Where Do You Go When You Are Sick?
Do you like that new hospital that opened up next door? What about that established hospital that is in the “not so great” neighborhood? How do you choose?
There are lots of reviews today showing what people think about hospitals, what their rate of re-admission is, what their mortality is from heart attacks, and the quality of their surgery.
The problem is that there are the metrics to evaluate hospitals, like the new Medicare Hospital Compare site, or Yelp, or Healthgrades. But are those metrics valid- the answer is they are being developed, but often they are not as good as one might expect.
The Metrics Are Bad:
Some of the metrics used by Medicare are good, but how they are entered by the hospital may affect the ranking. Further, the more complex cases a hospital takes on, the more chance for re-admission, the more chance for prolonged hospital stays. While metrics are improving, they are not a substitute for asking your doctor. On the other hand, when you have very good metrics – hospitals that score well – that is great.
Most Do Not Have A Choice:
If you are in an ambulance in the United States they will take you where they think you should go, and often it is the closest hospital. No choice in the matter here.
If you are urgently needing a hospital you may be ruled by your insurance company – find out you have an HMO or a plan that only goes to one hospital group and you will end up there for care.
If you have a great doctor and they only go to one hospital – then you don’t have a choice.
Avoid Shiny:
The best hospitals in the United States are in questionable neighborhoods. Consider that most the major hospitals were established years ago, and neighborhoods change. The hospital may have some very old parts, and some very new parts. Given a choice between being a patient at Johns Hopkins Hospital in a rough section of Baltimore or a brand new hospital in the suburbs I would choose Hopkins without a second thought.
My son was born in an older hospital in a questionable neighborhood. I went there because that is where the surgeon (my wife was having a C-section) said was the best place for our case. I passed ten other hospitals that were in better neighborhoods, had newer facilities and didn’t give it a thought.
Trust Your Doctor/Surgeon:
Twenty years ago most Phoenix/Scottsdale surgeons went to many different hospitals. But today most surgeons go to one or two facilities. The reason for the change is better quality.
If a surgeon is familiar with the operating room staff, the staff knows what to expect, what instrument the surgeon uses, then that makes the operation smooth. As a surgeon it is nice to know that the operating staff knows that instrument I need for the next part of an operation without me asking for it.
My favorite hospital in the world: The Alaska Native Medical Center in Anchorage.
We Need Consolidation of Services:
Too many hospitals offer “heart centers,” or “wound care,” or “stroke centers.” Those centers are built based on revenue returns from the hospital, not based upon a desire to make an excellent experience.
But if you are in London and have a heart attack the ambulance will take you to St. Bart’s Hospital – where they have 10 operating rooms and 250 cardiac beds and perform more heart surgery than anywhere in the world. Their quality – amazing.
Or if you have liver failure in London you would be taken to Royal Free Hospital – a world class center.
The marketplace in the United States offers lots of choices, but not much of a way to evaluate the hospital when all the great doctors are spread over multiple hospitals.
