Wednesday, January 12, 2011

When the Doctor Recommend Going Against Medical Advice

Yesterday all the tests were fine and the baby was doing well. The doctor said he wanted to keep her overnight and discharge her in the morning. When asked for a medical reason to justify his decision he was open and honest. The staff that handle the discharge papers leave at 15:00 and Rachel needed to have the 2nd steroid shot to help the baby's lung development at 16:20. Rachel explained that staying at the hospital was a non starter for a number of reasons. It would mean missing a medical appointment close to home with someone who is only available once a week. There would be no helpful medical care provided. Due to the lack of rooms, Rachel had been stuck in the post postpartum ward with all the crying babies. This also meant any medical care that she was supposed to receive while she was there was taking 10 times as long. The level of systemic medical care was embarrassingly poor. .

After hearing these arguments the doctor agreed that the healthier option for both Rachel and the baby was to be home. He recommended that Rachel sign out of the hospital "AMA" (Against Medical Advice). He told us what paperwork needed to be done and was ready in order to make sure the Kupah would still pay for the visit.

Last month, Bikor Cholim hospital was turned down by the government for extra funding to keep the hospital running. There was a real threat that it would finally be closed down. The hospital has been on financial life support for quite some time. This brought up all the arguments for keeping it open. There was criticism of the possibility of shutting down the hospital located in the heart of downtown, only a few blocks away from some of the worst terrorist attacks during the 2nd Antifada. They mainly serve the local Charedi population who would have a difficult time getting to the 3 hospitals on the outskirts of the city, especially on Shabbat.

After seeing it first hand, it reminded me of the arguments made to keep Branson Hospital open in Toronto. As a kid, it was the closest hospital to where I lived. In every single document for medical permission my parents had to sign for school or camp etc..., they noted not to send me to Branson. Despite their reputation for horrible medical care, people argued that it was close by for people who would have trouble getting to the other hospitals, especially in the Jewish community. Eventually it was closed down and the premises taken over by another hospital. Bikor Cholim is in a prime location for a top level hospital to serve the community. After 160 some odd years, it is about time that they get one.


Anonymous said...

I know you had a bad experience but I have being going to Bikur CHolim for over 3 years and never had a negative experience happen. This type of situation happens in all of the hospitals in Israel and I have heard from many different women in different places. I am sorry she had such a bad experience and I pray she will not need the hospital again until her 40th week

Rachel said...

Can I ask if you were there for something routine or something even slightly out of the ordinary? I have been told for routine straightforward births, even with somewhat complicated nicu requirements, they are okay- but trying to get the individualized care I needed was a disaster.