American health care at its finest.
Jun. 13th, 2007 04:26 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png)
Woman bleeds to death in Emergency room as doctors and hospital staff stand by watching, refusing to assist, and 911 repeatedly tells family and bystanders that they can't make the doctors look at a patient and they can't take her to a different hospital, and that the woman should complain to the hospital staff if she feels she's being poorly treated.
Bonus: The desperate family, confronted with a refusal by the doctors and staff to even look at a woman vomiting blood on the floor of the emegency room, called hospital security. Security called the police, who arrested the woman (still vomiting blood constantly and writhing on the floor in pain) and dragged her out of the hospital on an alleged parole violation. She died on the way out of the building.
Bonus: The desperate family, confronted with a refusal by the doctors and staff to even look at a woman vomiting blood on the floor of the emegency room, called hospital security. Security called the police, who arrested the woman (still vomiting blood constantly and writhing on the floor in pain) and dragged her out of the hospital on an alleged parole violation. She died on the way out of the building.
(no subject)
Date: 2007-06-13 08:47 pm (UTC)Similar stuff, although not (quite) fatal, happened to people in my family, but that was in backwoods Québec 3 decades ago. I'm probably writing this right now because my father insisted on certain things when I was arriving, and the c-section could almost certainly have been avoided.
(no subject)
Date: 2007-06-13 10:52 pm (UTC)(no subject)
Date: 2007-06-13 09:34 pm (UTC)(no subject)
Date: 2007-06-13 10:12 pm (UTC)(no subject)
Date: 2007-06-14 03:21 am (UTC)(no subject)
Date: 2007-06-14 04:24 am (UTC)(Just 'cause, you know, that "whatever ailment" bit seems to suggest that yes, you did.)
(no subject)
Date: 2007-06-14 10:26 am (UTC)(no subject)
Date: 2007-06-14 05:53 am (UTC)I mean really, since when has that had anything to do with whether a person receives care? And as torrain pointed out, no, it fucking didn't have anything to do with what kind of "shape" she was in.
(no subject)
Date: 2007-06-14 10:29 am (UTC)(no subject)
Date: 2007-06-14 07:37 am (UTC)As I think you're implying, the American health care "system" is a tremendously f**ked up chimera of a beast, torn between two almost mutually contradictory visions. On the one hand, there's what the majority of Americans -- and the majority of physicians, including myself -- think health care should be: a right guaranteed by the government, in the way that (in theory) justice and the national defense are provisioned by the government. On the other hand, there's the vision of health care as a commodity to be made profit on, whatever the cost of making that profit might be, and if you're too poor to afford it, too bad; that's the vision pursued by for-profit HMO's et al. These almost mutually contradictory visions of medicine -- as public service, or as potential profit center -- are, in my opinion, a major source of the many failings of the American health care system, and how we manage to provide such bad care to the average working American while somehow spending twice as much per capita as any other industrialized nation. How we ended up with a system where the average American that *doesn't* make six figures would probably be better off in any other industrialized nation's health care system than ours. (For the wealthy, America's health care system is the best in the world, bar none. But I think you and I agree the "success" of a system ought be measured by how it serves the majority, not how it serves the few who can afford anything.) And there are certainly legions of stories regarding where the pursuit of profit and the shaving of corners and pushing of margins in pursuit of it leads to dangerous, even deadly consequences to unfortuate patients caught in the gears.
This case is a little bit more complicated...
The hospital at the center of this story -- Martin Luther King Jr. / Harbor, formerly Martin Luther King Jr. / Drew -- has long been known as "Killer King" for the gross incompetence by which it practices medicine, and IMO should have been shut down -- permanently -- years ago. On an absolute, objective standard, the hospital *should* be shut down. It has failed dozens of inspections and has somehow been totally unable to rectify the massively gross problems it has in delivering quality patient care. These problems in management, however, do *not* come from the too-common story of greed leading to margins being shaved that really should never have been touched. I actually have no idea how or what *is* the cause of the systemic incompetence. But this article (http://www.latimes.com/news/local/la-me-king12jun12,0,6099514,full.story) hints at a few of the speculated reasons why King/Drew got more reprieves than it really should have ever deserved.
Again, IMO, none of those reasons are justifable reasons for the leniency King/Harbor has recieved, but they are what they are. Any other hospital without King-Harbor / King-Drew's political background would almost certainly have been terminated long before this. To me, it's a similar kind of inexplicable as, for example, the Congressional Black Caucus' (CBC) defense of William Jefferson (http://en.wikipedia.org/wiki/William_J._Jefferson) (although in fairness, two of the most powerful members of the CBC are reported to have rebelled against the CBC and led the fight to strip Jefferson of his seats).
It is true the nature of our health care system is why King/Drew is one of the only hospitals in a desperately poor and underserved area -- but it doesn't explain why that hospital does such a terrible job of providing it, nor why it has been allowed to get away with it for so long. Many other hospitals are equally underfunded, but they do the job *competently* within their financial constraints. So unlike the usual American Health Care System horror story related to the pursuit of profit in what (IMO) is supposed to be a public service, in *this* case a large part of the story is in some ways related to the kind of political crap that the other side of the aisle from us --
(no subject)
Date: 2007-06-14 01:48 pm (UTC)That there's no alternative hospital in the area, that there's a 20 minute drive in ideal traffic to the next hospital (and traffic is never ideal), and that those 47,000 emerg patients a year will overwhelm the surrounding hospitals even if they *do* close MLK?
These are all *good* arguments to not close MLK, not bad ones, and they're compelling enough reasons that a politician moving to block closing the hospital, citing those reasons, can be reasonably suspected to be doing so for justifiable reasons, not just race-based special treatment.
It's undeniably a horrible hospital, but it's still a hospital, and those are kinda necessary. What it really needs is a "spring cleaning" - entirely new management, entirely new procedures, and fire people who don't follow them. While you're getting up to speed, use triage and send all cases that *can* suffer the wait to other hospitals, treating only the cases that cannot survive the trip elsewhere at MLK until the restructuring is complete, the inspections are passed with flying colours, and the hospital can be reopened. It's an inner-city hospital. It *has* to be there, meaning your idiot government needs to either fix it or replace it, but all the politicians so far are right: They *can't close it*, not until going there becomes consistently more dangerous than staying at home.
(no subject)
Date: 2007-06-14 04:07 pm (UTC)Until recently, the management at King/Drew has been given repeated, extended opportunities to try to improve itself, rather than being terminated and completely replaced. They've gotten reprieves, rather than a definitive "spring cleaning". And a lot of that had to do with politically sensitive issues regarding who exactly the management was. There is a lot of pride in the King/Drew community regarding not just the fact the hospital exists, but that the community itself founded and ran the hospital. Unfortunately, for reasons I have no idea about, they did not run the hospital well, in contrast to other communities with similar financial and socio-economic challenges who *did* manage to do the job. For whatever reason, King/Drew and it's management failed where others in other cities succeeded. But to do the spring cleaning -- take the management away from the community and put it in someone else's hands -- was an extremely politically sensitive issue, especially given the very real issues that led to King/Drew's foundation years ago, and *that* has, I think, slowed and complicated the process much more than it should have, to the point where it repeatedly endangers lives, badly enough that the accreditation organizations really do think you might be better off taking the time to go elsewhere.
What should have happened long ago was the spring cleaning you propose -- take management responsibility away from the existing management structure -- even with all the political sensitivity regarding that -- and put it in the hands of competent management. And that is, belatedly, almost exactly what has been attempted in the last few months. King/Drew was severed from Drew University School of medicine and placed under the full ageis of UCLA -- hence the change in name from King/Drew to King/Harbor (for Harbor-UCLA), and they attempted to clean house on the staff. But there was tremendous resistance internally and externally for a whole panopoly of complex reasons, some political, with the net result that, so far, there are still severe problems. For now, the hospital has been shut down to the barest minimum, from 500ish beds down to 40ish, and ambulances taking everyone who can possibly be seen elsewhere taken elsewhere, while UCLA tries to get a grip on the place. I hope, for the sake of the people of that area, they succeed. It's a step that should have happened a long time ago, and would have, except for politics...
Everyone knows there must be a hospital in that region. The political fight is regarding who runs it, who funds it, and who controls it. And that political fight has continuously gotten in the way of and slowed the very real need to give the people of that area what they need -- a competent, functional hospital.