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Question regarding hospital experience.So, Im not sure

Question regarding hospital experience. So, I'm...
Question regarding hospital experience.

So, I'm not sure if this really a legal question or not but I thought I'd ask here and see what the experts think.

Recently I was in the ED due to symptoms suggestive of heart problems. While there I had a hypternesive event, tachycardia, and signficant chest pain and shortness of breath. The ED doctor advised me twice that he wanted to admit me to run tests and see what was going on. He did share that he was not concerned I was in a life or death situation but felt I could be best served by coming in to the hospital to find out what was going on quickly. He came back after some time and told me that the hospitalist and declined to admit me because he didn't think that insurance would cover it. Not because he thought an admission was inappropriate but because he suspected, based on his experience, that insurance would say no.

While there I was given no medications, even an ibuprofen for pain. I clealry had symptoms and the ED was concerned enough to want to admit me. He even said he tried "every angle" he could to get me admitted. He then said come back in the morning if I could not get in to see my cardiologist because I was more likely to be admitted then.

Needless to say, I was not happy. It wasn't because I was not admitted to the hospital. Instead, it was because insurance, and their paycheck, had seemingly been put before my well-being. Also, he said that it was clear the medications I was on were not working, but refused to prescribe me anything new, even temporarily, because I had an appoitnment with my cardiologist (which was 6 weeks away). He said I should do my best to be seen sooner, wished me luck and said come back if I have another episode.

So, last thursday I called the hospital to share my experience and unhappiness. I am a psychologist and must deal with managed care also, so I understand the complexties and dfiiculties faced by physicians. But, in both our fields our ethics demand that patients' well-being comes first. Which I felt, I was not given.

Yesterday, I get a call from my cardiologist. Which was unusual for two reasons. One, she explicity told me that she would not call with results, her nurse would, before this incident at the hospital. Second, the results from the tests were not alarming, thus indicating that there was no need for her to call and discuss a problem with me. She very quickly went over the findings and then began to question me about my experience in the ED. What I should tell you is that the same company, Centra in Virginia, owns both the hospital and her clinic. It became very clear that someone had spoke to her about my complaint. At one point she asked me if I was "just mad because I wanted to be admitted."

I was very upset that she called and questoined me about this experience. Her interaction made me feel belittled, and it felt like she could care less about my phsyical health and was perturbed that I had made a complaint, which she somehow had become involved in.

So, I called the hospital today and spoke with someon in risk management and explained what had happened. She stated that there was no reason that my cardiologist should be involved as she does not work at the hospital and was not part of the complaint. I suspect the cardiologist became involved because I told the hospital that the cardiologits nurse practitioner told me that the EKG from the hospital was so poor she needed to do another one and they would do it at no additional cost.

I am quiet frustrated and told the woman so. I have heard many bad things about this hospital but it is the closest, within an hour and a half, to my home and so if you are sick this is where you go. How should I go forward if they do nothing to address my problem? It concnerns me that I was treated this way, and I am familiar with the health care system. I worry aobut my own patients, and know of someone who was released from the same ED despite being danger to them self. I am very concerned and frustrated. Any advice you have is much appreciated!
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Answered in 46 minutes by:
10/1/2013
JBaxLaw
JBaxLaw, Lawyer
Category: Consumer Protection Law
Satisfied Customers: 11,396
Experience: Wide experience in consumer rights law.
Verified
Hello,

I am a professional here to assist you. I appreciate your use of this service. I see that you had a traumatic experience. I need more information to assist you.

Do you feel this is malpractice?

Are you asking about filing a complaint against the medical provider?

Please explain what information you are seeking?

Thank you
Ask Your Own Consumer Protection Law Question
Customer reply replied 4 years ago

Honestly, I'm not sure if it is malpractice. I definitely feel that how my case was handled was not professional and did not meet standards of care. Essentially, I believe that I was turned away because they suspected my insurance companies would not pay. When in acutliaty, the docotor felt I needed to be there, and they did not actually call and ask the insurance company.


I guess I'm asking what my options are in your opinion/experience. Do you think it meets the level of malpractice? And is there a way to request a mediation, with legal representation there, if they do not address my concnerns? I don't think it was the medical provider who saw me directly who made a mistake, I feel it was the hospitalist (admitting doctor) and the hospital itself.

I appreciate your patience. I can provide you some information regarding these situations. You do not indicate you suffered any detriment due to the lack of admission to the facility. That would typically make a claim of malpractice or even a claim regarding the provider's ethics tough. This is because these sorts of decisions are judgment calls. For example, for a malpractice claim you would need to show this is a deviation from the standard of care. That is not clear from the information provided. The provider you saw may take a more conservative approach while the hospitalist may be aligned with the normal standard of care. This is speculation on my part, of course, and you will not be able to make such a determination with out substantial research. You could, for example, take your records to other providers in this specialty and inquire if hospitalization would be the standard of care.

Whether the hospitalist made the wrong decision based on financial motivations is your concern. You can contact your insurance to see if you would be covered for admission purposes to begin. Obtaining alternative expert opinions from hospitalist gets expensive unless you know any personally. That would be key to showing the hospital administration that your care was substandard.

You mention mediation. There is no entitlement to mediation. The only way to force this matter to be addressed by the providers or hospital is to first file a civil suit and it would not be clear if there was any basis to do so until you determined the standard of care regarding your presentation of symptoms. As such, researching the opinion of other providers would be the starting point.

Please follow-up with me as needed. This is intended to be an ongoing dialogue. I rely on positive service ratings, so please do not forget to leave a positive service rating. I would greatly appreciate a positive service rating and optional bonus.

Thank you
JBaxLaw
JBaxLaw, Lawyer
Category: Consumer Protection Law
Satisfied Customers: 11,396
Experience: Wide experience in consumer rights law.
Verified
JBaxLaw and 87 other Consumer Protection Law Specialists are ready to help you
Ask your own question now
Thank you so much for allowing me to assist you.

Please let me know if you need any other assistance. Thank you for leaving me a positive rating and ensuring that I receive credit for assisting you.

Thank you again
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JBaxLaw
JBaxLaw
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Category: Consumer Protection Law
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