Much has been said about patients who leave against medical advice, but little has been described about patients who stay against medical advice. When a hospital setting is no longer appropriate for a patient, a physician will recommend discharge to the next appropriate level of care. For most well adjusted patients, the hospital is the last place in the world they want to be, but for a select subset of customers, the hospital is the only place they would like to be.
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The average adult probably finds it hard to believe some patients actually want to stay in the hospital longer than necessary, but it's true.
Staying longer than necessary does come with risk, including hospital acquired infections, medication errors and other unspecified iatrogenic badness. But, try explaining that to the clientele refusing to leave and many doctors risk getting a 4 instead of a 5 on their patient satisfaction experience scorecard.
Staying longer than necessary does come with risk, including hospital acquired infections, medication errors and other unspecified iatrogenic badness. But, try explaining that to the clientele refusing to leave and many doctors risk getting a 4 instead of a 5 on their patient satisfaction experience scorecard.
Remember, an unsatisfied patient is a hazard to a hospital's health. With Medicare paying hospitals these days partly based on the patient experience, hospitals and their healthcare providers must walk an often impossible line between doing what's good for the patient and what's good for the patient experience.
In fact, Medicare believes so strongly in a patient's right to refuse discharge and stay against medical advice, they have a form that allows the patient to stay against medical advice and have their discharge decision appealed by some unknown entity with an unknown degree deep within the Medicare Fort.
So why do some patients want to stay against medical advice and risk all the complications of continued hospital care? Here is a Top 15 List of real quotes from patients who were allowed to stay against medical advice by hospitals fearful of not getting 5/5 on their patient satisfaction scores.
- "You have the best Dilaudid of any hospital I've ever been to."
- "My daughter ain't going anywhere until you have her pseudoseizures under control."
- "My ride is out of town until Tuesday of next week."
- "Someone stole my Oxycotton script and I'm not leaving until you write me another one."
- "My husband got admitted to the hospital yesterday and I want to stay here until he goes home too. Can he stay in my room too?"
- "I'm lonely at home and my kids never call."
- "The chicken cordon bleu here is amazing."
- "I have a call button. Why would I want to go home?"
- "I've been having abdominal pain for 20 years and I'm not leaving until you figure it out."
- "My team is playing tonight and I don't have cable at home."
- "I'm not going to rehab until I'm strong enough for rehab."
- "I'm a squatter. Get over it."
- "My kids don't get back from vacation until next week."
- "My water got shut off and I have no way to take a bath."
- "You all make me feel so good."
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