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Discussion

Paying for priority

At my hospital, our Foundation (fund raising department) has started what they call the "Circle of Caring". You become a member of the "Circle" by donating $10,000 or more to the Foundation. One of the perks of membership is "Healthcare Navigation Services" where a representative of the Foundation stays with you for the first 24 hours of your stay in the hospital starting in the ED. The names of the "Circle" members are flagged in our computer system and when they come in to the ED or are directly admitted we get a pop-up telling us to page the Foundation rep on call. They get taken directly to a private room and don't have to wait in the ED waiting area or in a multi-patient room regardless of their condition. The Foundation won't comment on it, but nurses have reported that they get seen much sooner by a Doc in the ED than they would have as a regular patient. I have had one of these patient's on the floor and the Foundation Rep basically lets you know, directly and indirectly, that this patient needs to be your top priority.

I realize the hospital depends on donations, but as a nurse it seems like we should be advocating for the seriously ill patient who is now having to wait even longer to be seen so that a big donor can have his "burning with urination" evaluated.

Is this becoming a new thing elsewhere in the country or is it just where I work?

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    Wow. This is wrong on so many levels.

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    I don't agree with that at all. That's terrible.

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    Wow, small world -- I just saw a job posting for something like that the other day, at a big university teaching hospital. I had always been kind of vaguely aware that this sort of thing went on in some places, but I'd never actually run into it in real life before. The job would be to be the "liaison" to the big donors, responsible for making sure they get every little thing they want while they're in the hospital and that everyone else in the hospital understands they are Big Cheeses and first in line for anything and everything. Although it is a 40-hour/week position, the posting stated that you would be on call 24/7. :uhoh3:

    I'm not going to be applying for that position :rolleyes:, but it was certainly interesting to read about.

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    Wow..........that is a slippery slope......is your facility for-profit or not-for profit.?

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    Wow..........that is a slippery slope......is your facility for-profit or not-for profit.?

    We're a not-for-profit healthcare system run by a group of nuns.

    (Reading that I realized it sounds sarcastic but I'm being serious).

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    You all know the saying: "Money talks."

    Cash rules everything around us. As unethical as it may seem, it's true. Big donors with plenty of cash are going to be seen. People who lack money and/or insurance often get to wait in crowded conditions.

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    We're a not-for-profit healthcare system run by a group of nuns.

    (Reading that I realized it sounds sarcastic but I'm being serious).

    Ha! They attempted to run me too!!

    It is all about the money but the implications for a not for profit, tax exempt, accepting government money.......the rules are different.....they may have bitten off more that they realize............You may not discriminate do to a person's ability to pay. The patient bill of rights.....when are they due for JACHO? That will be interestng......:rolleyes:

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    Thinking about this, wouldn't this policy open the hospital up for a lawsuit? I mean if you have 2 or 3 big donors in and your nurses and docs are all tangled up with them and you have a regular Joe in the ER waiting room that dies from a heart attack because he hasn't donated 50K to the hospital. I would think that this policy would be an open door for abundant lawsuits. Especially in a day where eveyone is lawsuit happy and so many lawyers are chasing ambulances.

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    It is all about the money but the implications for a not for profit, tax exempt, accepting government money.......the rules are different.....they may have bitten off more that they realize............You may not discriminate do to a person's ability to pay. The patient bill of rights.....when are they due for JACHO? That will be interestng......:rolleyes:

    In my experience (and I worked for several years as a hospital surveyor for my state and CMS, and enforcing EMTALA rules was part of my job), the prohibition on discriminating based on a person's ability to pay only applies to EDs and emergency situations. Hospitals are free to decline to admit or treat people for non-emergencies if they can't pay for the treatment, and there are no laws or regulations about who gets seen in what order.

    However, in this case, the situation is not that anyone is being refused treatment; just that some people (with extra $$$) are getting some extra perks and consideration.

    And JCAHO is such a racket -- they have no interest in anything that actually affects real, live clients and their care.

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    So the rich donor with a hangnail gets treated before the poor schlub with an evolving MI. Whatever happened to triage?

    My, my, my...things have come to a pretty pass, haven't they? Makes me ashamed for some of my sisters and brethren in healthcare.

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    I'm OK with it up to a point. If people want to pay extra to get some extra services, I'm OK with that. If you want a private room, you pay more. If you want special meals, you pay more, etc. I have no problem with that. Health care providers have products to sell: other people want to buy those products -- and some people can afford to buy more of those products than others.

    However, I would never allow another patient to receive sub-standard care in the process. That poor patient is also entitled to a certain amount of service and care and I would not shortchange the poor person. That wouldn't be right. So, I would not let the poor person die or suffer while I did "some piece of fluff" for the rich person. But if the hospital can adequately meet the needs of both types of patients, I see nothing wrong with that.

    What's the name of that TV show about the "consierge doctor" in the Hamptons?

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    Hamster, I am fairly sure I am familiar with the hospital you speak of (judging by your screen name :), as I used to work there too. That does not surprise me at all. Shameful. Just goes to show how there is no leveling field even in healthcare and there won't even be one when we all have the "same" insurance with government funding. Wish there was a competing hospital in our town.

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