'You're not God': Doctors and patient families say HCA hospitals push hospice care

[dalton99a]

https://www.nbcnews.com/health/health-care/doctors-say-hca-hospitals-push-patients-hospice-care-rcna81599

'You're not God': Doctors and patient families say HCA hospitals push hospice care
Transfers to hospice care from HCA's facilities grew faster than the national average, while HCA's "in hospital" deaths were lower than average, data shows.
June 21, 2023, 5:30 AM CDT
By Gretchen Morgenson

As Marisol Perez fought for her life in a Texas hospital in autumn 2021, her mother, Alma Salas, sat with her every day praying. Perez, then 42, had such a virulent case of Covid and pneumonia that doctors at St. David’s North Austin Medical Center, an HCA Healthcare facility, had put her  on a ventilator and  into a coma  to try to save her.

Salas said she believed her daughter would pull through, but doctors and nurses at the hospital kept telling her otherwise. Over 10 days in October, less than a month after Perez entered St. David’s, Salas received repeated visits from a palliative care nurse,  her hospital record shows. Every other day,  Salas said,  the nurse urged  her to initiate end-of-life care for her daughter. Several of Perez’s doctors also pressed Salas to remove her daughter from the ventilator, she said, in visits confirmed by details from Perez’s chart.

On one occasion, six or seven doctors and nurses gathered around Perez’s bed, Salas said. "We really feel it is in the best interests of your daughter to let her go,"  she recalled one doctor telling her.

Salas held firm. “I don’t have the authority to take anyone’s life,” she said she told them.

A month later, St. David’s discharged Perez, her chart shows. She went on to make a full recovery.

....

[Aristus]

1. It's crazy the way Americans live in mortal terror of the government making medical decisions,

which it wouldn't under a National Health Insurance system. But they seem resigned to having powerful, greedy, immoral corporations make medical decisions instead of having doctors make them; or paying doctors to make their employers' decisions.

Of course, the wealthy corporations spend billions in media messaging to convince the American people to continue this travesty of medical care.

[Warpy]

7. You nuts? They LOVE having the government make medical decisions

as long as it affects somebody else, like women who need abortions, trans kids who need counseling and possibly medications, just don't touch their Viagra.

[erronis]

9. Great point! NIMBP

Not In My Body Part

[DENVERPOPS]

8. I remember reading an article

a year or two ago how the corporations had figured out what a huge profit center hospice care could be, and were buying up all the existing hospice care facilities and building many more.............

Another trend is the "Hospitalists"....... Dr.'s employed by hospitals, that take over all care when you step thru the doorway of the hospital........

Your Doctor use to direct your care, now it is the Dr. that is employed/paid by the hospital that decides everything........

[Dustlawyer]

19. My oldest sister was in a coma and on life support years ago.

The doctors and nurses would tell my brother-in-law she needed to be unplugged. He needed to let her go. He sat with her everyday and refused. They insisted she was brain dead. It got so bad they were filing suit to be able to pull the plug.

She came out of the coma and was completely ok. She lived for several years at home resuming cooking, cleaning, shopping, living and loving. No apologies from the hospital or doctors!

[Aristus]

23. I didn't say medical providers don't make mistakes.

Only that government and corporations aren't better qualified to make medical decisions.

It's worth pointing out that, when questioned about the current state of corporate medical care, or the prospect of national health insurance, nearly everyone asked affirmed that they want medical providers to make medical decisions. That they want these medical providers not to be employed by insurance companies rather goes without saying.

[crickets]

2. Only ghouls stop seeing a patient as human

and see them instead as a threat to the bottom line.

[evolves]

12. Or physicians whose

livelihoods depend on remaining employed. Most physicians graduate from medical school with >$100k in debt and become locked in to employment contracts with hospital corporations, which is really the only viable employment model today.

Physicians are saddled with the assumption that they are burning out, when the system is actually inflicting moral injury.

https://www.statnews.com/2018/07/26/physicians-not-burning-out-they-are-suffering-moral-injury/

https://www.fixmoralinjury.org/

[Aristus]

24. Inflicting moral injury is only one of the many sources of provider burnout.

I'm in my "I just don't give a shit about these fucking insurance companies anymore" phase.

I had a patient who needed a newer, upgraded prosthetic leg after years of pain and poor mobility with his old one. The insurance company sent me a prior authorization form basically questioning whether he actually needed a new prosthetic. There was a box - "Prognosis":___________________

I was so annoyed by that paralyzingly stupid question that I wrote "The possibility of the patient growing a new leg seems remote from a clinical standpoint", and FAX-ed it off.

I got my authorization, and a note from one of my organization's admins saying "Um......please don't do that again."

[spanone]

3. K&R

[lastlib]

4. St. Luke's did the same thing to my mother last year.

After three weeks in hospital, she wan't getting better, wasn't eating, kidneys ween't wrking well. They basically told us that they weren't going to give her any further care, and told us to take her home to hospice. We did, and after getting home, she started eating, and getting a little better each day. But we couldn't maintain the care we were giving her, and finally had to put her in a nursing home. But it pisses me off that the hospital essentially gave up on her, and didn't want her dying on their watch.

[Freethinker65]

6. Hospitalists. This happened to both my mom and dad.

My sister is a doctor and she was livid. Instead of checking basic electrolytes, they wanted to write my dad off for hallucinating and complaining of pain. After fluids (because of my sister's insistence) he was released and within days a fistula, exactly where he indicated the pain was, was detected.

[Lonestarblue]

10. When you have a for-profit healthcare system, then profits come first, not medical care.

It amazes me how much substandard crap we put up with in this country, and a substantial number of our citizens don’t even know it’s substandard. They think we have the best of everything. We spend more money on healthcare by far than any other nation but get worse results. Our lifespan has been declining for a number of reasons, including poor or lacking healthcare and gun violence. We are charged outrageous drug prices because Republicans protect government from negotiating prices to be in line with other countries.

Every country has infrastructure issues, but we just ignore ours until something falls down unless it’s to build more roads to add to accommodate more cars and fossil fuel profits. Our passenger rail system is laughable when compared with countries like Japan, China, France, and other European countries. Our food is laced with chemicals, or as the French call it Frankenfood. As test scores show, our public education is declining instead of improving. College degrees are some of the most expensive in the world.

We have more gun violence and deaths than any other Western nation. Our police departments in many states are full of white supremacists. And we have one of the most corrupt political parties of any Western nation, though corruption is not in short supply in many countries.

We have the most expensive military in the world, but at least it seems capable. We also have some of the most innovative technology and some of the best graduate schools in the world. Medical research and science are top notch. We also have some of the most beautiful scenery in the world and have managed to preserve a lot of it with national parks and federal lands.

If we had the political will, we have the resources to fix every one of the issues I described in the first three paragraphs. Imagine what a fabulous country we would have with modernization, accessible healthcare for everyone, and a Republican Party that wants to govern for the country instead of for the loonies and the billionaires.

[The Animator]

11. My girlfriend was admitted to one of their hospitals last summer

To call it a shit show does a disservice to shit shows everywhere.

She was admitted because her body was no longer digesting food. Most of the doctors there were very dismissive. only one seemed to give a shit and suggested tests they ought to run, but then he was never seen again.

They discharged her without actually accomplishing anything. This was after she insisted that without help her body was going to end up starving itself to death.

Thankfully she pulled through, no thanks to them.

[3Hotdogs]

13. What is HCA?

[Fla Dem]

15. It's a health care chain.

HCA Healthcare is an American for-profit operator of health care facilities that was founded in 1968. It is based in Nashville, Tennessee, and, as of May 2020, owns and operates 186 hospitals and approximately 2,000 sites of care, including surgery centers, freestanding emergency rooms, urgent care centers and physician clinics in 21 states and the United Kingdom

https://en.wikipedia.org/wiki/HCA_Healthcare

Google is your friend.

[reACTIONary]

16. HCA Healthcare is ...

... A healthcare corporation. Not a gov or non-profit.

https://investor.hcahealthcare.com/overview/default.aspx

[NowISeetheLight]

18. Hospital Corporation of America

The largest for-profit hospital company in the country. They own over 180 hospitals and over 2000 surgery centers. Wikipedia has a good article.

https://en.wikipedia.org/wiki/HCA_Healthcare

They’ve been in trouble in the past for billing and stuff. Having worked in hospital finance I can say they had a bit of a reputation.

Their profit in 2022 was $5.6 BILLION dollars.

https://www.beckershospitalreview.com/finance/hca-revenue-net-income-up-in-q4-6-details.html

Their CEO made over $14 MILLION last year.

https://www.beckersasc.com/asc-news/what-hca-executives-were-paid-in-the-last-5-years.html

[dalton99a]

22. HCA was run by Rick Scott who pocketed $300 million by defrauding Medicare in a $1.7 billion scam

https://www.deseret.com/2000/12/15/19544312/hca-pleads-guilty-in-fraud-case
HCA pleads guilty in fraud case

https://www.politifact.com/article/2010/jun/11/rick-scott-and-fraud-case-columbiahca/
Rick Scott and the fraud case of Columbia/HCA

[SleeplessinSoCal]

25. AND He looks like Voldemort!

[maliaSmith]

14. Hospice care

My feelings for Hospice care is different. My sister got cancer due to her doctor telling her at age 65, she didn't need to continue to have a PAP exam every year. My doctor also told me, that they don't recommend women past age 65 continuing to have a PAP exam yearly. At age 75 my sister found a lump in her private area, went to PP, had a test and was found to have cancer. After diagnosis, it was found to be stage 4. Had her doctor not told her to stop having her PAP yearly, she would still be here. Hospice was wonderful and allowed us to bring her home to have family and friends around when she passed. Some people have had bad experience with the issue of Hospice and death, but let's not forget how wonderful they are helping families. I'm so glad this woman recovered, and also glad she got the care she needed to recover. Doctors aren't Gods, they do make mistakes and I think they honestly thought this woman was going to die.
I talked to my doctor about still continuing PAP exams at my age, 75, and she said she didn't recommend it even after I told her about my sister. I went over my doctor's head, contacted my insurance company and they asked why I hadn't been getting my exams. I told them what my doctor said, and my insurance company told me to get my PAP yearly which I'm now doing. I don't even talk to my doctor anymore about it. I go to another doctor for my exam. I think doctors don't care about old people. We cost them too much since they can't gauge us since we're on Medicare.

[lostnfound]

28. Hospice is wonderful for people who have a terminal illness

The issue is pushing people who have unknown prognosis into it, in order to avoid treating them.

[maliaSmith]

29. responding to you.

I discussed how wonderful Hospice is to some people and obviously other people have had a not so good experience with them which I don't dispute. I had a good experience and I'm sorry others haven't. In a discussion, anyone can discuss the pros and cons of the subject which was Hospice.

[lostnfound]

32. They were there for my father and mother who both died at home.

We did not need much from them but they were extremely kind, unobtrusive, and helpful.
Especially when we offspring were in our 20s, a bit overwhelming to not know how to handle practical matters. Back in the 1980s.

[reACTIONary]

17. For those wondering, HCA is a...

.... health care company, not a gov or nonprofit organization.

https://investor.hcahealthcare.com/overview/default.aspx

[KT2000]

20. thank you

I didn't know what it was but was afraid it had something to do with government health care.

[reACTIONary]

26. Me to. I imagined Health Care Agency, even though...

.... I never heard of such an agency.

[NowISeetheLight]

21. HCA and Mission Health (NC)

When I lived in SC working for the big health system there HCA went after Mission Health in North Carolina. Mission was the not for profit system in Asheville. They purchased Mission in 2019 for $1.5b. It was very controversial and the community was not happy.

Citizens actually started a Facebook group called “Mountain Maladies” about HCA. It’s an incredible read and people post their HCA hell-stories.

After the merger HCA started hitting patients with surprise fees for ‘facility’ use.

https://carolinapublicpress.org/29815/confused-mission-health-patients-want-answers-about-surprise-fee/

As of last year over 200 doctors have left.

https://www.fiercehealthcare.com/providers/report-over-220-doctors-left-mission-health-its-2019-acquisition-hca-healthcare

The NC Attorney General had concerns the buyout was “rigged”.

https://www.northcarolinahealthnews.org/2022/03/20/hca-deal-was-rigged-ag-office-concerned/

This article is from four days ago and is pretty damning.

https://www.medpagetoday.com/special-reports/features/105087

[area51]

27. Time to nationalize the hospitals.

[KentuckyWoman]

30. My doctor went OFF last week. I mean -- OFF.

I have a pacemaker now and just had a follow up with that cardiologist. He lost it for a good 15 min before managing to pull himself back because of having to fight with for profit insurance to get care for his patients. He works for a non-profit hospital and mostly deals with the over 65 crowd. I can't even imagine what the pressures would be at a for profit hospital as well.

[CTyankee]

31. This has a Monty Python- y feel to it: "I'm not dead yet!" NOT funny.