A morbid hospital story
March 2, 2004 | 12:00am
Some wit or nitwit – depending on which side you’re on – said that 10 percent of what we eat keeps us alive; the other 90 percent keeps the doctors alive. The truth is, a lot of people have a mortal fear of hospitals because it’s one thing to overcome an illness and quite another to survive the skyrocketing costs of hospitalization. There’s the sick joke about a patient who had a heart attack after looking at his hospital bill. Perhaps doctors ought to review or reexamine critically their Hippocratic (hypocritic?) oath, where a line reads: "With purity and with holiness I will pass my life and practice my art."
Here is a patient’s (or it is a victim’s?) account of a recent morbid hospital experience.
Dear Consumerline,
Remember your column sometime in October last year about the spiraling costs of hospitalization? Well, here’s my personal experience piping hot off the oven, in a manner of speaking. Of course, I’d rather you don’t publish my real name because I don’t want to cause anybody any harm and so, I’m not identifying the hospital except that it’s one of the top five in Manila, and I’m using pseudonyms for the doctors involved. I simply want to share with your readers a first-hand experience that made me shell out more than what I think was necessary. And here’s why.
A few weeks ago, my surgeon Dr. Reyes referred me to a gastroenterologist for colonoscopy. Let’s call him Dr. Cruz. He had taken care of me previously and I was quite satisfied with his services. This time. he suggested that I be admitted because I’d need sedation. And so I was admitted. After the procedure, and when I was completely awake, Dr. Cruz told me it would be best to remain in the hospital and undergo surgery. There was a new mass in my colon. He said he would endorse me to Dr. Reyes.
Dr. Reyes visited me in my room later that day and said he’d be free to do the surgery only the following Friday. That meant I’d spend an extra two days loafing in the hospital. At P1,200 a day, I figured it wasn’t really too much compared to the hassle of reserving a room again. Besides the HMO was going to pay and I was sure there was still a good amount left of the maximum allowable.
What I didn’t factor in was this: Because I was admitted under the care of Dr. Cruz, he and the medical residents under him continued to visit me every single day of my confinement for at least a minute or two, up to the day I was discharged. In my naiveté, I thought that to be "endorsed" to another doctor meant that the other doctor (Dr. Cruz) and his assistants would exit as soon as Dr. Reyes had taken over. But they did not. This meant two things: First, the "meter" for the professional fee continued ticking daily; and, second, Dr. Cruz and his staff could and did order all sorts of tests to be taken.
For example, a CBC had to be taken before and after the operation. From what I understand, this is normally done when there is blood transfusion or when there is blood loss. Neither of that happened, so why the CBC had to be done is beyond me.
Among the lab tests and medical exams required by Dr. Cruz and his staff were blood chemistry, creatinine, urinalysis, ECG, chest x-ray, and ultrasound, each of which has its own price tag. If I had not undergone surgery under Dr. Reyes a year ago, maybe I would have thought all those lab tests and exams were obligatory. It seems they are SOP because they are part of the routine tests for people undergoing surgery.
However, Dr. Reyes practices "selective" testing – he did not require any lab test for my previous surgery, which was also a re-sectioning of the colon. In fact, the SSS clerk who checked my claim for benefits could not believe that absolutely no lab test was done on me for that particular surgery. She found it strange. But there I was in good health.
This means that doctors have a choice of what tests and exams to order for their patients and, in so doing, save money for the patient. But then, doing the tests de cahon is a lot easier than thinking of which one to choose. It’s more time-consuming for the doctor, too. And doctors, you know, are very busy people. As for the costs involved, the patient shoulders them anyway.
When I asked for the bill, I found out that Dr. Cruz had charged me P15,000 for professional fee. Certainly, it would have been much less had I gone home during the two days I was waiting for surgery because I would have paid only for Dr. Cruz’ fee during the colonoscopy. Likewise, I’m almost sure that Dr. Reyes, who would have taken over as my primary attending physician, would not have ordered all those lab tests. In other words, the lab fees would have been drastically reduced. Compared to zero lab fees a year ago, this time the hospital charged me almost P7,000!
As if to compound my woes, I was surprised to receive an extra bill for professional fee from another doctor, Dr. Santos, whom I never saw but whose name was posted at my door as one of my attending physicians. I thought he was an associate of Dr. Cruz. Sure, he sent a resident almost every day to say hello and he also ordered a few lab tests. When I inquired at the nurses’ station who he was, I learned that he was one of several medical coordinators of my HMO.
It turned out that HMOs have medical coordinators who are affiliated with hospitals and carry out some work for the HMO. Instead of the HMO paying for the services of these doctors, it is the client-patient who foots the bill! It was a "modest" P2,500, but I felt like it was a "forced donation" to someone who earns at least 20 times as much as I do. It is another neat trick for HMOs to pass on the cost to their clients.
There you have it. I know doctors want to do their best for the benefit of the patients. And they learn in medical school that such and such routine tests are mandatory. But perhaps it’s also high time for them to think about the expenses shouldered by the patients. If one doctor practices selective testing and manages the patient well, what’s preventing others from doing the same? Is it mindset? Habit?
May I suggest that medical schools review their practices with regard to teaching some SOPs? If they consider the costs borne by the patient, health care would not be that exorbitant.
– RICA MARTIN
Sick and tired of high prices? Tired of living from payday to payday? Feeling shortchanged? This item should interest consumers. Trade Secretary Cesar Purisima calls for a revitalized Bantay Bilihin program, which brings together DTI’s assorted initiatives on consumer protection and empowerment.
More, the Consumer Welfare and Trade Regulation Group, headed by Trade Undersecretary Adrian Cristobal Jr., has taken a number of concrete steps to help protect and empower consumers.
The Bantay Bilihin program intensifies DTI’s existing consumer welfare projects, such as:
DTI regional and provincial offices with the Local Price Coordinating Council members conduct weekly monitoring of basic necessities and prime commodities in public/private markets, hardware stores, grocery stores and supermarkets and other retail establishments.
• Text DTI anytime anywhere for consumer queries, complaints, information and feedback, and get appropriate action. Just type <DTI>space<message> and send to 2920. Each message costs P2.50.
• Easy recall consumer hotline 8977-DTI (897-7384).
• i-reklamo – a web-enabled system for online filing of complaints and queries, accessible through www.i-reklamo.ph or through DTI’s official website www.dti.gov.ph; or e-mail at i-reklamo@dti.gov.ph.
• Bantay Bilihin Assistance Center (CWDs) establishes more assistance centers in public and private markets, and strengthens existing CWDs.
• Monitoring/enforcement of fair trade laws – compliance with fair trade laws, including ordinances of local government units, will be monitored and enforced accordingly.
• Publication of guide prices – an information on prevailing prices of selected commodities published in selected national broadsheets/tabloids as well as in local newspapers.
• Consumer Voice and Consumers@Today – regular columns of DTI in major broadsheets inform consumers of the laws that protect their rights and also serve as venue for alerts/advisories on consumer issues and concerns.
• Press releases – ensure that the public is updated on DTI’s continual implementation of policies and projects that promote consumer welfare.
• Pamilihan ng Bayan – affixes its good housekeeping seal to public/private markets that maintain quality and safe products. To become a Pamilihan ng Bayan, the market must have a Timbangan ng Bayan, a consumer welfare desk and clean surroundings.
Now, this is one idea we certainly hope would sell.
If there’s something bugging you and you think we can help, e-mail us at ching_alano@yahoo.com.
Here is a patient’s (or it is a victim’s?) account of a recent morbid hospital experience.
Dear Consumerline,
Remember your column sometime in October last year about the spiraling costs of hospitalization? Well, here’s my personal experience piping hot off the oven, in a manner of speaking. Of course, I’d rather you don’t publish my real name because I don’t want to cause anybody any harm and so, I’m not identifying the hospital except that it’s one of the top five in Manila, and I’m using pseudonyms for the doctors involved. I simply want to share with your readers a first-hand experience that made me shell out more than what I think was necessary. And here’s why.
A few weeks ago, my surgeon Dr. Reyes referred me to a gastroenterologist for colonoscopy. Let’s call him Dr. Cruz. He had taken care of me previously and I was quite satisfied with his services. This time. he suggested that I be admitted because I’d need sedation. And so I was admitted. After the procedure, and when I was completely awake, Dr. Cruz told me it would be best to remain in the hospital and undergo surgery. There was a new mass in my colon. He said he would endorse me to Dr. Reyes.
Dr. Reyes visited me in my room later that day and said he’d be free to do the surgery only the following Friday. That meant I’d spend an extra two days loafing in the hospital. At P1,200 a day, I figured it wasn’t really too much compared to the hassle of reserving a room again. Besides the HMO was going to pay and I was sure there was still a good amount left of the maximum allowable.
What I didn’t factor in was this: Because I was admitted under the care of Dr. Cruz, he and the medical residents under him continued to visit me every single day of my confinement for at least a minute or two, up to the day I was discharged. In my naiveté, I thought that to be "endorsed" to another doctor meant that the other doctor (Dr. Cruz) and his assistants would exit as soon as Dr. Reyes had taken over. But they did not. This meant two things: First, the "meter" for the professional fee continued ticking daily; and, second, Dr. Cruz and his staff could and did order all sorts of tests to be taken.
For example, a CBC had to be taken before and after the operation. From what I understand, this is normally done when there is blood transfusion or when there is blood loss. Neither of that happened, so why the CBC had to be done is beyond me.
Among the lab tests and medical exams required by Dr. Cruz and his staff were blood chemistry, creatinine, urinalysis, ECG, chest x-ray, and ultrasound, each of which has its own price tag. If I had not undergone surgery under Dr. Reyes a year ago, maybe I would have thought all those lab tests and exams were obligatory. It seems they are SOP because they are part of the routine tests for people undergoing surgery.
However, Dr. Reyes practices "selective" testing – he did not require any lab test for my previous surgery, which was also a re-sectioning of the colon. In fact, the SSS clerk who checked my claim for benefits could not believe that absolutely no lab test was done on me for that particular surgery. She found it strange. But there I was in good health.
This means that doctors have a choice of what tests and exams to order for their patients and, in so doing, save money for the patient. But then, doing the tests de cahon is a lot easier than thinking of which one to choose. It’s more time-consuming for the doctor, too. And doctors, you know, are very busy people. As for the costs involved, the patient shoulders them anyway.
When I asked for the bill, I found out that Dr. Cruz had charged me P15,000 for professional fee. Certainly, it would have been much less had I gone home during the two days I was waiting for surgery because I would have paid only for Dr. Cruz’ fee during the colonoscopy. Likewise, I’m almost sure that Dr. Reyes, who would have taken over as my primary attending physician, would not have ordered all those lab tests. In other words, the lab fees would have been drastically reduced. Compared to zero lab fees a year ago, this time the hospital charged me almost P7,000!
As if to compound my woes, I was surprised to receive an extra bill for professional fee from another doctor, Dr. Santos, whom I never saw but whose name was posted at my door as one of my attending physicians. I thought he was an associate of Dr. Cruz. Sure, he sent a resident almost every day to say hello and he also ordered a few lab tests. When I inquired at the nurses’ station who he was, I learned that he was one of several medical coordinators of my HMO.
It turned out that HMOs have medical coordinators who are affiliated with hospitals and carry out some work for the HMO. Instead of the HMO paying for the services of these doctors, it is the client-patient who foots the bill! It was a "modest" P2,500, but I felt like it was a "forced donation" to someone who earns at least 20 times as much as I do. It is another neat trick for HMOs to pass on the cost to their clients.
There you have it. I know doctors want to do their best for the benefit of the patients. And they learn in medical school that such and such routine tests are mandatory. But perhaps it’s also high time for them to think about the expenses shouldered by the patients. If one doctor practices selective testing and manages the patient well, what’s preventing others from doing the same? Is it mindset? Habit?
May I suggest that medical schools review their practices with regard to teaching some SOPs? If they consider the costs borne by the patient, health care would not be that exorbitant.
– RICA MARTIN
More, the Consumer Welfare and Trade Regulation Group, headed by Trade Undersecretary Adrian Cristobal Jr., has taken a number of concrete steps to help protect and empower consumers.
The Bantay Bilihin program intensifies DTI’s existing consumer welfare projects, such as:
• Easy recall consumer hotline 8977-DTI (897-7384).
• i-reklamo – a web-enabled system for online filing of complaints and queries, accessible through www.i-reklamo.ph or through DTI’s official website www.dti.gov.ph; or e-mail at i-reklamo@dti.gov.ph.
• Bantay Bilihin Assistance Center (CWDs) establishes more assistance centers in public and private markets, and strengthens existing CWDs.
• Monitoring/enforcement of fair trade laws – compliance with fair trade laws, including ordinances of local government units, will be monitored and enforced accordingly.
• Consumer Voice and Consumers@Today – regular columns of DTI in major broadsheets inform consumers of the laws that protect their rights and also serve as venue for alerts/advisories on consumer issues and concerns.
• Press releases – ensure that the public is updated on DTI’s continual implementation of policies and projects that promote consumer welfare.
• Pamilihan ng Bayan – affixes its good housekeeping seal to public/private markets that maintain quality and safe products. To become a Pamilihan ng Bayan, the market must have a Timbangan ng Bayan, a consumer welfare desk and clean surroundings.
Now, this is one idea we certainly hope would sell.
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