I am a geriatric doctor caring for elderly and bedridden patients. Keeping them out of the hospital is a challenge as they face problems different from the general population.
Diminished mobility at home comes with skin breakdown and ulceration, muscle and joint atrophy, less ability to expand the lungs and exercise the heart, pain management, and psychologic support requiring family and friends.
Once they are admitted, their response to treatment can be slower, but all want to return to their environment where they have semblance of control and familiarity. They know going to a nursing home might lead to their demise.
Hospitals today want patients admitted and discharged with cookie-cutter care.
Many of my patients do not fit into this category and require one crucial element of healing: Time.
Hospitalization is a threat exposing them to infection and other complications, yet being admitted for treatment and accepting these risks could return them home with renewed quality of life.
When their hospital length of stay is long, I am branded “overutilizating” patient care resources.
If “overutilizating” means keeping my patients out of a nursing home or dying, I gladly accept my moniker.
Gene Uzawa Dorio, M.D.
Comments: http://scvphysicianreport.com/2018/07/08/doctors-diary-july-8-2018-overutilization-monicker/ Hit “Home” for past snippets.