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Examiner.com Blog/Richard Blake

May 06, 2009
It should come as no surprise that not all hospitals are equal. Unfortunately for those of us with pressing emergency medical concerns, there is no possibility of taking the time to look around. We must go to the nearest facility and worry about the rest later. Or in the case of those of us without medical insurance we have to try to make it to University Hospital or Denver General. Fortunately for me, at the time of my recent heart attack the nearest hospital turned out to be Lutheran Hospital in Wheatridge. I cannot say enough about the skill of the staff, their compassion or their diligent follow-up. Unfortunately this is not the case in all Denver area hospitals, a few of which are the source of far more than their share of consumer and other complaints. The US Department of Health and Human Services has created a website called Hospital Compare, which compares "how well hospitals care for patients with certain medical conditions and surgical procedures." That link is: http://www.hospitalcompare.hhs.gov . The website also contains a link to a survey of "patient's hospital experiences." Another website, http://www.healthgrades.com/ gives hospitals a grade by condition treated of from 1 to 5 stars. Comparing the Denver area hospitals with which I had had some experience I came to the conclusion, that while such websites were helpful, they could not be expected to factor in all considerations, leading to the conclusion that good old fashioned word of mouth was necessary to fill in the blanks about what a hospital was really like. For example, when rating Denver area hospital's heart attack care, using the 5 star scale, only St. Joseph's, a downtown Exempla hospital, received the full five stars. While I have no doubt that St. Joseph's cardiac care is excellent, I was not able to understand why Lutheran, which from personal experience I would give all the stars possible to give on any scale, rated only three stars. Just as difficult to understand was how St. Anthony's North also rated even three stars, especially in light of the experience of a cardiac ER patient that I am able to independently confirm. The patient in question came into the North ER with nausea and left arm pain, two classic heart attack symptoms. While all heart attacks present differently, my own symptoms included these plus back pain and a cold sweat, it was only on my way to the ER that I experienced any chest pain at all and even then it was a good deal milder than I would have imagined one would experience during such an event. The initial Emergency Room response was fairly routine. The patient gave the hospital her insurance information and was assessed by a Triage nurse. She was then hooked up to various IVs and tests were run. What happened next was (hopefully) far from routine. While lying on the ER bed, wearing only a hospital gown, hooked up to various IVs and monitoring equipment, a lady from the Finance Department walked in and demanded immediate payment of what she claimed was a $200 co-pay owed at that time as if the stress level of a possible heart attack was not enough. That no doctor or nurse would bother to intercept what turned out to a be a little bit too gung ho, Finance Department worker spoke volumes about the real priorities at St. Anthony's North. Shocked, dumbfounded and hoping to just relieve herself of this new additional stressor, the patient paid the "bill." Fortunately, tests revealed that the patient was not having a heart attack (no thanks to the Finance Department), and she returned home. There she placed a call to her insurance who confirmed what she had expected. That was that St. Anthony's North ought not to have collected the $200 until and unless she was admitted as an in-patient to the hospital. Still fuming, she called the hospital administration. Making a bad situation infinitely worse, the hospital administration was not only not apologetic, but confrontational, even after conceding that the patient did not owe the $200, refused to return the $200, stating that the patient would owe at least that much to the hospital in any event. While such incidents might not have an affect on the number of stars a hospital receives on Healthgrades.com, it would seem to be very pertinent information indeed. Of course, hospitals do necessarily need to be concerned with their bottom lines. Yet allowing their Finance Department to act as aggressive collection agents, pressing patients even while they are being treated in an emergency room (especially when the hospital is in error and even when it is not) is a line that even the most strapped hospital ought to have the good sense not to cross.