First, don’t try to handle this all by yourself. “You need someone to speak for you. It’s like buying a car. Never do that alone,” said Dr. Aaron Lazare, chancellor and dean of the University of Massachusetts Medical School. Ideally, you should have an advocate with you, a friend or relative you know and trust. You can also call your regular, primary care doctor and ask him or her to help.
In addition, you can pick up the phone and ask for the patient advocate, patient care representative, care coordinator or whatever other term the hospital uses to designate the folks who are supposed to deal with situations like this. “Every hospital has” such people, said Dr. Michael Gustafson, vice president for clinical excellence at Boston’s Brigham and Women’s Hospital. “We have built this important infrastructure to try to help patients.”
In general, these folks want to help. They also want to avoid lawsuits. Often, you may be scared of specific things – like bleeding, or developing a fever, or not being able to climb stairs. Case managers can help arrange for services to help with specific concerns. And never accept discharge with having the names and phone numbers of doctors or nurses you can call 24/7 if you need to.
You can also simply refuse to leave. But in this case, be prepared to pay for an extra night or two yourself or at least for a fight with your insurer, whom you can call from the hospital, said Dr. Don Berwick, president and CEO of the Institute for Healthcare Improvement, a Boston-based nonprofit group.
Finally, remember this: “Every day you spend in a hospital bed you are exposed to the risks of errors, to infections that only occur in hospitals and other forms of inconvenience that are not trivial – like bad food, noise at night, bad air, indignity and interruptions,” said Berwick. “No patient should really regard a hospital as the safest place to be. In general, you will be safer at home.”