I’m a former elementary school teacher.
Ever since I was a child, I’ve always taught something to someone, whether it was my little brother against his will “playing school,” my students when I had a bona fide paid teaching job at a Catholic elementary, or my children when I became a mom.
Now I type online. And I teach. And I’m learning more in this blogging gig than ever before, mostly that I don’t know much at all.
Nonetheless, the educator in me will not stop breaking things down and explaining them to others.
When I write to my legislators, the CEO of a company, or a letter to the editor, my goal is always to teach and usually to incite change. This week I encouraged the KS readers to advocate for something important to them, shared a recent letter from a reader doing just that, and took up the flag and wrote my own letters just now.
I don’t think either of these letters would have happened without the encouragement of Kitchen Stewardship readers and this community.
After I shared this post with my reactions to the sugar water nearly administered to my newborn for pain relief, I got a kick in the pants from an RN via my Facebook page (written in the shorthand of a busy mom herself):
As an RN I have to say that is now my #2 dumbest policy I’ve ever heard of. What’s the evidence behind this? I know u r a busy mommy but I would encourage a f/u w the dept manager to determine if this is standard operating procedure. If so I would f/u w a strong letter to the hsp pt services rep w a cc of the letter to your pediatrician. Advocate for all the moms and babies out there that don’t know any better to ninja chop bad policies. 🙂 If nothing else if they r giving it as a pain relief method (which personally I think is nonsense), like all meds, there should be a discussion and informed consent given. Good for u to ask the ?’s mommy!!!
I still need to do step one with the department manager, but since it happened twice during our hospital stay, I’m pretty sure I didn’t waste my time writing this letter:
To the Hospital Patient Services Representative:
I’m getting back in the groove after giving birth to my third child in mid-August. This delivery was my first at Metro Health, and although overall I had a positive experience, I have two issues I’d like to recommend be looked into.
Although I’m not a medical professional and don’t claim any superior knowledge in the field, I hope you’ll hear me out.
My infant son was nearly given Sweet-Ease, a sugar water, as pain relief for a routine heel poke blood test when he was 12 hours old. I asked what it was and what it was for just as the syringe was being placed into his mouth, and I was able to decline the procedure. (My son slept through the entire heel poke experience anyway.)
I was quite surprised that the sugar water solution was offered for two reasons:
- It took place a mere minute after the pediatrician examining my son explained that newborns have zero gut bacteria at birth and that the gut is populated during the first week. I know that I have trillions of bacteria in my gut – both healthy, helpful bacteria and the “bad guys.” From what I understand, the “bad guys” like to eat sugar. I didn’t want my newborn to have even a teaspoon of sugar unnecessarily when he was only getting a few teaspoons of colostrum with each feeding.
- I wasn’t asked if I wanted to administer the sugar water to my child.
Foodist opposition aside, if Sweet-Ease is being offered as pain relief, the parent should have to give informed consent for the procedure. Particularly for nursing moms, breastfeeding during or immediately after the procedure should give more than sufficient comfort to the infant. Thank you so much for looking into this and requesting that the nurses (at least) ask permission.
The second issue is another of consent, but this time a more financial issue than medical.
In our day and age, patients are increasingly responsible for more of their medical costs than ever before. I was personally charged for two pharmaceuticals that I didn’t use, and perhaps because of that realized what had happened. A foaming hydro-cortisone spray and a pain relief spray (Dermaplast, I believe), both for stitches, cost $188 and $42 respectively. Either can be obtained over-the-counter for a fraction of the cost.
I believe that hospitals could do a great service to the country, literally, by simply including prices with optional procedures and pharmaceuticals. High medical costs are wreaking havoc on the economy and the average person’s wallet, and I’m sure most folks would prefer to know what they are paying for a Motrin or a Dermaplast spray; they just don’t know enough to ask.
I called the labor & delivery floor with my story and encouraged the head nurse there to discuss pricing with the staff, and she seemed very interested in the situation. I thought following up with my suggestion through this avenue would be helpful to the hospital overall as well.
Thank you so much for your time, and I would be willing and interested to discuss either issue in greater detail in person. You can reach me at 616-555-1760.
Look at me going all Hollywood with the “555” number! Aren’t you all proud of me that I’m smart enough not to include my real phone number in the online version? Glad my mommy brain cleared enough to realize that’s a bad idea…
Is this one ready to send?
To the Editor:
Note: I haven’t sent this letter yet, so I submit it to 10,000 editors for refining. Is there anything I should delete or add or clarify? It might be too long…a chronic problem of mine.
It’s time for a change in the way healthcare is provided in American hospitals.
Hospitals now have advertisements on billboards and television commercials, behaving like any other for-profit business.
If I was taking my vehicle in for service or buying a new laptop, I’d shop around. I’d ask for price quotes and certainly wouldn’t make a major purchase or repair without a price tag.
However, we do this all the time with medical care. Why should hospitals be exempt from fairly standard commercial practices like posting prices?
The health care costs in our nation are out of control, partly because most folks never checked their bills when insurance picked up the tab 100%. I’m willing to be that countless patients blindly accepted unnecessary (and overpriced) line items as part of covered medical care.
The inspiration for this letter comes from my recent experience giving birth at Metro Health Hospital (that costs about $7000 for the bare bones package, not including baby’s care, by the way). Three parts of the experience accentuated the state of medical economics in our culture today:
First, I was charged $188 and $42 for two items for stitches care that I didn’t even use. The less expensive item is available at any pharmacy, same brand, for under $5.
I found myself wishing that the nurse who offered to bring them into the room, at which point I was charged although I didn’t touch them, had mentioned the prices. I would have declined emphatically (but politely).
Second, I also priced a circumcision for my son. It was going to cost $3800 at Metro Health Hospital and only $437 at a local urologist.
Finally, I was lucky enough to be asking some questions via phone before heading to the hospital and discovered that new moms can “board” for free if they get discharged after one day, even if their baby has to stay two days. I was able to stay in the same hospital room for an extra day, receive free meals, and care for my baby, saving myself almost $1000. I would have missed out on this if I hadn’t asked questions and continued to advocate for myself by requesting to be discharged.
Mistakes often happen in billing as well. A friend’s grandfather was charged for five packages of menstrual pads, and another was charged twice for labor and delivery: once for the baby, once for the placenta. Those are pretty inseparable.
To anyone who ever has been or will be a patient: be smart. Ask questions like, “Is this necessary? Will I be charged? How much? Is there any way to save?”
After the fact, always get an itemized bill. Make sure you know what you (or your insurance) are paying for. We all ultimately pay extravagant medical costs via higher premiums.
And finally, to the medical establishment: it’s time to do your part to get our economy back on track. Please unravel the tangled web of billing, paperwork, and charges for healthcare. Publish your prices, especially for voluntary or optional procedures and medications.
Sometimes I think simply reducing the massive amount of paperwork necessary to get through a medical procedure would save millions of dollars. (Are you listening, insurance companies?)
In a time when the average worker has to pay more out of pocket for medical insurance and direct healthcare than ever before, it’s up to all of us to work together to make sure we can afford simple things like having babies and setting broken arms twenty years down the road.
Do you think healthcare costs could be improved if everyone took a little more responsibility in watching the bottom line, hospitals included?
See my full disclosure statement here.