we expected it to show and then the surgeon ordered an additional scan to cover more area to make sure he understood exactly what was necessary. He then recommended surgery. Not taking the surgeon's word for it, I sought a second opinion. Fortunately, my ex's brother was a surgeon in the same specialty and he offered to look at the MRI (I would have gone to another surgeon myself had he not been available to me). He completely concurred with the surgeon and I had a successful surgery. However, the normal process for surgical procedures, especially since there are significant pre-surgery protocols including medical history workups, blood work, discussions about what the surgery entails and risk factors, as well as a pre-surgery consult with the surgeon and/or his scrub nurse. What's more, the surgical team (not with the patient) will meet at least once pre-surgery to review the surgical plan (which includes reviewing any imaging), and this may result in additional testing if there's any ambiguity. And none of that is optional. What's more, on the day of the surgery during prep they will mark the location to be operated upon and confirm, multiple times, via existing imaging, discussions with the patient to confirm, specifically, what the surgery is for and what procedure is to be performed. All of that is done before any sedation or anaesthesia is administered. So no. That's not a credible story.
srtjstjsj 6y ago
You're conflating bad medicine with cheap medicine. Unnecessary surgery is exactly what I'd expect from bad medicine charged at "whatever the seller wants" prices.

by nickjj 6y ago

noir_lord 6y ago

Over here in the UK they generally mean well, almost without fault every one of my specialists, doctors and nurses have been awesome. That said man do they fuck up, most recently was a fun one, I had a scheduled appointment, turned up for it, doctor was in his treatment room seeing patients, forgot to see me and went for lunch. I mean it's minor but I'd checked in, the computer had me as waiting but he'd looked at the list, not seen me and went for lunch - I spoke to the nurse told her I didn't mind waiting while he ate and she tracked him down, he was incredibly apologetic (unnecessarily so, shit happens). It's inevitable in a system as complex as healthcare that mistakes are going to be made but we probably should assess the proximal causes much like the airlines/plane manufacturers did to reduce the incidence.

cameronh90 6y ago
Almost exactly the same thing happened to me (also in the UK), except rather than checking me in, they had transposed a couple digits on my NHS number and checked in a random person. Not sure if the NHS number has a check digit, and if not why not, but I digress... Rather than going to lunch, after I sat waiting for 3hrs they closed the department. When I went up to let them know I hadn't been seen yet, they apologised profusely, called back the specialist - who had already left - and saw me after closing time.

sjg007 6y ago

That sounds like malpractice but I dunno.

Renaud 6y ago

I find it bonkers that the surgeon had no prior involvement in reviewing the case before the patient is brought into the operating room. That's really scary.

boomboomsubban 6y ago
Requiring a surgeon's consultation before scheduling seems like it would be a huge hassle to arrange, and greatly reduce the amount of surgeries they could perform. Beyond that, I'm not sure what benefit there would be to a surgeon independently reviewing the case early. Thinking about what they'll need you do in tomorrow's surgery would distract them during today's surgery.
- wl 6y ago
  At least with the surgeons I know in the United States, they have days devoted to clinic and days devoted to surgery. They meet with nearly all their patients beforehand to evaluate their conditions and discuss the options. The exceptions are emergent cases or if a surgeon (resident, fellow, or attending) is assisting on someone else's case that was seen in clinic by the primary surgeon.
- billforsternz 6y ago
  When I had cancer surgery, it was the surgeon (literally "the consulant") who consulted with me. He looked at the scan with me and explained my diagnosis and prognosis. We had at least one more meeting before the surgery, and I still see him every year for follow up (I think he's cutting me loose next year after six years - I will miss him he's a nice guy). Isn't this how it normally goes?
- tsimionescu 6y ago
  My understanding is that (1) the patient has the right to be explained what the surgery will be, what is their prognosis, what are the risks etc, so they can give informed consent - not sure who other than the surgeon could do this; and (2) that surgery needs to be planned, the surgeon needs to know how many nurses they will need, whether they need any assisting surgeons etc. This is all medical knowledge, a surgeon is not waiting in an operating room and operating whoever they bring in. The whole story smells of very bad medical practices (and I'm speaking with the perspective of someone living in a formerly communist country, not some medical Mecca).

nobody9999 6y ago

>- Person A goes into doctor's office for something pretty common >- Doctor requests cat scan or MRI (I forgot which one is which) based on symptoms >- Person A gets the scan >- Doctor evaluates results and says to book surgery in a hospital ASAP as it's probably cancerous >- Person A books surgery >- Surgeon comes in and looks at the scan in the operating room >- Surgeon says this scan is nothing to worry about and surely doesn't warrant surgery and it's not a tumor or cancer This seems really unusual. I'd also say that (as someone who lives in NYC), I can't imagine things going this way. I have never heard of a surgeon not reviewing the radiology reports, preparing a surgical plan and consulting with the patient pre-surgery. If this is true, it's flat-out malpractice. Given the sheer number of people, resources and precious operating room time involved in ordering, prepping and performing surgery, your story stretches credulity well past the breaking point. To put a fine point on it, I call bullshit. I had surgery a couple years ago. I had specific symptoms and went to my doctor. He referred me to an actual surgeon who ordered an MRI. The MRI showed what we expected it to show and then the surgeon ordered an additional scan to cover more area to make sure he understood exactly what was necessary. He then recommended surgery. Not taking the surgeon's word for it, I sought a second opinion. Fortunately, my ex's brother was a surgeon in the same specialty and he offered to look at the MRI (I would have gone to another surgeon myself had he not been available to me). He completely concurred with the surgeon and I had a successful surgery. However, the normal process for surgical procedures, especially since there are significant pre-surgery protocols including medical history workups, blood work, discussions about what the surgery entails and risk factors, as well as a pre-surgery consult with the surgeon and/or his scrub nurse. What's more, the surgical team (not with the patient) will meet at least once pre-surgery to review the surgical plan (which includes reviewing any imaging), and this may result in additional testing if there's any ambiguity. And none of that is optional. What's more, on the day of the surgery during prep they will mark the location to be operated upon and confirm, multiple times, via existing imaging, discussions with the patient to confirm, specifically, what the surgery is for and what procedure is to be performed. All of that is done before any sedation or anaesthesia is administered. So no. That's not a credible story.

srtjstjsj 6y ago

You're conflating bad medicine with cheap medicine. Unnecessary surgery is exactly what I'd expect from bad medicine charged at "whatever the seller wants" prices.