Thursday, November 20, 2008

Shady company.

If you've ever seen my blog before you know that I'm always preaching about doing what's right for the patient above all else. Forget the fact that you feel slighted by someone calling you and bitching, forget about extra work it may cause you. Above all else, our responsibility is to the patient. With this said, I now understand a little better why many of the older techs at our hospital are good with washing their hands of any problem and not worrying about it so long as they won't be held responsible.

I was working a night in the blood bank. I think I've stated before that we're a reference lab for many smaller hospitals in the area. On the shift previous to mine, one of the smaller local hospitals sent a sample for a red cell antibody ID. The patient had a FYa antibody. This particular antigen on red cells occurs in about 66% of the normal population so there is about a 33% chance that a randomly selected unit of blood will be compatible with this person. They sent us sample of two units in their inventory to do testing. They needed two unit crossmatched. At a 33% likely hood of compatibility, it's not too likely both of them would be negative.

The tech on the shift before me basically washed his hands of the problem by informing the smaller hospital that they had to call the blood donor center they use and have them do the work since we didn't have everything we needed to help them out. About an hour later I get a phone call from the local blood center, of course it's midnight on a friday night, I'm informed that unless it's a medical emergency they're not coming in. That's fine, It really doesn't effect me. Except, The hospital says We need it tonight, but it's not a medical emergency, I don't get it.

What I find out, is that this gentleman's only diagnosis is anemia and they want to discharge this patient. The Dr. seems to be looking out for his best interest, in terms of cost for the patient, and in hoping to get him out of the hospital to prevent things like nosocomial infections. I can appreciate that. So I agree to have the blood center send me some historically FYa antigen negative units. I'll do the antigen typing and the extended crossmatch and go ahead and send these units on to the smaller hospital. It's alot of extra work, but it should do two things, It should save the hospital money considering this hospital is a satellite hospital and under the same blanket organization. The second thing it should do is enable the patient to receive the units he needs more quickly.

I complete my end of the bargain and send the units on their way. and try to leave an email to the blood bank supervisor about what happened, hoping all the charges can be fixed appropriately. Come to find out, the blood center charged us for the units, then charged us a "consulting fee" of $800 even though the on call tech from the blood center called me. Somehow, they even passed on charges for the work I did, to the satellite hospital.

Basically trying to do the right thing financially effed us, not to mention it caused me a shit ton more work. I easily could have washed my hands of the situation and said that it's a contractual problem between the blood center and the smaller hospital, but nooooo I had to try to do the right thing for the patient.

Frankly, I hope events like these won't cause me to think twice about doing the right thing for the patient. I can see why people are so hesitant to go out of their way to help, in the long run you're just screwing yourself. I hate being a hypocrite more than anything in the world

No comments: