One Step Closer to Third-World Medicine? | Guest Blog

First, families start walking the patients because the nurses are "too busy" to do it. Next, will we have to bring linens and food and barter for medications?

In a post 2 weeks ago, I discussed why elderly patients don’t get out of bed and walk when hospitalized. You can read it here. I wrote that a major reason that staff does not have time to walk patients is that they are too busy documenting useless checkboxes on the electronic medical record.

The New York Times article about the negative effects of bed rest on the elderly that led me to write the post stated that “hospital nurses seemed grateful” when the author offered to walk her father. She also mentioned that she had to supply a walker, robe, and slippers.

My next question is: Could this be the first step toward third-world medicine? [Pun intended.]

We’ve all heard stories about how in certain countries, families must provide hospitalized patients with bedding, food, and basic hygiene.

A recent article about a family’s experiences with a relative who had surgery in Cuba illustrates the point.

The author wrote, “Prior to the trip [to Cuba], my wife wisely purchased towels and two sets of sheets and pillowcases for her mother’s use during her hospital stay. In addition, we packed several aerosol cans of spray disinfectant, special soap used for sponge baths, and a room air-freshener that plugs into to an electrical outlet.

Regarding the postoperative stay, he says, “The next 2 days for me was [sic] spent shuttling food and juice to the hospital for my wife and her mother.”

“At the end of the third day, my mother-in-law had arranged to trade her used sheets and towels for a week’s supply of Vicodin and Percocet with another MD on staff.”

Is this where we are headed?

First, families start walking the patients because the nurses are “too busy” to do it.

Next, will we have to bring linens and food and barter for medications?

Maybe it won’t be that difficult. The way it is now, a family member should be present at the bedside of any relative who might be sedated or confused to help prevent some of the thousands of medical errors that occur each day.

If someone is going to be standing watch anyway, he might as well bring food and sheets and get the patient out of bed too. Maybe we could also enlist the relative to do some of the charting in the electronic medical record.

Of course, there are always loose ends.

What happens if the patient has no relatives who are free to spend days in the hospital caring for him or has no family at all?

Where is all that money that hospitals are making by overcharging everyone going?

Skeptical Scalpel is a recently retired surgeon and was a surgical department chairman and residency program director for many years. He is board-certified in general surgery and a surgical sub-specialty and has re-certified in both several times. For the last two years, he has been blogging at SkepticalScalpel.blogspot.com and tweeting as @SkepticScalpel. His blog averages over 900 page views per day, and he has over 6,100 followers on Twitter.

  • Karen J. Pataky says:

    As a nurse [ since 1965] I am well aware of what “too busy” really is! And yes, paper or EHR documentation is a bit much.
    But, of course, families must supply robe and slippers unless its a boutique hospital. And its far less expensive for the family to obtain the walker. That is NOT 3rd world. And families must get involved in patient’s care: they will be on duty 24/7 when he/she returns home. Where is the money? The CEO’s, CFO’s, COO’s, PR folks have snarfed it off the top!

  • vince says:

    Despite the fact that health care is by far more expensive here than elsewhere. We rank 33 in overall life expectancy behind such country’s as Qutar’ ; Cyprus ,Kuwait…..in infant mortality we rank behind many industrialized nations who spend far less ; and also behind such nations as Cuba ; and Malta. Respectfully where are the results …….

  • brianne says:

    Family support, third world medicine…sounds like what Victoria Sweet the author of God’s Hotel calls slow medicine and I (also a nurse since 1971) am all for it.

    • SkepticalScalpel says:

      Brianne, thanks. It’s fine as long as the patient has family who are willing to pitch in. Unfortunately, not everyone has family or family who are willing.

  • Yvonne Knauff says:

    I’ve recommended for years that anyone admitted to the hospital have a family member or advocate sleeping under their bed. Truly! No lie! Necessary?? You bet!

  • Maranon says:

    The idea that the medical care in the USA is (was) the best in the world, it has been an illusion, that now people have become aware of the shortcomings.
    In the days when the health care insurance paid for the patient to stay overnight before surgery “for preparation”, then to recover from the surgery until he/she felt well enough, it was a money making for the hospitals, and it was often abused and people was kept against their will and “against medical advice”. When the MBA’s groups took over the community/ religious affiliation hospitals in the aggressive manouver to make money for themselves, the cuts to patient care became even more drastic, firing all the experienced personnel, limiting bed changes, limiting aides, etc.
    So…blame it in the greedy corporations that own the hospitals, as it has become an INDUSTRY, and the purpouse is to make money for the CEO’s and investors. The patient and the staff, are just there to be squeezed.

    • SkepticalScalpel says:

      Maranon, thanks for the comment. It definitely is a business these days. Hospitals that don’t make money close. Not-for-profit is nonsense. The profits are obscured by creative accounting.




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