2. Choosing A Hospital

Millions of people are hospitalized each year who need no hospital care whatsoever. Many physicians now admit that at least 10 percent of hospital admissions are not necessary. We know, however, that the true statistics were actually much higher than that, more like 95%. If you feel as though you must go to the hospital, you should ask your physician the names of all hospitals where he has admitting privileges and then discuss with him the pros and cons of each. A lot of your time, energy, and money can be wasted if you let your physician "send" you to a less-than-adequate hospital. If you are not satisfied with your physician's plans for your hospital admission, you should seriously consider finding a physician at the hospital of your choice, or simply going there as a "ward" or "clinic" patient.

Once you have assured yourself about equality, you may wish to consider a hospital's efficiency; its length of stay, occupancy rate, and daily cost. If you have a choice, let's say, between two hospitals you might wish to take these "efficiency factors" into account. You might wish to choose the hospital with the lower daily rate, or length of stay.

If you have been in an accident, you will not have a chance to go through all this decision making concerning an appropriate hospital. It may be worthwhile, however, to go through these steps in the event such a decision would be necessary.

2.1 Your Admission

Some hospitals, on admission, ask you to sign a blanket consent form covering many items, but these vague and indefinite forms have not held up in court. And, even if you do sign such a form, you still have the right to refute any procedure during your stay. Before each major procedure, you will also be asked to sign a specific consent form, once the procedure has been explained to you.

Some hospitals also ask you to sign a form releasing them from legal responsibility in case of negligence. This type of release has not held up in court either. If you object to signing such forms but the admitting clerk insists that you do so, keep in mind that they have not been known to be enforceable.

Most hospitals will want the following five items:

1. The social security card or number of the head of the household (that person who will have the ultimate responsibility for the bill).
   
2. Your insurance cards or numbers.
   
3. Your Medicare and/or Medicaid card.
   
4. Name, address, and phone number of your employer and of your spouse.
   
5. Name, address, and phone number of the person to notify in case of an emergency.

2.2 What to Bring With You

Take the items that you would need for routine comfort: toothbrush, shaving equipment, pajamas or nightgown, robe and slippers. Optional items might include stationery and stamps, address book, needlework projects, books, etc. However, keep in mind that you should try to discharge yourself as soon as possible and it may be unnecessary to bring many such things with you. Circumstances will dictate. If you have been in a severe accident, it may be necessary to stay in the hospital for awhile. In this case, you may ask friends to bring in reading material and other needs.

2.3 Questions to Ask

Don't be afraid to ask questions. Not only do you have the right to question your care; you owe it to yourself to do so. Here are some questions you should ask:

1. What do you think is wrong with me?
   
2. What tests do you recommend? Is there any special preparation for any of these tests?
   
3. What medication do you suggest? What are their purposes? How will they be administered? How often? (As you know, we do not recommend medications, but if surgery is required for repair of bones or tissues following an accident, you may have to take certain anesthetics and drugs.)
   
4. Will I see the anesthesiologist before the operation? What preparations are required before surgery? After the preliminary tests are completed, you may ask:
   
1. What are the test results?
   
2. What did the various consultants think?
   
3. Are there any changes in medications?
   
4. How long a recovery period is anticipated?

2.4 Initial Tests

You will be given a blood test, during which time blood will be drawn from a vein in your arm and then your blood will be subjected to a dozen or more tests for information about your kidneys, liver, and endocrine glands. Sugar and cholesterol levels will also be measured. You will have X rays if you have been in an accident. Do not allow them to take X rays every day of the same parts.

If you think that the X rays have been excessive, you may refuse further ones until you discuss this situation with your physician. You may also be given an electrocardiogram.

Once you are in your room, a nurse will appear to take hat is called a nursing history. She will want to know about any previous hospitalizations and problems. She will take your blood pressure, pulse, respiration, and temperature, and ask for a urine specimen.

If it is a teaching hospital, you may be examined and questioned more than once. If this becomes unbearable, speak up and let them know that you have already been examined and do not want to be again.

2.5 Your Room

The choice of a private or semiprivate room may be left up to you, but sometimes physicians recommend a private room. Some people can't bear the thought of being in a room with strangers; others enjoy the company and would not opt for a private room even if there were no cost differential. Sometimes, however, a roommate or mates can be unbearable (especially if they smoke) and make rest impossible. If that is the case, ask the nurse on the floor to have your room changed.

Most insurance policies cover, semiprivate rooms—usually two patients to a room. In most hospitals semi-private rooms are now two-patient rooms, some are four, and a few still have as many as six. If you wish to have a private room, discuss this with your physicians. If you choose a private room, you will almost surely be responsible for the difference in cost, since insurance coverage is usually limited to semiprivate facilities.

Some hospitals not only give you a choice of semi-private versus private, but also allow you to choose smoking or nonsmoking areas. You will probably not be able to choose your roommate, but if you have serious roommate problems, as mentioned above, you can switch rooms.

2.6 If You Want to Leave the Hospital

What happens if you go in for a particular procedure and then change your mind? What if your doctor recommends an operation, but you decide you don't want to have it? Tell him, and ask that he discharge you. Usually he will do this willingly, but if he feels strongly about your staying put, he may be resistant. In fact, he may refuse. In that case, you can sign yourself out. Don't be intimidated; trust your instincts and do what makes you feel most at ease.