Hospital Nightmare
Last activity 07 December 2022 by PalawOne
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'Hospital Nightmare'
By Dr. Raymundo Lo. MD, FPSP
Published Today Dec 6, 2022 https://mb.com.ph/2022/12/06/hospital-nightmare
From their former image of disease and death, hospitals are now viewed as centers of wellness and healing.
We have no shortage of first-class hospitals.
St. Luke’s Medical Center, Makati Medical Center, and Medical City all exemplify the highest quality and standards of health care by being accredited by Joint Commission International (JCI).
JCI accredits hospitals in America, and worldwide, and is now recognized as the gold standard for patient care in the international health care community.
It is no mean feat to qualify for JCI accreditation, requiring adherence to the highest standards of medical care, because the first dictum of doctors is, “Primum non nocere,” Latin for “First, do no harm.”
Having been in practice at St. Luke’s Medical Center for 35 years now, I’ve seen how St. Luke’s has grown from strength to strength, and I have proudly participated from the first time St. Luke’s applied for JCI accreditation.
Thus, I expect the same high standards of care for patients in hospitals everywhere.
But alas, this is not the case. A very recent experience left me with nothing but frustration and anger.
At work yesterday, my son Richard had several bouts of vomiting and diarrhea that left him dehydrated, and the company nurse told me my son needed to be admitted to the hospital for intravenous therapy.
Since their company had a tie-up with another hospital, they had him admitted there the same day.
Right away, I packed my overnight bag and proceeded to that hospital. There, I found Richard in bed, looking weak and dry-mouthed.
He had been admitted 30 minutes ago, but to my dismay, the nursing staff had not taken his vital signs nor had they inserted an intravenous line to start the process of rehydration.
Only after I inquired did they attempt to insert an IV line, which they failed at.
Another nurse came in with the first and inspected his arm veins which, of course, were collapsed because of the dehydration.
They then left. After an hour, nothing was happening, and I was getting nervous about my son’s situation, since he was having difficulty breathing and his fingernail beds were dusky blue, which indicates lack of oxygen.
At the nurses station, I asked politely if they had contacted the resident. The nurse claimed she had. Yet, considering the patient’s situation, which I doubt they knew about as no vital signs had been taken, I told them I was a doctor and needed to talk to the resident-in-charge.
Still, nothing happened for the next half hour, at which point I started calling on my med school classmates still practicing in that hospital to get some action on my son. Only then did the resident arrive and get an IV line in my son’s arm going.
Noticing the slow IV drip, I asked the nurse what the rate of infusion was. Her answer was “to consume one liter of IV fluid in eight hours.”
Well, I blew my top. I told her that the patient, if she had taken his vital signs, was moderately dehydrated and needed to have lost fluids replaced at a faster rate. Again, I had to turn to my classmates for help.
Can you imagine a non-medical person in that situation? There definitely would be a high risk of harm or even death for the patient if no action was taken, which required medical acumen and connections to correct!
My classmates had notified the chief of clinics and the chief quality officer of the situation, and things were better from that point on. Finally, a bolus of 150 ml. of IV fluid was given and the IV drip was hastened.
Fortunately, Richard was also able to drink and keep in several bottles of water and a liter of Gatorade, which is good for replenishing lost electrolytes. He looked better then and his nailbeds were now pink.
Then I turned on the TV to get some news, and all I got from the tiny 19-inch screen was a blurry picture and bad sound from only local channels. Next, to add injury to insult, I was trapped in the toilet due to a malfunctioning lock. The nurse had to open the door from the outside.
Last point, the diet ordered was low-fat, but the breakfast was beef tapa and fried egg with rice. How was that low-fat?
I had Richard discharged first thing in the morning.
I could take care of him better at home. End of nightmare.
So much room for improvement in that hospital, which used to be one of the best in the 1970s.
--
@PalawOne I sure wish he could have mentioned the name of the hospital but I know that, due to the strict slander laws here, it was wise for him not to. I would like to find the list of JCI accredited hospitals in the Philippines. We have a few private hospitals here that might be but no way would our govt provincial, that accepts phil health as payment in full, be qualified.
St. Lukes has a great reputation. . . .
When I told my US Cardiologist (a Filipino Doctor) that my stepson was a nurse at St. Lukes he praised the hospital.
Shortly after moving here my wife became very ill and spent about 10 days at St. Lukes, their diagnosis was an UTI infection (Cost about $9,000)
Several months the same problem, again the diagnosis was UTI another 10 days and another $9000.
A third time back to St Lukes with the same symptoms, this time $10,000. The problem was kidney stones and operation. (paid up front).
The costs just keep adding up, an office visit to remove a stent $1500, plus follow up visits of P1500, expensive meds plus lab tests.
If it was diagnosed correctly I could have save $18,000.
Where do you find all this tripe P1?
Cheers, Steve.
-@bigpearl
Between the Lechon Baboy and Pag Pag.
@Enzyte Bob It seems there is no accountability here for repeated misdiagnosis. It's almost as if misdiagnosis is a profit center for them...a JCI "accredited" profit center lol.
`
This 'treatment' from an apparently well-regarded Phils hospital seems shocking.
And I'd guess it's true, written by a doctor and published in a national newspaper.
So anyway as Dan and Bob suggest, and I'd agree, this is simply not good enough.
If this treatment is typical of the 'big name' medical hospitals, imagine what your normal or smaller or poor-area or geographically isolated hospitals are like for professional medical treatment?
I know my wife, whose family comes from a small island group, says no-one dares visit their 'hospital' on the big island because their one doctor is widely regarded as bat-shit crazy. And very likely to kill you. Besides which, their one-bed 'hospital' has zero medical equipment, or medicines.
However, I'd guess their main concern is the skill and knowledge of their doctor?
Seems, good doctors, that's what really matters. So, what can be done about this?
I don't know. Do us folks have any ideas about improving Phils medical treatment?
Maybe one idea, as most areas have reasonable internet these days, perhaps the current Marcos government could invest in providing systems of basic and simple tele-health resources?
With just an office, any nurse should be able to conduct elementary diagnostic medical examinations, utilizing your simple, basic diagnostic medical equipment?
Then the nurse might report their results to 24 hour on-line tele-health doctors in Manila?
With good diagnostic staff, and tele-health resources, then reasonably professional, country-wide medical assistance might indeed be possible?
Quick and fairly cheap to implement. Maybe worth trying?
`
@PalawOne Here in Dumaguete my wife was able to have online face to face with the Silliman university med doctor and it worked out well, even sending prescriptions thru email. It was like a zoom call but using a different medical app called "Now Serving". Not sure if other hospitals have a similar service. Doctors already rely on medical techs and specialists to operate diagnostic equipment that neither doctors nor nurses are trained to operate. My doctors always repeat blood pressure tests taken by the office nurse and are probably not ready to delegate much responsibility to their "helpers", just my opinion. A hard nut to crack here and it's not just about money.
When in the states many CVS drug stores had a mini clinic with an RN for simple things on a Walk-In basis.
While my Medicare Advantage provider had numerous Clinics for Walk-Ins with Doctors and Lab, thus avoiding an appointment with your Primary Doctor weeks away.
I would simply go online and check the wait time of the various clinics, sometimes driving further for a shorter wait.
@PalawOne Here in Dumaguete my wife was able to have online face to face with the Silliman university med doctor
-@danfinn
.
Pretty soon the online doctor will be in India.
I am still not convinced telemed is as good as face2face. The doctor cannot see your body language and your smell. To me, guesswork is much broad in telemed.
.
@PalawOne My doctors always repeat blood pressure tests taken by the office nurse and are probably not ready to delegate much responsibility to their "helpers"
-@danfinn
.
I am still in the US. If I am coming in for my routine cardio checkup, the doctor sometimes check my again after the nurse does the history taking and vitals. If I am coming in on a sick call (i.e. cough & cold), the doctor does not re-check my BP.
`
Thanks Dan and Bob. You both seem to have provided excellent suggestions regarding more accessible, top-quality-but-with-lower-cost medical care for everyone. Correct, Dan and Bob?
And Jackson, thanks for the news re India. That's indeed great news for a county that really needs such care.
And gents, all of your suggestions would seem to offer significantly better / quicker / cheaper Philippines medical care? So, apparently significant medical-care improvements in the Philippines are not a complete mystery.
Dan, your suggestion might readily and most securely be government run, and yours Bob might most easily be funded by the private sector. Though both could also readily be either?
All we need now is for the Phils government to hear this and be brave/bold and explore such?
All, surely medical care provisioning is right up there at the top of government responsibility?
For instance, here in Australia I've had heart by-pass surgery, a hip replacement, and recently, had plastic surgery for a minor skin cancer. All completely FREE. At no charge what-so-ever.
Also of course, every visit to my own, selected GP also my local hospital are also completely free-of-charge, and have been for many, many years. In fact, free or very nearly so, for most of my life. It's what we Australians wanted and so our government listened to everyone, and then just did it.
Would suggest the Philippines government listen to all of the problems their people face with medical care, and DO SOMETHING ABOUT IT. That's your job, that's why people elected you!!!
That what governments are for, to provide for what-ever a majority of their population wants. Ok, maybe not free in a country of more than 100 million, but surely better care than all the horror medical stories that we hear!
With all due respect, come on President Marcos !!
(Rant-mode off)
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