Tuesday, January 22, 2008

Hospitals as a Business

From: Arnel Limuaco ajsl_365@yahoo.com

May I share my story also from a five star hospital.


All 5 of us in the family are Valuecare health cardholders for the last several years and so far we have not experienced any problem with the utilization of this medical insurance. Most of our cases are managed in the emergency room of Cardinal Santos Medical Center, most accessible from our house. Except for one when Joan had to undergo surgery due to gall bladder stone in 1998 where she was confined for several days. Such confinement was also remarkable in terms of accommodation and service. Until last Aug 3, 2005, when we had to rush Nanay to the ER of CSMC for severe stomach pains with continuous vomiting and LBM, we will now have second thoughts of coming here for medical services especially without the assistance of a health insurance. I’d like to share with you a detailed story of our horrible experience because we don’t want you to be the next victim. We all deserve to get our hard-earned money’s worth.

At around 9pm of August 3, 2005, I dropped off Nanay and Arlene at the ER of CSMC and parked my car. As I leave my car, a security guard approached me to give me a parking card because I bypassed the main gate because Nanay was in severe pain. Well-trained guard. He made sure that I would not miss paying the 20peso-parking fee when we go out. Nanay was immediately attended to and was given initial medications. It took several hours before she got over the pain. At around 3am, the Resident on Duty recommended an ultrasound. The ultra sound section opened at 7am and until 8am, Nanay was still in the ER. The ER personnel failed to inform ultrasound section about Nanay. It was only when I inquired what’s delaying the procedure, Nanay was escorted to the ultrasound section. After the ultrasound, the ROD requested us to wait for the initial result because Nanay might be admitted. At that point, they were already suspecting stone problem. The ROD said that the initial result would be available by 9am. However, the result came out a few minutes before noon and, indeed, she needs to be admitted. There was no available room at that time. Rates were Php1, 800.00-private with extra bed, TV, ref, phone and a CR; Php750.00-small private with couch, common CR outside room; Php700.00-small private with chair, common CR outside room. Nice strategy yeah. We were allowed to go home and just inquire by phone of room availability.

Nanay was finally admitted late afternoon. Any amount will do for deposit. Woweee! Have you heard about the Php15, 000.00 deposit after the lobby renovation? A pedia friend in CSMC confirmed that to me. It was stopped when a patient complained and posted her complain in the Internet. On Nanay’s first day of confinement, she was given a very powerful antibiotic (Ciprofloxacin-Ciprobay IV 200mg, administered via dextrose) 2x a day. This is for pneumonia. She could have probably acquired this during her long stay at the ER (hospital-acquired pneumonia). She had 2 vials of this already when I requested for a bill update on her second day. Woweee again. Each vial costs Php2, 400.00, net of senior discount. Outside, each vial only costs Php 1,300.00, net of senior discount. Called up my friend from Bayer, Ciprobay’s manufacturer, and committed to give me 2 vials for free. Thank heavens. According to hospital policies, patients are not allowed to purchase meds outside however one of the residents attending to Nanay allowed us. Joan and I picked up the vials from Tandang Sora where my friend lives, 10pm. These 2 vials were supposed to be for the 2am and 2pm dose of the next day. I was surprised to learn later that the 2am dose was not given. When I asked the nurse on duty why, I got a very horrible answer. They are not allowed to administer drugs bought by patients outside the hospital and they even expect us to do that according to her. I told her that isn’t that against her oath as nurse? She just said, “Sorry, it’s the hospital policy”. I talked to the resident who allowed us to buy meds outside and she just volunteered to administer the anti biotics whenever needed. Looks like it’s a strict policy. Even putting the patient’s condition at risk. Nanay needs to undergo ERCP according to her Gastro MD. It’s a procedure where a tube is inserted to the throat all the way down sa stomach area. It should find out the location of the stone. Another trouble. CSMC machine for this procedure is out of order at the time of Nanay’s schedule, Friday, August 12. The gastro says that the procedure will be done at St. Lukes where he is also affiliated and instead will be done Saturday because Friday’s full already. CSMC told us that an ambulance to and from SLMC would transport Nanay. CSMC claims that they don’t maintain ambulances anymore. Instead they call outside services. “Isang malaking ospital na tila mahusay ang serbisyo, walang ambulansya?” To add insult to injury, CSMC told us that we would be the ones to shoulder the charges of the ambulance service. Php2, 800.00 to and from SLMC. However, the ambulance only has a one-hour allowable waiting time. In excess of this, an additional of Php350.00 will be charged per hour. I estimated to spend Php5, 000.00 just for the ambulance. No way! I signed a waiver that we will just be the ones to transport Nanay to SLMC. I rented a van for Php1, 000.00. Picked us up from CSMC at 11:30am and back at almost 4:00pm already. But before we got over the procedure at SLMC, we got involved again in another CSMC hostage drama. They wouldn’t allow us to leave CSMC unless we pay Php10, 000.00. Sort of bond? Oh dear Lord. And we were only informed about it when we’re about to leave already. We only have the amount for the procedure in SLMC. I tried my best to be able to call Nanay’s gastro. After several minutes, I was able to contact him and he vouched for our leaving the hospital without bond. This seemingly good hospital can afford to put their patients at risk just to make sure they get the ransom money from their patient-hostages. Back to CSMC, daily, I make sure that I get a detailed copy of the updated bills. I noticed one day, the powerful, super expensive antibiotic in vial form, which we buy outside, appeared and charged. I called the attention of the nurse station. They conferred about it and got back to me later that it was already ok and credited. And, very surprisingly, this happened 3 more times later and from different shifts. We were never told why these things happened, despite numerous inquiries, which forced me to suspect some misbehavior of some hospital personnel. Total mis charged drugs amounted to almost Php5, 000.00 that were reversed later accordingly. “Paano kung hindi ako nag check?” How about the cotton, syringes, plasters, and other supplies from Central Supply Section, which almost come out of the bills daily? Nanay’s total CSS charges amounted to Php9, 000.00. How I’d wished I had the time to trail the CSS supplies. Oooops, another mess. From the lobby, if a patient needs a wheelchair, you need to submit an ID to the entrance guard to get one. You have to return the wheelchair back to the entrance area to get back your ID. Ano ba yan? Lahat ng klase ng bulok na serbisyo meron! Husto naman ang bayad!

To top it all, Nanay was discharged after 7days with NO firm/contrete report of diagnosis/findings. They did all the necessary (?) examinations and laboratory tests including a CT scan outside CSMC (done 2 days after confinement). I got a second opinion from a gastro friend at Capitol Medical Center. It was only then that things were explained to me seriously. Reports that I expected to get from CSMC. More importantly, the findings of Capitol were very favorable. Praise God!

This Cardinal Santos Medical Center horrible experience will definitely be a very unforgettable one. I don’t want you to be the next victim!

Arnel Limuaco

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