<p>First, I agree with Kelsmom. Please don’t stay and subject your patients to your attitude. I’ve encountered too much of that at a university teaching hospital in our city. I have a very short fuse when it comes to arrogant, know-it-all med students.</p>
<p>“Why do Americans abhor wards? Each bed is located in a spacious, hotel-room like environment. When a patient is immobolised, I am not sure if this is necessary. And sometimes, social interaction is good.”</p>
<p>Let me add another voice of dissent. Not wishing to share antibiotic resistant bugs is one good reason to prefer a private room. And avoiding seeing wound care or listening to others in severe pain or delerium would not be served by simply exempting intensive care patients. I’ve been a patient in a ward and do not want to be (or have my loved ones) subjected to that dreadful experience again. </p>
<p>Patients whose conditions are serious enough to be seen in-patient need their rest. They’re not there to play canasta or bridge with new chums. There are enough interruptions to the patient’s sleep for necessary medical care. I don’t even permit the Grey Ladies, Candy Stripers or chaplains to visit. </p>
<p>I’ll just quote intparent and move along: “I think you are probably pretty young and inexperienced and naive about what it takes. Like I said, take a stint in hospital administration for five years, then you have some room to criticize and suggest.”</p>
<p>I’ve been a patient many times in that hospital … braces, infections, mercury swallowing. I was warded three times. Frequent visits for court-mandated psychological counselling (as part of divorce proceedings). And also for general clinician procedures. Also have been intimately acquainted with the procedures (due to the conditions of several family members) of many hospitals of my birth country. Because of my family, I’d say that 15% of my free time as a youth was spent in medical centres…</p>
<p>These are my observations of course. They are not authoritative. I am not a consultant, just a mere student, observing differences between cultures. I do work in a top-ranked teaching hospital and I daresay, with a very bright prinicipal investigator, and I have very permissive supervisors that allow me to make these observations in the first place. </p>
<p>I hope I am not sounding ingrateful. For the fact remains that American healthcare seems needlessly costly – so I want to ask – where does all our money go? My observations were meant to investigate (as a common citizen!) that question.</p>
<p>This is the purpose of my thread. Why are other nations able to afford universal healthcare? Because their health systems are far more efficient.</p>
<p>I was frequently hospitalized growing up due to a congenital issue. When I was hospitalized at 18 to have the problem surgically corrected I had to share a room. That was not a pleasant experience. Over a three week period I had to share the room with a delirious elderly woman, another woman who would have her boyfriend in for a little bedtime R&R, and another that was on the phone all the time with a loud and grating voice.</p>
<p>Ha ha, the administrative and financial side of US health care is a global bad joke, but let some ‘foreigner’ dare criticize it and he should be deported on the spot.</p>
<p>For this reason, we should have segregated waiting rooms for everyone.</p>
<p>(Though the bedtime R&R sounds forbidden – maybe you should have complained?) </p>
<p>My birth country implements it as a tiered system – so there are x number of A1 rooms, A2 rooms, B1 rooms, B2 rooms, C1 and C2 rooms and so forth.</p>
<p>Besides when someone is hospitalised for observation, it is really a waste to give them an A1 room…unless they really have the money to pay for it.</p>
<p>I know my low-income family much preferred the tiered-class system (I believe the Class C copay was 15 USD/day; class B was somewhere on 55 USD/day) than having to pay exceeding high insurance premiums and copays. Had we had an insurance company rather than the government (which btw is antisocialist), they probably would have preferred that too.</p>
<p>The less insurance companies have to pay, the more premiums will decrease.</p>
<p>And there’s no reason why you can’t just install slideable soundproof boards between different beds as necessary. If it really bothers people that much.</p>
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<p>In efficient healthcare, certain sacrifices have to be made. It’s true; happy patients ==> healthier patients, but then we force our schoolchildren into factory-like conditions all the time, and they don’t seem none the worse. The problem is one of culture. </p>
<p>I ask you: would you be willing to risk eliminating healthcare capacity by half or the doubling of healthcare costs just so patients could be wheeled into hospitals without ever having to see the unpleasant conditions of other patients?</p>
<p>I recommend reading “Health Care Will Not Reform Itself: A User’s Guide to Refocusing and Reforming American Health Care” by George Halverson. It is shocking to see the cost comparisons for the same services in different countries. Too much energy is spent in insuranace billing and not enough on healthcare services.</p>
<p>All these “go back to where you came from” comments are downright embarrassing. The OP isn’t saying that the United States isn’t a wonderful place to live. He or she is saying that U.S. major hospitals are terribly inefficient, and generally that’s right. It’s no real answer to say that the problem is intractable for this or that historical or bureaucratic reason. Of course, all of the inefficiencies exist because some other problem was getting solved. But the net is that we spend an awful lot of money we don’t need to, and it’s worth having that pointed out from time to time.</p>
<p>Regarding private rooms, though, I think there’s a fairly simple answer. In global terms, land and building construction are pretty cheap throughout most of the U.S. If floorspace were a real constraint, hospitals would have fewer private rooms. The situation in Singapore is very different.</p>
<p>My one and only hospital stay in my lifetime was in a labor & delivery ward, after giving birth 9 weeks early to twins who were sent straight to NICU and would ultimately be there for close to 2 months. I had a private room for my own recovery. The idea of rooming with some new mother and her bouncing 7 pound baby would have been cruel and unusual punishment when I didn’t know if my babies would live the night. No thanks. Spare me social interaction – I’ll do that on my own time.</p>
<p>Interesting. As it would happen, I design hospitals for a living. Kick and scream all you want, but you’re wasting your energy, as 90% of what you’re talking about is already implemented in the hospitals we’re building. The other 10% is on the horizon.</p>
<p>In fact, there are companies who focus exclusively on how to make hospitals more like what you’re looking for, and they’re doing a really good job on it. </p>
<p>This article is a good view of what the buzz is in hospital design and renovation, and where hospitals are going.</p>
<p>I tend to choose doctors who work in structures that I’ve helped with, and all my charts are computerized. My doctors e-mail each other and they e-mail me, and they know who I’m seeing and what I’m around for. Communication and interactivity are vastly improved from what they used to be… My dad was one of the pioneers of teleradiology back in the early 90’s, so healthcare innovation has been on my radar for a very long time.</p>
<p>Yep, a lot of the older healthcare facilities are inefficient. The new ones are very, very well-researched, though.</p>
<p>Re: private rooms-- privacy, nothing. It’s not for a social or privacy or HIPAA reason at all. Wards are a disaster from an infection-control standpoint; that’s the reason for separating patients. Keep your social little staph infections to yourself.</p>
<p>After a very long surgery and alot of pain I had a roommate that screamed all night. I made the fastest recovery that a person could make because after just three short days and nights of not getting any sleep I realized I was better off at home. </p>
<p>To criticize our American hospitals and say the word ward in the same sentence is ludacrous. We can certainly save money and resources but not by practicing the type of care that you suggest.</p>