Med Follies

Mike and I have a bet. UNC Patient Relations dropped off a card (form letter) on James's door inviting us to contact them with any concerns or compliments about our hospital stay. After waiting for almost two hours down in the hospital pharmacy for James's discharge prescriptions on Wednesday, I called their number -- and got an answering machine, which doesn't exactly scream excellent customer service. I requested that someone please explain to me why discharge prescriptions couldn't be electronically submitted by the doctors to the pharmacy, and then the pharmacy could either call the patient's room or alert the patient's nurse when the prescriptions were ready. That way, parents like me wouldn't have to leave their infants in a hospital room while they waited around downstairs (and heck, other people getting out of the hospital probably aren't eager to extend their stay in a pharmacy waiting room, either). I left our phone number and said I was looking forward to speaking with someone.

Mike wins the bet if they call any time before close of business tomorrow (Friday), and I win the bet if they call later than that or (as I expect) they never call. So far, I am winning (which of course means that hospital patients are losing).

And then down at the pharmacy, the pharmacist informed me that the insurance company was refusing to pay for the antibiotics because they alleged that the dose was too high. He said he'd have to "play a little chess with the computer" to see if he could get it to go through. I'm not sure if he did or not (because the cost was listed as the same as the co-pay), but it turned out the cost of the few milliliters of antibiotics that James needed came to a total of less than $20.

So, BCBS, let me get this straight. Once again you're wasting the time of highly trained medical professionals over what is essentially pocket change for your organization. But more importantly, do you really think that it is cost effective for you to 1) deny coverage for antibiotics and instead pay for a hospital readmission for post-surgical infection? Or 2) encourage your customers to stop in the middle of a course of antibiotics and thus encourage antibiotic resistant infections?

Is it possible to arrest a corporation for practicing medicine without a license?

Finally, because James's recent blood pressures have been good, James's nephrologist decided to try discontinuing his blood pressure medicine after surgery. The idea was that since they check blood pressure multiple times a day for hospital patients, this would give us a good sense of whether he still needed the medication or not. Well, in the two days after they discontinued the medication, we did not get a single accurate blood pressure reading. What I mean is that they'd get readings where the diastolic and systolic pressures were separated by a point, so it was obvious that they were not correct readings. Frustrating! The nurses said it was because he was moving around a lot, which is true as far as it goes, but there should still be a way to get some kind of good reading. (And on that topic, what genius decided that if a baby is moving, the automatic blood pressure cuff should JUST KEEP INFLATING until it's over 200 and the baby's foot is purple and he's screaming? Watching that makes MY blood pressure go through the roof, and I think I'm probably being a bad mom by resisting the urge to just rip the cuff off at that point.)

Anyhow, that one ended reasonably well because we got a blood pressure downstairs in the clinic as we were leaving that both seemed to be accurate and was in the normal range. Yay!

[Photo is the view from Jamesie's hospital room window.]