Privacy and Stupidity

Here in the US, every visit to a doctor, every visit to a hospital, every visit to any type of health care provider is governed by the HIPPA laws. The US Department of Health and Human Services if worried that my private health information may not be private enough. So there are rules upon rules and forms upon forms. There are reams of rules, stacks of forms and then there is the:

HCAHPS. Hospital Consumer Assessment of Healthcare Provider and Systems. The government sponsors the collection of data from recently hospitalized patients. The survey is sent to a named person regarding a stay at a named facility. So much for privacy there, Big Government.

The Survey is built to elicit the patient's or perhaps client's perspective on the hospital stay. I don't know what term the medical community is using for sick people right now. They used to be patients and then they were clients. I have no idea what they are anymore. Income stream, I guess.

Anyway, the questions are either Yes or No, which is straight forward. Then the assessment is judged as Never, Sometimes, Usually, or Always.

How often did the nurses treat you with courtesy and respect? asks the survey (formatting from survey maintained). I guess that's fairly straight forward. Maybe. Some patients (I'm just going to call them that for this) are quite sensitive and if you aren't overly solicitous, you are rude. If you aren't fawning, you are rude. If you tell them it isn't time yet for the paid medication, you are rude.

The second question is did the nurses listen carefully to you? As a woman, as a nurse, and as a mother I've learned how to multitask. If I didn't do three things at once, I would have never gotten everything done. How in the hell can someone else tell if I'm listening carefully. Some people feel slighted if you don't stop everything and sit down with your hands folded and listen CAREFULLY to them. Great. I can sit there and my mind can be a million miles away. Or I can be fiddling with the IV and comprehend everything you say, words and nuance.

How often did nurses explain things in a way you could understand is the next question. So, if I use normal adult words and you have a little baby vocabulary but are too embarrassed to tell me you have no idea what I'm talking about when I use a word like "urine" which I think is a common word, I guess I would be graded poorly. No question on whether or not the patient asked clarifying questions if things weren't explained to his or her satisfaction.

Next question is how about how long it took for staff to answer the call button. Well, how long is relative. But actual wording is how often did you "get help as soon as you wanted it." Well, I don’t care how fast you can answer those bells, by the time you get to the room, it is already too late because "as soon as" happened before the call bell was hit.

The coup de grace for me was this question: During this hospital stay, how often was your pain well controlled? Now, let's say you had some major surgery. Let's also say you were a drug addict or alcoholic at some point in your past. Even if you were a casual drug user or moderate drinker, this is a problem now. There is nothing here to see what sort of patient is answering the questionnaire. But if you were a heroin user at one time, I can pretty much guarantee that you are not going to answer this question with the Always choice. Very low likelihood of the Usually, too.

There are people who are suffering the agony of the damned when they get a hangnail. Their pain is not going to be controlled after major abdominal surgery. It's not. Get over it. Won't happen. There are people who can be so soporific they are almost not breathing, but open their eyes to tell the world they are in such pain that on a scale of one to ten, they are at about fourteen.

Some hospitals cater to a different client base and their patients may be more of the entitled mindset. If they come to the hospital with a problem that doesn't warrant an MRI, but they want an MRI, they are going to feel slighted or less cared for. There is no way to compare a patient's expectations that are unreasonable to one whose expectations actually align with reality.

Just today in Annie's Mailbox was an angry woman whose husband suffered from arthritis. She was outraged at doctors who couldn't prescribe something to help her husband's disease. All they could give him was more pain medicine. Well, there isn't anything to cure the disease. That same mindset is going to skew these results as well.

So all in all, I'm thinking this is against HIPPA privacy codes and will result in faulty "science" numbers.

But all the compiling of answers and making of graphs and charts and listing each hospital against the other will, I'm sure give people jobs. So in these trying economic times, this is probably just fine and dandy.