Government and medicine

I started neurology at a government facility. It was a long day to say the least. I have had a few rotations now that are at government hospitals and one thing I have noticed is that those facilities are run horribly. There is no organization, unbelievable laziness of the staff and poor follow through on anything. It is amazing that anything gets done and that more people do not die. 

Here is an example. I was told to be at the human resources at 8:00 to meet the HR director and have my paper work processed and be cleared to work in the neurology department. Upon arrival I find the office is closed and no one is there. After waiting 1 hour someone finally shows up and I explain that I am supposed to meet the HR director and when I tell them the name of the person I am supposed to meet they inform me that she has not worked there for 6 months. They have no idea what to do with me. After asking many questions and getting no answers they tell me to go home.  Rather than going home I decide to go to the neurology department because they must be expecting me. 

I went to the neurology clinic and found an attending neurologist and explained that I was the new rotating medical student. He said that the chief of neurology was out of town until next Monday and had left no instructions. The  secretary of the neurology department finally told me to go back to HR and have them make me an ID. I arrive at the ID center at 11:00 am and when I explain that I am there for an ID I am told that they have met their quota of 25 IDs and will not do anymore. She explained that if you do not get there by 9:00 am then you can't get an ID because they will have already hit their quota. I asked her if she did anything else besides the IDs. She said that was her only job and that she works from 8:00 - 4:00 but once quota is met she just hangs out until she clocks out at 4:00. She explained this was they way it has always been. Usually from 9:00 to 4:00 she does nothing. I asked her about the quota and she did not know why they had a quota.

I was told that without an ID I could not work and that I should go home. Rather than going home I went back to the neurology clinic and just started seeing patients and presenting them to the attending physician once I had worked them up. 

This is how the entire hospital runs, including patient care. Tests and labs can't get processed timely or properly. Patients are given the run around on everything. Tons of time is wasted away. Often life saving exams like ECG that could dictate treatment when ordered are not processed with the explanation that the tech has reached his/her quota. The while waiting for the test at a later date the patient decompensates and can ultimately die as everyone just watches with a "there is nothing I can do" look on their face.

The rotations I have done at private hospitals are run the polar opposite when compared to the government hospitals. They are lean and efficient. You order the exam and the tech is there before you even hang up the phone. Very little time is wasted and the patients are respected and treated like customers. Why do people even go to the government facilities? The answer is simple; it is free. The public aid patients and the veterans get the care (if you can call it that) for free, nada, zip, $0. This is what makes many people afraid of socialized medicine. The government gets involved and everything becomes a bureaucratic nightmare and inefficient. There is no incentive to provide efficient and quality care so it simply is not offered. Hopefully if we ever turn to a socialized model it will not be run like the government hospitals are run in today's healthcare world. This kind of healthcare is dangerous.