Better Health Care Elsewhere

My personal & professional medical experiences on both the east and west coasts. Nurses General Nursing Article

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Better Health Care Elsewhere

This new year didn't start quite as planned. I woke up on 12/31 with high hopes and a very sore throat...about to be walloped by a nasty little virus. I was laid up on the couch for over a week. The unplanned break was great at first. Despite feeling terrible, it was nice to just lie around and rest, catch up on some TV, read a few chapters, drink some tea. Day six I began to go a bit stir crazy. Luckily, I did get out long enough to check out the local urgent care. Too bad they were so efficient I was well taken care of and home in 2.5 hours! I was in awe of their pace - blood work/urine sent, flu swab done, IVF and IV antibiotics administered, a nebulizer treatment, a CXR. And all done with a smile. I even got a warm blanket and tea upon arrival. I saw the RN many times (she was great!). Most shocking of all to me was that I saw the MD three times before I left. They kept my husband and I informed every step of the way. This was completely different experience than I ever had back east.

I must really love the medical field - between having a chronic illness and being a nurse, I'm kind of entangled in this profession for life. Being on both sides does have its benefits though. I'm able to be a better nurse, knowing how vulnerable it is to be on the other (colder!) side of the stethoscope. I've also gotten to be a better patient - realizing when I'm rambling on and learning how to describe my symptoms more concisely. Clear communication is key on both ends and accountability should be shared.

As a patient I've noticed a world of difference in the care I've received here on the west coast. The physicians have been some of the most attentive I've ever been to (and like I said, I have a bit of a track record). They take the time to listen and I've never felt rushed during an appointment. I've felt that they actually appreciate my input as a long term patient and we usually work together in more of a collaborative effort. This was never my experience in the north east and I went to some of the top doctors in their respective fields. I usually felt rushed and at least one bad attitude was not uncommon somewhere in the office. I'm not sure if it can be attributed to the sheer volume of people in the tri-state area but somehow bad attitudes were almost excusable. I would find myself mentally saying, "well they are pretty busy, cut them a break". That would never, ever fly here. As the patient the last thing you deserve is a bad attitude from anyone working in healthcare. Chances are you probably already don't want to be there, in that office. Certainly, anyone that's getting paid to be there should not be making it any worse for you. On the other side, when I'm working, I try to be conscious of that. Our patients pick up on more than we may always realize.

The attitudes are different on the west coast. No shock there, but particularly so in the medical field. Everyone I encounter at my MD appointments (from reception to check out) is generally pleasant. I say generally because some go above and beyond and could not be merely described as pleasant. Gleeful, maybe? Their bubbly, warm personality does influence my mood as the patient and I appreciate it (it's almost admirable - those traits do not necessarily come easy to me at all times). To be fair it has not just been my experience with one hospital either. Due to some personal changes in medical insurance I've been to three different hospital systems over the last four years and all have been great.

Lastly I've noticed the most difference in availability of physicians outside of the office. Yes, I exchanged emails with some physicians on the east coast, but none seemed to like to use it for anything other than medication requests. Most would just have you come into the office anyway to discuss anything else (the time off from work and the copays start to add up). I also never used any type of online platform/patient portal until I moved west. Maybe this has changed in recent years? Labs are back within a day or two. My current MDs are always happy to respond to any message within a few hours. You can feel the compassion from them even through email. They'll say things like, "hang in there" or "we'll get you feeling better soon". They sign off with their first name.

It's definitely a little more laid back here. People don't take themselves too seriously. However, that somehow doesn't translate into lackadaisical medical care. That still surprises me. I seem to have found the best blend yet of smart, patient, compassionate physicians with great support staff that make the entire experience so much easier.

Have you received care in multiple states? Where do you feel you have received the best care as a patient? Have you worked in multiple states and noticed a difference in patient care by region?

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Ashley Hay, BSN, RN

About Ashley Hay, BSN, RN, BSN, RN

Over 10 years of nursing experience in several areas of Pediatric & Adult Oncology including clinical research, chemotherapy, transplant, hematology, proton therapy, GI surgery, wound care, post anesthesia recovery, etc.

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Specializes in Critical Care, Education.

Thanks for sharing your personal experiences - it's always enlightening to hear from someone who is actually qualified to evaluate healthcare services. But I don't think you can make sweeping generalizations based on such a limited sample size - LOL. You are also not taking into account all of the confounding variables at work, such as the recent impact of HCAHPS and Pt Sat on reimbursement schemes. If it were possible to clone yourself and make simultaneous, identical visits to both coasts .... it would provide stroner evidence.

Srry - research geek here.

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Specializes in Nursing Professional Development.

I have lived in multiple states (10 states in 4 of the regions on your map) and have found that while there are general cultural differences in different areas of the country, the quality of the care I have received depends more on the particular individuals involved than the region they live in. I now live in Virginia and have my favorite PCP -- and have the online portal, etc.

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Specializes in Pediatric & Adult Oncology.
Thanks for sharing your personal experiences - it's always enlightening to hear from someone who is actually qualified to evaluate healthcare services. But I don't think you can make sweeping generalizations based on such a limited sample size - LOL. You are also not taking into account all of the confounding variables at work, such as the recent impact of HCAHPS and Pt Sat on reimbursement schemes. If it were possible to clone yourself and make simultaneous, identical visits to both coasts .... it would provide stroner evidence.

Srry - research geek here.

Thanks for your comments. I can appreciate your pointing out different research variables I may not have taken into consideration, as they certainly do have an impact on care. I tried to give you my own personal account with specific examples. While I agree it is a small sample size I cannot deny the difference I have seen in care. The idea of this article was to explore if it really does have anything to do with region - or more of the above outside factors you mentioned. What better place to test out a theory than here at the allnurses community? A larger sample size for sure. I'm looking forward to reading what others nurses experiences may have been.

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Specializes in Pediatric & Adult Oncology.
I have lived in multiple states (10 states in 4 of the regions on your map) and have found that while there are general cultural differences in different areas of the country, the quality of the care I have received depends more on the particular individuals involved than the region they live in. I now live in Virginia and have my favorite PCP -- and have the online portal, etc.

Thanks for weighing in! 10 states - that is impressive. You've definitely seen your fair share of healthcare systems. Glad to hear you've found your favorite PCP, it makes a world of difference.

PS- I so appreciate your Fox Mulder quote...huge XFiles fan :bookworm:

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I work in an area with a literal global view of healthcare and I have traveled to and worked with hundreds of hospitals throughout the United States. Great care can be found in every region of the country.

When comparing regions you cannot just compare region to region, California and Texas for example are larger than most countries...not only in size but economies and population as well.

When comparing healthcare quality the basic question you have to consider is what you are comparing, is it outcomes, which outcomes, level of patient centric care, etc. If you look at this recent Consumers Report article Consumer Reports: “Zero Tolerance” List Identifies 31 Teaching Hospitals That Pose Risks to Patients you would think UCLA and UCSD provided terrible care when I know that they actually provide great care.

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It's great that you've found good physicians, but I wondered why you wrote an article expressing your appreciation for your physicians on a nursing forum. I thought at first that I was reading an advert. Have you thought of telling your physicians that you appreciate them?

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Specializes in Pediatric & Adult Oncology.
It's great that you've found good physicians, but I wondered why you wrote an article expressing your appreciation for your physicians on a nursing forum. I thought at first that I was reading an advert.

That's an interesting take on this article. I mention great nursing care and support staff as well. The intention was not to express appreciation but more to examine the possibility of regional impact on care I've received. As someone who is frequently on both sides of the bedrails (as both an experienced RN and chronic patient) it struck me as an interesting topic and one that might spark a discussion between readers.

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I can only speak to Northern California but I have had positive experiences the vast majority of the time from both sides of the fence, nurse and patient/family member.

A question that begs to be asked however, does that have more to do with me? No doubt not everyone, or even close, in Northern California will express the same experience.

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Specializes in Pediatric & Adult Oncology.
I can only speak to Northern California but I have had positive experiences the vast majority of the time from both sides of the fence, nurse and patient/family member.

A question that begs to be answered however, does that have more to do with me? No doubt not everyone, or even close, in Northern California will express the same experience.

Very true, but it is interesting to hear everyone's feedback on this topic. While I know there's a ton of factors weighing in on care it is interesting to see what everyone here thinks about the difference in care by region. Waiting to hear from some of my fellow east coasters. Thanks for reading.

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I actually have been thinking a lot about this same topic recently. I am from the Midwest but have lived in AZ for the past 16 years. And although "home" has a good reputation for medical care, I could not be happier with my family's care in AZ. Also, I would like to add that I have made an excellent living (6 figures) as a nurse out west and I could never had made that kind of money back home. I find the attitude different as well. Much more professional and collegial out west.

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Specializes in Burn, ICU.

I wonder if the patients are different in different areas? I'm in the northeast and I called a specialist's office today to schedule an appointment. I've been there before but not for a couple of years. I'll need some imaging done before the appointent, so the person I talked to said she'd have to have the scheduler contact me. I thanked her and...she sounded genuinely surprised & said 'you're welcome!' Was I seriously the only person who said thank you all morning?

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