Health Care Choices


Health Care Choices

pulse-818378_640When my dad was diagnosed with bladder cancer in 2004, I asked him about getting a second opinion, about taking advantage of the incredible university hospital systems we have in the Chicago area (Northwestern University, University of Chicago). He refused and said he was fine with his urologist and the local community hospital to which he would go to receive his regular treatments.

While I disagreed, I respected his decision. I thought more about the hospital where he and my mom went for his scopes and treatments. Located close to home, the hospital had easy access--a parking lot in front (rather than a large parking garage) and short walks because of its smaller size. It made sense to me that they would choose a hospital that was easy.

A few years ago, I met an administrator who works at one of the two hospitals in our area at a Super Bowl party hosted by my sister. Sue and I began a conversation about which hospital to choose for care. She works at the hospital in our area everyone chooses--it handles trauma, is state-of-the-art, has a terrific reputation.

Sue's daughter was diagnosed with cancer as a young girl. They chose the best oncologist they could find--an oncologist affiliated with University of Chicago. They loved the oncologist but the distance proved a challenge, especially in an emergency. During one of her daughter's health care crisis, they fought terrible traffic in the city of Chicago to get to her doctor--a harrowing and awful 60-minute car ride. Sue assured me that my parents' decision to stick with a local community hospital was a good one.

When my mom called "911" three Saturdays ago, I wasn't home. I was at my other sister's home, watching her three teen-agers while she and her husband spent the weekend away celebrating her 50th birthday. When the ambulance arrived, my mom asked to go to "the other hospital" in our area, the one I always avoid. She chose the closer hospital out of convenience for my dad.

When we learned where parents were--"the other hospital"--we all groaned, worrying about what would happen. Would my mom receive substandard care? Get worse? Be misdiagnosed?

When I called "911" early Thursday morning, I requested transfer to this "other hospital" because of convenience. We can't visit two patients in two different hospitals. It turned out to be a blessing. He was transferred to the "observation unit" and to a fantastic nurse named Katie. She connected us to the ostomy nurse, who was amazing.

When my dad had chest pains in early July, I called "911" and requested transfer to the hospital near us with the great reputation. When my dad finally moved to a room at about 9 p.m., his nurse gave him a hard time about his ostomy bag. He needed an overnight bag (a larger bag that connects to his smaller bag so he doesn't have to get up during the night to empty his bag) and she said she didn't think she could get one, that the hospital didn't have them. In essence, he needed a catheter bag. We were floored. How could this large, state-of-the-art hospital not have a catheter bag? She did finally find one but couldn't figure out how to attach it to the ostomy bag and refused my dad's help (he does it every night so knows how to did it). She finally taped the two together.

Can you imagine? He already worries and frets about the bag and to have a healthcare professional basically say she has no idea how to care for it just made the situation much, much worse. When the hospital called for a patient satisfaction survey after my dad's discharge, my dad complained about her.

But Katie didn't blink an eye. She made my dad feel comfortable and confident in her care. In addition, just about every staff member with whom my dad interacted knew my mom was in ICU.

I've been thinking about our experience with this "other hospital". The convenience factor--only five minutes from our home--cannot be over-rated. It also feels like a community. I visited a farmer's market last week held in the cafeteria courtyard. The gift shop had something like a sidewalk sale last week. When I sit outside to eat lunch in the cafeteria, I sit near a garden created to honor "a beloved cafeteria manager."

We've had some difficult moments and an incompetent discharge planner but we've also met such kind and caring professionals.

With this latest hospitalization for my parents, I'm reminded that health care choices are about people. What works for my parents? What's easiest and convenient for them so they can participate in their care the best way possible? Where do they feel most comfortable? Who provides compassionate care? Who treats patients and families with gentleness during rough times?

Health care may be an institution. But, it's ultimately about people--those who care and those who receive care. I think we're best when we follow the care.

What about you? Do you have a choice about where to receive care? Or, is the struggle about a lack of choice? Please share your experiences in our comments section, below.

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My friend's family and I also so wanted her to go to the U of Chicago and she did for a second opinion and testing. The referral was made by her local oncologist. But luckily she is getting the best of two worlds right now. She is getting treatment locally, but the U of C doctor is staying involved on the case with her local oncologist. I was grateful we didn't have to drive to U of C instead only 5 minutes to her local hospital in the middle of the night last week. Although, I am concerned with some of the hospital doctors that get assigned to her. Its not a consistent team like it is at U of C.


Looking back on things, it seems incredible that we ever discussed where my husband should be treated -- the local hospital or the state-of-the-art teaching hospital 90 minutes away. I remember we discussed whether he would feel up to the commute and whether winter weather might make the commute difficult. The commute has been entirely worth it. We are very comfortable with and confident in our treatment team. Scary to think that \nMichael would have died from that GI bleed in April if we had gone to the local hospital.

Lillie Fuller

Locally we don't have many options. We always deal with the same hospital because it is a Catholic Hospital, my mom can receive communion there and there is always a priest or a deacon running around. For the past 5 years my mom has been treated there once each year for one reason or another. The nurses on the cardiac care floor, where my mom usually ends up, always remember her. It's a great feeling. Some of the nurses also remember her name and that she is very quiet. They also know better than to call her \"mama\". We hate that. So yes, we always deal with the same place, the place we are comfortable and have always received great care.