When Atlanta psychologist John Paddock, 59, needed both of his knees replaced, he spent a lot of time looking at surgeons and hospitals. He wanted a surgeon who had ample experience, great communication skills and a relationship with a hospital that had a low rate of hospital-acquired infections.
“All the online rating services say doctors’ success rates are 99 percent, so you have to pepper the surgeons with questions about what ‘success’ means,” Paddock says. “They all say the infection rates are less than a half of 1 percent, so I asked an infectious-disease specialist, and he said to ask not only about the doctor’s infection rate but that of their hospital unit—and then go to the hospital and see what the atmosphere looks like.”
When Paddock visited the hospital that he eventually chose, he noticed hand-sanitizer units everywhere and signs in obvious places that urged hospital workers and visitors to wash their hands.
“There was a real culture of cleanliness—not scary, but firm,” he says.
Paddock spoke highly of his experience. He suffered no complications, and he is recovering well. Of course, Paddock’s experience represents the ideal situation of what you should expect if you have to spend time in a hospital.
Unfortunately, according to recent studies, more than 1 in 10 hospital patients—sometimes as many as 1 in 3—suffer unintended consequences because of hospital errors. Department of Health and Human Services (HHS) in 2010 calculated that among Medicare beneficiaries alone, 134,000 patients suffer from at least one medical error in hospitals in a single month. Using that figure, HHS projects that up to 15,000 of those patients die as a result of the error. What makes matters worse, HHS estimates that nearly half of the time the harm that was caused by errors was preventable. Today, more information about hospitals exists than ever before, but it’s debatable how much of it will help you to choose the right facility.
“For the large majority of conditions and procedures, I would say, good luck trying to find the best hospital,” says Dr. John Birkmeyer, who studies hospital quality and safety at University of Michigan. “The information you can get access to is maybe better than nothing, but not much better.”
Birkmeyer says his pessimism is rooted in the fact that the information that’s available typically isn’t pertinent to consumers’ specific problems.
Some tools are in place to help you to understand what hospital that’s in your area might suit your needs best and how much that it will cost to undergo a procedure there. Unfortunately, conditions can change on a daily basis in a hospital.
The Rating Game
STAFFING ISSUES. Traditionally, in the event that you found yourself in a hospital, your primary-care doctor came to your bedside as frequently as possible to coordinate your health care. However, primary-care doctors don’t have time to do that anymore.
Since 2009, board certification has been available for a new field of medicine—hospital medicine, which is performed by doctors who are known as hospitalists. A hospitalist comes to your bedside as soon as you’re admitted to the hospital—often when you’re still in the emergency room—and serves as the liaison between you, your primary-care doctor and the hospital nurses for the duration of your stay.
According to Society of Hospital Medicine, an estimated 34,000 hospitalists work in 3,300 hospitals in the United States. Not every hospital employs a hospitalist, but when one is on the staff, that’s a good indication of a modern-day approach, says Dr. Alan Wang, who is the director of hospital medicine at Emory University. Hospitalists can provide better coordination of care, which works to reduce the miscommunication that can cause medical errors.