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Abigail Zuger

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How hospitals have changed

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Abigail Zuger, M.D., writes in The New York Times:

“Once hospitals were where you found a doctor when you suddenly needed one; now doctors are all over the place, from big-box stores to storefront clinics. Hospitals were where you were headed if you were very sick; now you can heed your insurer’s pleas and choose a cheaper emergency center instead.

“Hospitals were where you stayed when you were too sick to survive at home; now you go home anyway, cobbling together your own nursing services from friends, relatives and drop-in professionals.

“Once hospitals were where you were kept if you were a danger to yourself or others. They still serve this function — although, perhaps, the standards for predicting these dire outcomes have tightened up quite a bit.

“These days, it may be easier to define hospitals by what they are not. They are not places for the sick to get well, not unless healing takes place in the brief interval of time that makes the stay a compensated expense.

“Hospitals are definitely not places for unusual medical conditions to be figured out, not if the patient is well enough to leave.”

To read her whole essay, please hit this link.


Tougher for patients to be in the right place

 

Abigail Zuger writes in The New York Times:

“It is increasingly critical for patients to be sick in the right place, and increasingly difficult for them to do so. As the great plates of medical care heave and split in cash-based tectonics, the options are multiplying in confusing plenty.

“There used to be the doctor’s office and the hospital. Now we have street corner wellness centers and urgent care centers, free-standing emergency rooms with no hospital attached, chain pharmacies with occasional doctors attached, and nursing practices with no doctors attached.

“We have hospitals that have merged and split and merged again into configurations that put all the cardiologists uptown, all the neurosurgeons downtown, and all the pediatricians somewhere that keeps changing.

“Accordingly, we spend a lot of time and energy getting people to where they need to be, launching them according to condition, severity and, always, insurance….”


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