From 2016, a model for a healthcare letter

Spoiler: I didn't pay for any of the disputed charges

Greetings:

I have reviewed the submitted claims for my stay in New York Presbyterian’s emergency department from the morning of October 12, 2016 through the afternoon of October 13, 2016. I see among the individual bills, is a claim for $15,847.23 for “room and board/medical-surgical.”

I think I may need treatment for an exploding head.

For about 16 hours, from approximately 9:45 Wednesday morning until about 1:15 Thursday morning, I sat around the emergency department. I say “sat” advisedly, because there was no place for me to lie down until then, when, after awaking from a painfully rare bout of sleep, I staggered to the nurse’s station begging for a place to lie down. She found a stretcher, and I crawled onto it in exhaustion. (Should I have used a call button? Perhaps. I did look vainly for one. At no time in my stay was I anywhere near anything identifiable as a call button, except for my visits to the restroom.)

I was told repeatedly in the course of the 24 hours I spent in the emergency department hallway, that there were no beds available in the hospital. Neither, to put a fine point on the matter, were IV poles available for much of that time. A resourceful nurse scavenged a wheelchair with a pole, so I could at least get myself to the restroom. A pillow was not manifest until some time after I started live-tweeting my stay in the emergency department, at which point some very nice people from Patient Services arrived as well. A bed was wheeled into the hallway that I had been inhabiting, sometime late Thursday morning after the intervention of a friend who had arrived. Finally, in the early afternoon, I was wheeled on the before-mentioned bed into Millstein, where I was treated to a change of scenery, more populated but still solidly in the genre “hallway”.

So much for the “room” part of the bill.

As to the “board,” that would rather accurately describe the consistency of the turkey-and-whole-wheat sandwich I wheedled out of a nurse sometime in the evening of Wednesday. (At no time was I ever told an NPO order had been issued, which would only have made sense before the diagnosis of pneumonia was made.) All I can tell you about the one and only food tray presented to me, sometime in the early afternoon of Wednesday, was that the turkey was so salty I took only one bite. The salt in that meal beggared belief—particularly since I had made no secret of being on hydrochlorothiazide for elevated blood pressure. (How elevated it actually got in the course of this stay, is probably better left uncontemplated.) I did drink the juice out of desperation.

Finally, shortly before discharge, a nurse offered my one dose of my blood pressure medication and two Colace, which she accurately described as “stool softener.”

I had presented with diarrhea as a symptom, and had explained to every medical professional who asked, that I had diarrhea. What possessed someone to prescribe stool softener, I have no clue. When I informed the nurse of this, she wisely disposed of the pills. Had I taken them, the resulting body fluid disaster would still be soaked into crevices of your floors.

Let us be extremely clear: I understand triage, and from my perspective as a lay person who has never watched House, I saw people arriving with emergent conditions that far outweighed mine in apparent severity.

I received 500 milliliters of contrast solution prefatory to a CAT scan, as I had arrived with symptoms indicating the possibility of appendicitis, and had to wait for that solution to wend its way through my system before the scan could be performed. I understand that. I saw that for most of Wednesday, the staff were wildly overrun with patients. I am in no way unhappy with the wait for most of that day. After midnight, however, it got much less busy, but no one reached out to me to try to ascertain what my needs were. I had to look for a place to lie down myself.

So, in light of all this, a claim for “room and board” is just unsupportable by any rational definition of either word.

Regards,

Mary E. O'Shaughnessy

PS—I would not leave you with the impression that my stay was irredeemably bad. I was treated appropriately, with intravenous antibiotics for pneumonia and four liters of fluid for very serious dehydration. The staff were uniformly pleasant, and it was obvious for most of Wednesday they were wildly overrun with patients. At no time was anyone rude, dismissive, demeaning, or annoyed. At no point did I overhear confidential or personally identifiable information discussed in public places. The restrooms and patient areas were clean, in the face of lots of traffic. My concerns were heard by the Nursing Coordinator and Patient Services people, who did give me their business cards (which I lost in my sleep-deprived haze.)

xc: Oxford / United Healthcare