Women and children first. The elderly last.

[Substance]

I've wondered: why is it that the atmosphere on O&G is far more comfortable than on a general medical ward?

On O&G, there are multiple experienced nurses per each patient. Each patient gets her own room, and each room is fitted with nice furniture for visitors, and a TV. The security and privary of the O&G ward is top notch, with multiple different checkpoints that screen passes-through. The whims of each patient are catered to vigorously.

On medicine, there are inexperienced nursing school students and new nurses. Patients are in rooms with multiple other very ill patients, and one nurse takes care of multiple rooms by herself. The decor is spartan, the lighting poor, and the privacy nonexistent. The sounds and smells of the ****ting and retching of the other patients are easily heard, and often overpowering. This is generally the last moment of many of these unfortunate elderly people's lives. Patients are often ignored even if they are in pain.

I cannot see why its justified that one population is treated with such adulation whereas the other is treated oppositely. It saddens me to see elderly folk that have lived virtuous lives - war veterans, community volunteers, and other good(and even not so good) folk - live their final years or days in such a disgusting undignified environment, and on the other side of the hospital the women giving birth is given so much comfort and respect. It makes me cynical.

Any thoughts?

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[Mistress S]

I would guess that reimbursements are much higher for L&D than the Medicare reimbursement for the average internal medicine hospital stay. I'm sure some of it is also a reflection of societal values, misplaced or not, but at the end of the day hospitals aren't going to pour resources into the departments that lose money. Also, women is most areas can choose where they want to deliver, and hospitals want to attract women to deliver at their hospital (especially if they have private insurance). Most elderly patients who are admitted, on the other hand, likely didn't have the opportunity to plan out where they would go when they had an MI/ruptured their varices/developed pneumonia/etc. so it's not as if there is some benefit to trying to "attract" these patients to the hospital- although some community hospitals I have seen do put considerably more effort into making their medicine wards more attractive places, I would assume in an attempt to lure in a better payor mix for those who do have a choice in the matter. I agree that it is very sad that so much in medicine is dictated by the almighty dollar, but that is a separate topic unto itself.

 

[smq123]

Moving to Topics in Healthcare.

 

[rosebud1]

Mistress nailed it. Women choose where they want to have their babies. Of course they're going to choose the hospital that's going to make the experience most comfortable for them. So the hospitals have an incentive to make O&G nice.

I don't think that it's necessarily a bad thing, though. Competition drives better results.

It is sad that the elderly don't receive nicer conditions. They deserve better. But I don't think that we should be upset about how nice O&G is. It's good that US hospitals provide such nice facilities for women during such a stressful time. The disparity is something that we definitely should work to improve as a society, but at the same time, we should be proud of the great facilities that we do have and learn from their success. Maybe a competitive incentive for hospitals - the hospitals with the highest level of patient satisfaction get some sort of special bonus. Competition drives improvement.

 

[RTrain]

There's also the fact that, by and large, women delivering babies are not sick people. They are well, healthy people choosing a place at which to undergo a major rite of passage and life event. A supportive and home-like environment is quite appropriate for that.

A medical ward is more utilitarian because it needs to be. There needs to be more monitoring and more equipment. There's less privacy because patients are sicker and need to be easily monitored; plus there are just more patients, and they have to go somewhere.

I don't disagree that the oldest and most vulnerable patients also deserve dignity and respect, but there's no need to compare their experience unfavorably to the experience of women giving birth to babies, or to feel bitter and angry that healthy young women are given a pleasant and supportive environment in which to deliver their children. We can work for older, sicker, more marginalized patients to have a better experience in the hospital without hating on L&D. It is what it is.

 

[rosebud1]

I don't disagree that the oldest and most vulnerable patients also deserve dignity and respect, but there's no need to compare their experience unfavorably to the experience of women giving birth to babies, or to feel bitter and angry that healthy young women are given a pleasant and supportive environment in which to deliver their children. We can work for older, sicker, more marginalized patients to have a better experience in the hospital without hating on L&D. It is what it is.

This. You said what I wanted to say so much better.