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J.R. Buchanan


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Then and now, a tale of two hospitalizations

December 2016

I've been inpatient for psych several times over the years. The first time was in October 2003, the latest was in November 2015. Twelve years and the same ward of the same hospital. So different in so many ways.

One thing did not change, the staff was friendly, polite, and treated me well both times. That's normal at the two hospitals I've been inpatient at. This is not a given, I've read some real horror stories on-line.

The first time, 12 years before, they kept me busy. All day, from the time they woke me up until evening, the day was full. There were groups almost every hour, groups on mood, groups on anxiety, groups on anger, groups for general psycho-education, process groups where we worked through our problems. We also had art and craft groups where we made projects that we could take home. I made a plaque with a copper lion and a coaster/trivet made of small ceramic tiles. I still have the plaque, I've lost track of the coaster. During this time my meds were revamped and I saw my own psychiatrist almost every day for about 12 days. I saw another psychiatrist the other days. I saw a therapist almost every day as well. Several times those of us who signed ourselves in got to go on walks around the grounds. Not exciting, but a nice break. I got a lot out of this stay.

The most recent stay was very different. The stay was about the same length and that's about all it was, a stay. I did see a psychiatrist every day, not my own, but good. I only saw a therapist twice, a couple days after I got there, and as I left. No groups at all, just some visits from the hospital chaplain, which were a nice break. Other than that, just sitting and reading or watching TV all day long. I slept a lot, I'm prone to do that when I'm depressed, and unlike past trips to the hospital, they just let me. Wake up for vitals checks, meds, and food, then back to sleep. I suppose they knew that they had little else to offer. I didn't even get to spend time talking with other patients, unlike every other time I've been inpatient, there was no one else to talk with. Several non-verbal people and one poor person who was so delusional that she didn't make sense. The staff was nice enough to allow my family to bring in Thanksgiving dinner. I've got no complaints about niceness, I just didn't get much treatment for the condition that brought me there, it was mostly an exercise in warehousing.

Why the change? I can only assume funding, that's so often the problem with mental health care. It would cost money to have enough staff to keep a whole ward of patients busy and getting better. The cost of the salaries, and I suppose, to a lesser extent the cost of materials for the group handouts and craft supplies. Cheaper to just let them sit, keep themselves from hurting themselves and hope that the meds or the passage of time do something good. I presume that the amount of money that they could bill for the missing activities is less than what they feel is a good return on the investment of paying employees to do the work.

I'd wager that most businesses are founded by people who are interested in building a good product or providing a valuable service. But, as the business becomes successful, the management is taken over by people with a business background who are far more interested in the bottom line than making a good product or providing a good service. I'm sure you've heard them referred to as "the bean counters." Just enough to keep customers coming, understanding that their competitors (if they have any) are doing the same thing. A race to the bottom, run by people with no souls. I first learned of this way of doing business years ago when I saw a quote by Thomas A. Murphy, the CEO of General Motors during the '70s. He said, "General Motors is not in the business of making cars. It is in the business of making money." Thinking back on the cars they made in the '70s and '80s, it seems that minimum quality at the maximum profit was the intent, not the production of excellent automobiles. And now, this philosophy is ruling health care. What could go wrong?

Do you have any health care experiences that you'd like to share? Or thoughts on the state of business today? Let us know in the comments!

As usual, I'll post future updates to my Facebook and Twitter pages. Feel free to follow or friend or message me.

mental health mental illness business hospital hospitalization bipolar depression

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