The Two Sides of Healthcare
Patient-Centered Care
Two stories that commanded my attention last week showed that while hospital clinical staff are often in touch with their patients, the business and billing offices are woefully out of it.
The first one was the letter Boston-based Peter DeMarco sent to the staff of CHA Cambridge Hospital regarding the care his late wife, Laura Levis, received after suffering from a devastating asthma attack.
โEvery single one of you treated Laura with such professionalism and kindness and dignity as she lay unconscious,โ DeMarco wrote. โWhen she needed shots, you apologized that it was going to hurt a little, whether or not she could hear. When you listened to her heart and lungs through your stethoscopes, and her gown began to slip, you pulled it up to respectfully cover her. You spread a blanket, not only when her body temperature needed regulating, but also when the room was just a little cold and you thought sheโd sleep more comfortably that way.โ
DeMarco not only thanked the staff for his wife's treatment, but for the way he and Laura's parents and her friends were treated, as well. And, as the end neared, for making space to allow DeMarco to spend some time in the hospital bed holding his wife. He signed his letter with the phrase โwith my eternal gratitude and love.โ
Patient Consent and Awareness
Then there was this other story: Utah Valley Hospital in Provo, Utah charged the low, low price of $39.95 for a mother to hold her baby after it was born. According to Vox, the hospital billed the patient for what is known as โskin-to-skin after c-section.โ
The father didn't have a problem with the services his wife received: โThe nurse let me hold the baby on my wife's neck/chest. Even borrowed my camera to take a few pictures for us. Everyone involved in the process was great, and we had a positive experience,โ he told Vox. โWe just got a chuckle out of seeing that on the bill.โ
As it turns out, the charge is related to having an extra nurse in the operating room to ensure the mother could hold the baby properly after undergoing a C-section. However, it wasn't billed that way.
I'm glad the couple is amused. But their episode raises two serious issues: The continuing lack of price transparency for consumers in hospitals and the complete disconnect between clinical and business staff.
No doubt this couple in Utah is not the first to have been billed for being able to hold their child after it was born. They are merely the first to notice it. And just because they noticed it does not mean they could actually make sense of what that charge means--they had to ask.
The Transparency Problem
But as more and more Americans are responsible for larger parts of their hospital bill (the Vox couple were on the hook for nearly $1,700 in total), they will wind up being twisted and whipsawed like a pretzel. During their stay they're treated well, even tenderly, by clinical staff ... and then walloped with a large and mostly inexplicable bill.
Hospitals have long operated with their clinical and business staff in silos. That has made sense for decades. But with more and more of them putting payments at risk partially due to how patients perceive their experiences and interactions, that's going to have to change. One side is going to have become as compassionate as the other. Or at the very least, they're going to have to meet in the middle.
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Originally posted in Fierce Healthcare by Ron Shinkman
