The sheer level of medical malpractice in America horrifies me. What the fuck kind of asshole doctor do you have to be to immediately assume a patient in distress is a criminal and go Cop Mode on them :doomer:

  • charly4994 [she/her, comrade/them]
    ·
    2 years ago

    I understand the concern that you don't want to fuel an addiction since there is a small population that will go ER shopping to get some opioids. Like if the person is saying they're in 10/10 pain, worst pain in their life and they're just non-chalantly watching TV while laughing on the phone, I'm going to have my doubts. There might be pain still, but not as significant. On the other hand people also have learned how they have to play the system. They know that 5mg oxycodone will manage their pain, but the doctor put them on 2.5mg for 4-6 pain so they just say they're in 10/10 pain when in reality they're probably at a 6 or 7. Going from working in a hospital to a short term rehab though, there's a bit less gatekeeping in pain management. I still have coworkers that will gripe about certain patients that will ring on the dot for when their next dose is due. It's not particularly difficult to just get into an unofficial schedule with people and in the end as long as you manage their pain, they're not going to be annoying.

    The author sounds like a frequent flier in the local hospital which usually doesn't come with the benefit of the doubt. Hospitals in particular are heavily incentivized to avoid having repeat admissions since readmitting someone <30 days after discharge impacts the hospital's rating with Medicare which will impact the amount of compensation provided. This also counts should they go to a different hospital and be admitted. So you have the unhinged bloated management screaming downwards at the medical staff telling them to watch out for drug seeking behavior and avoid readmits. You'll get called into the office, have strongly worded emails sent, and have your general job security threatened if you don't tow the line properly.

    • BeamBrain [he/him]
      hexagon
      ·
      2 years ago

      Hospitals in particular are heavily incentivized to avoid having repeat admissions since readmitting someone <30 days after discharge impacts the hospital’s rating with Medicare which will impact the amount of compensation provided.

      Reminds me of the quote "A measure ceases to be useful when it becomes a goal."

    • UnicodeHamSic [he/him]
      ·
      2 years ago

      When I saw her list of diagnosis at the bottom my internal alarms went off. Especially given that her stories about thr hospital are related to her likely haveing developed a liver damage form too many pain meds. If she isn't a med seaker then her situation is simply outside the scope of what hospitals can manage.

        • UnicodeHamSic [he/him]
          ·
          2 years ago

          Depends on the unit. Where I have worked they'd be perfectly content to run the tests but of those diagnoses I recognized none of them would be observable at below a specialist level. Which means at our low level is on the honor system if she has them or not. It is entirely possible for a person to have every single untraceable nonspecific pain condition at the same time. It is not likely. It is highly convenient. So we have to weigh how much we like DEA paperwork vs the risk of her ODing.

          In general we have a very poor syatem for pain management and it sucks. It is soul crushing to work those cases where you know you aren't going to be ablw to help. Me personally I feel like we should just give people pills that ask. I get why that is a bad idea though. And for her it probably isn't helpful. However I don't think that our system the way it is will likely offer her meaningful treatment for her situation. So that sucks. Those kinda cases are the ones I know I problem drink over after work.

        • UnicodeHamSic [he/him]
          ·
          2 years ago

          To the first point though, I don't belive he would get better care. More care for sure, absolutelyyou are correct. However there is just a hard limit to the extent of what we can figure out given the goals and methods of our system. Past a point it is just doctor's bravado, so if you pay enough a doctor will give you a diagnosis. He just might have made it up though.