I’m a Physician and Hospitals are Starting to Scare Me

Warning sign

When you entire a hospital, there should be a bright, yellow caution sign that says “Enter at Your Own Risk” and for those who think I’m exaggerating, I assure you I’m not. My concerns are real and they should be yours as well.

In my city, there are only two healthcare systems in town in addition to the VA system which reduces the competition and thus, the level of quality care. I was a patient at one of those hospitals and ended up on CNN because of the outrageous bill that I received. A few days ago, the Orlando Sentinel reported that one of those hospitals is cutting their staff by 20% and the night shift nurses’ salaries by 15% as a result of a bogus program called “Value Creation.” The announcement was made while the CEO, who earns over a million-dollars-a- year frolicked in the sun at a Caribbean resort with her family compliments of one of the hospital suppliers. Isn’t that a conflict of interest by the way?
Night-shift nurses work under trying conditions because they don’t have the level of support that occurs during the day shift. They work at night because the additional money helps a single mother take care of her family; or a nurse to go to school; or eliminate the need for a babysitter because the mother is allowed to stay home with her kids during the day time.

In addition to cutting back the nurses’ salaries, the hospital plans to eliminate pharmacists, respiratory therapists and increase the price of cafeteria food by 20%. Why am I scared to enter this hospital? Because the night shift will be short of nurses if I happened to be admitted at night. There will be fewer pharmacists to prepare medication in the event of an emergency. The staff morale will be low and the quality of care will be diminished which results in more medical mistakes.

A hospital is no longer a place of healing. It’s a business. And that’s a shame.

Pregnant Moms: This Test Will Save Your Baby’s Life

 

Smartmothers guide book cover

Each day, U.S. healthcare providers obtain a vaginal culture for Group B Strep (aka Streptococcus) from pregnant women in a routine manner, yet there is nothing “routine” about the way this simple test can miraculously save your baby’s life.

Group B Strep (or GBS) is bacteria found in the intestines, rectum and vagina in 15 to 40 percent of pregnant women. Although it can cause a urinary tract infection and occasionally meningitis and an infection of the lining in the uterus (aka endometritis); most women are not aware that they are GBS carriers because it usually causes no symptoms.

GBS is the leading cause of a severe illness known as sepsis in newborns and up to 50 percent of newborns can die before the 6th day of life. The good news is that since the late 1980’s, OB healthcare providers have been testing pregnant women between 35 to 37 weeks of pregnancy which has reduced the death rate of newborns significantly. When a woman has a positive GBS culture, she is treated with antibiotics while she’s in labor. The reason she is not treated before the onset of labor is that the infection is passed on to the baby as it passes through the birth canal. If we prescribed antibiotics before birth, the infection would return by the time the woman is in labor.

Every pregnant woman should be tested for GBS AND know the results of the test. Ideally, the hospital should have a copy of your records, especially if your provider and hospital have electronic medical records. What happens if you don’t know your GBS result and go into labor? The hospital should be able to do a test that provides instant results. You should also be treated with antibiotics if you have the following risk factors:

  1. Have ruptured membranes (broke your water) for greater than 18 hours
  2. Are in premature labor with ruptured membranes
  3. Had a GBS urinary tract infection during your present pregnancy
  4. Had a positive GBS test during a previous pregnancy
  5. Have a temperature of 100°F while in labor

If the pathology report of your baby’s placenta reports a diagnosis of chorioamnionitis, which is an infection of the membranes, your baby should receive antibiotic treatment before it leaves the hospital. Knowing whether or not you have GBS could literally, save your baby’s life.

Are you able to recognize potential red flags that could hurt your pregnancy? If not, then please pick up a copy of The Smart Mother’s Guide to a Better Pregnancy.

Pregnant Moms: Please, “Escape Fire”

EscapeFire_Article1

Every so often, a film comes along that makes us sit up and take notice. Escape Fire is one of those films.  Executive producers Donna Karan (fashion designer) and Scott Douglass along with directors Matthew Heineman and Susan Froemke produced this magnificent film that premiered at the 2012 Sundance Film Festival.

Why is this film so important? Because it takes a heart wrenching look at our very broken healthcare system. “Escape Fire” is a technique used by firefighters who are faced with an impending wildfire. They purposely set an area of grassland on fire so that when a raging wildfire approaches, there’s nothing left to burn. It’s a drastic measure that saved lives which is what we desperately need in our healthcare system.

The film addresses several issues that include

  • The influence of drug companies on healthcare
  • The problems with overmedicating patients
  • The over-treatment of patients
  • Paying more for healthcare and receiving less
  • The importance of preventing disease
  • The “fee-for-service” payment system for doctors and hospitals
  • The importance of treating the whole person and not just her illness

As a pregnant woman, you might think these issues don’t affect you but they do; especially issues that involve money. What the film teaches us is that doctors are paid for procedures and not the quality of care given to the patient. I personally witnessed this first-hand. There is a line from the movie where a physician says “I don’t care about my productivity. I care about helping my patients.” I became teary-eyed because that was the story of my life for 15 years. How many times had I said that during the course of my professional career?

A former employer hired a friend, paid him for the number patients he saw and consequently put the patients’ lives at risk. It was an exercise in futility trying to get state regulators and medical societies to stop this clinic from scheduling 80 (no, that is not a typo) patients per day. Unfortunately the practice continued until the administration changed the way the physician was paid. When he was paid by the hour rather than by the number of patients seen, he no longer had a burning desire to see 80 patients per day.

As a pregnant woman, you are entering a healthcare system that is flawed which was the inspiration for writing The Smart Mother’s Guide to a Better Pregnancy®.  I strongly encourage each of you to be alert and outspoken regarding your healthcare. The life you save, might very well be your own.