Commentary: I just spent an overnight stay in one of our local hospitals, and I’m afraid the experience was, well, disappointing. Oh, at least as far as I can tell, the actual medical care was good—I got the medicines I needed when I needed them. But health care should be more than this. Patients have a right to know about their care. And at least in my case, the lack of communication rose to the level that I question whether there was informed consent.
I’ve had experiences with good health care. My wife suffered from an ultimately fatal illness that was diagnosed while we vacationed in Oregon. This meant many visits to doctors’ offices in the Portland area, and ultimately a week-long stay at Oregon Health Sciences University Hospital. I came away from this experience frankly awed at the magnificent edifice of science that is modern the U.S. health care system. Overpriced perhaps, bloated maybe, but marvelous.
Every effort was made to ensure that we were fully informed at each step in the process both as to the recommend procedure as well as the alternatives. We even had a “social worker” assigned to us that made sure that we were informed about treatment, to aid in discharge, and to ensure follow up.
The experience locally was much different. All though the process, was a failure to adequately inform about treatments and alternatives. There were problems from admission to discharge and during outpatient services.
For example, in the emergency room, I was administered an antibiotic without being told. After transferring to the floor, I asked when I was to get the antibiotic. Since I claimed incorrectly to have not received the medicine, the result was a series of phone calls and enquires that took about 2 hours to resolve the issue.
Certainly, it would have taken less time, effort and expense if I had just been informed along the away. And my care would have been better as an informed patient is more alert to possible side effects, thereby, better able to assist in their own care.
Then there was the resident who came by to prep me for surgery. Of course, I had not been informed that there was to be surgery; moreover, the surgery obviously wasn’t necessary as I was responding to the antibiotic. Moreover, the surgery that involves general anesthesia is a big deal, especially for those of us over 60, and is not to be done lightly.
I asked the resident if there would be a scar. The resident’s sarcastic response: “It’s surgery, so of course, there will be a scar.” Ordering unnecessary surgery, being snippy when asked questions, not the type of behavior that inspires confidence. Later, when the surgeon finally showed up, I tried to complain about the resident’s awful behavior. I was shut down. See no evil; Hear no evil.
At discharge, I was told incorrect information about my insurance. I knew it was incorrect and questioned the discharge specialist as to what she was saying. It was obvious that she didn’t understand basic insurance terminology. Then there were problems getting signed in to outpatient services.
The problems during my hospital stay were so pervasive that individuals can’t be blamed. Rather, it is the way that health care is administered in Las Cruces that is to blame. There is a systematic lack of concern about informed consent; an overall failure to communicate. This must come from the top. How else do you explain the difference in my experiences between Oregon and Las Cruces.
Of course, local hospital administrators will point to poverty and an attempt to reduce costs. They will argue that Las Cruces is a low-income community and they need to cut corners to make care affordable. But this is nonsense as informed patients who take part in their own care reduce costs.
Besides, ensuring informed consent is a moral obligation. Administering drugs without telling the patient, shutting down patient questions about a surgery, not listening to patient complaints is the opposite of informed consent. The medical community needs to act. This needs to be fixed.
Christopher A. Erickson, Ph.D., is a professor of economics at NMSU. He has taught at NMSU since 1987. The opinions expressed may not be shared by the regents and administrators of NMSU. Chris can be reached at firstname.lastname@example.org.