A hospital is driven by the goal of saving lives. It can vary in size and service from a small unit providing general care and low-risk treatments to large specialized centers offering dramatic and experimental therapies. Your choice of hospital may be limited by factors beyond your control, including insurance coverage, your physician’s hospital affiliation, and the type of care available.
Before entering a hospital, you should be aware of the possible dangers. Well-known hospital hazards are unnecessary operations, unexpected drug reactions, harmful or even fatal errors, and hospital-borne infections. The Institute of Medicine recently identified three areas where the health system, in general, and hospitals and their staff, in particular, often fall short: the use of unnecessary or inappropriate care (too many antibiotics), the underuse of effective care (too few immunizations or Pap smears); and deficiencies in technical and interpersonal skills. The single greatest danger posed by a hospital is infection, which is largely preventable.
What can lay people do to ensure proper and safe care while in hospital? The following guidelines should be considered.
If you have a choice between hospitals, ask about their accreditation status. Hospitals are subject to inspection to make sure they meet federal standards. Policies implemented in 1989 require the release of information upon request to state health departments regarding a hospital’s mortality rate, its accreditation status, and major deficiencies.
Before registering at a hospital, you need to decide on your accommodation. Do you want to pay extra for a single room? Do you want a non-smoker for a roommate? Do you need a special diet? Do you need a place to store refrigerated medications? If someone will be staying with you, will you need a cost? You should try to avoid going on a weekend when few procedures are done. When you get to your room, you should immediately speak up if it is unacceptable.
You should be familiar with your rights as a patient. Hospitals must provide an information brochure that includes the Patient’s Bill of Rights. The brochure will inform you that you have the right to respectful consideration and care; information about tests, medications and procedures; dignity; courtesy; I respect; and the opportunity to make decisions, including when to leave the hospital.
You must make informed decisions. Before authorizing any procedure, patients must be informed of their medical condition, treatment options, expected risks, prognosis of the condition, and the name of the person responsible for treatment. This is called informed consent. The only times hospitals are not required to obtain informed consent are cases involving life-threatening emergencies, unconscious patients when no family members are present, and/or law enforcement or a court order, such as examination of sexually transmitted diseases. If you are asked to sign a consent form, you should read it first. If you want more information, you should ask before signing. If you are skeptical, you have the right to postpone the procedure and discuss it with your doctor.
Authorization for a medical procedure can be given non-verbally, such as an appearance at a doctor’s office for treatment, cooperation during the administration of tests, or a lack of objection where consent can easily be withheld. This is called implied consent.
You must weigh the risks of drug therapy, X-ray examinations, and laboratory tests against the expected benefits. When tests or treatments are ordered, you should ask about their purpose, possible risks, and possible actions if a test finds something wrong. For example, the injection or ingestion of X-ray dyes makes body structures more visible and greatly facilitates the physician’s ability to make a correct diagnosis. However, the dyes can cause an allergic reaction ranging from a skin rash to circulatory collapse and death. Finally, you should educate yourself on prescription drugs. You should avoid taking medications, including pain relievers and sleeping pills, unless you are sure of their benefits and aware of their dangers.
When you are scheduled for surgery, prepare for anesthesia. In rare cases, general anesthesia can cause brain damage and death. One cause of such catastrophes is vomiting while unconscious. To reduce your risk, refuse any food or drink that may be offered to you by mistake in the 8 hours before surgery.
You should know who is caring for you and record the office number and when you can expect a visit. If your doctor transfers your care to someone else, you need to know who that person is. If your doctor is not available and you don’t know what is happening, you can ask for your nurse case manager.
You should keep a daily log of procedures, medications, and doctor visits. When you receive your bill, check each item against your written record. Insist on an itemized bill.
You must stay active within the limits of your medical problem. Many bodily functions begin to suffer after just a few days of inactivity. Moving, walking, bending, and contracting muscles help clear bodily fluids, reduce the risk of infections (especially in the lungs), and cope with the stress of hospital procedures that add to the depression and discomfort of hospitalization.
You should be alert. Throughout your stay, you can keep asking questions until you know everything you need to know. According to some experts, the biggest improvement in health care has not been technological advances; They have been patient asking questions. The more questions, the fewer errors, and the more power patients have in the doctor-patient relationship.
Selection of a health professional
Choosing a doctor for your general health care is an important and necessary duty. Only physicians are discussed here, but this information applies to the selection of all healthcare professionals. You should select one who will listen carefully to your problems and diagnose them accurately. At the same time, you need a doctor who can guide you through the modern medical maze of technology and specialists.
For most people, good health care means having a primary care doctor, a professional who assists you as you take responsibility for your overall health and guides you when specialized care is needed. Your primary care physician should be familiar with your complete medical history, as well as your home, work, and other settings. You are better understood during times of illness when your doctor also sees you during times of wellness. However, finding a primary care doctor can be difficult. Of the 700,000 physicians in the United States, only 200,000 (less than 30%) are in primary care.
For adults, primary care physicians are usually family doctors, formerly called “general practitioners,” and internists, specialists in internal medicine. Pediatricians often serve as primary care physicians for children. Obstetricians and gynecologists, who specialize in pregnancy, childbirth, and diseases of the female reproductive system, often serve as primary care physicians for women. In some places, general surgeons may offer primary care in addition to the surgery they perform. Some osteopathic physicians also practice family medicine. A doctor of osteopathy (DO) emphasizes manipulation of the body to treat symptoms.
There are several sources of information for the names of doctors in your area:
Local and state medical societies can identify doctors by specialty and tell you a doctor’s basic credentials. You should verify the doctor’s hospital affiliation and make sure the hospital is accredited. Another sign of prestige is the type of society to which the doctor belongs. A surgeon’s qualifications, for example, are enhanced by a fellowship at the American College of Surgeons (abbreviated as FACS after the surgeon’s name). An internist fellowship at the American College of Physicians is abbreviated F ACP. Membership in academies indicates a physician’s special interest.
All board-certified physicians in the United States are listed in the American Medical Directory published by the American Medical Association and are available in larger libraries. About a quarter of practicing physicians in the United States are not board certified. This may mean that a doctor failed the exam, never completed training, or is incompetent. It could also mean that the doctor just didn’t do the exam.
The American Board of Medical Specialists (ABMS) publishes the Compendium of Board Certified Medical Specialties, which lists physicians by name, specialty, and location. Pharmacists may be asked to recommend names.
Hospitals can give you the names of staff doctors who also practice in the community.
Local medical schools can identify faculty members who are also in private practice.
Many colleges and universities have health centers that maintain a list of physicians for student reference.
Friends may have recommendations, but you should be aware of the possibility that their opinion of the doctor may be different.
Once you’ve identified a top candidate, you can schedule an appointment. You should check with office staff about hours of operation, availability of emergency care at night or on weekends, back-up physicians, procedures when calling for advice, hospital affiliation, and the procedure for payment and insurance. You should schedule your first visit while you are in good condition. health. After you have seen your doctor, think about the following: Did the doctor seem to be listening to you? Were your questions answered? Was a medical history taken? Were you informed of the possible side effects of the medications or tests? Was respect shown for their need for privacy? Was the doctor open to the suggestion of a second opinion?
