(Snippets from the frontline)
The “glitch”
He was ill requiring a stay in the ICU for sepsis. Still weak, yet recovering enough to eat, the “four-day rule” of hospitalization was fast approaching.
The discharge planner rapidly began churning to get him to a nursing home. Married for decades, his wife was adamantly against it as they lived at home, and she was willing to care for him despite both being in their early 90s.
All arrangements were made for 14 days of intravenous antibiotics covered by Medicare, so the patient was discharged and arrived home at 4 pm. The antibiotics did not.
Frantic phone calls to the discharge planner met with reassurances, but doses were now being missed. The next day, the discharge planner called and said there was a “glitch.” The patient would have to pay for the antibiotics…$400 per day…but they could charge it on a credit card over the phone!
I saw the patient on an urgent housecall at the request of my worried colleague, and found him with fever, low blood pressure, and altered mental status. He was admitted back to the ICU.
Beware of “glitches.”
Gene Uzawa Dorio, M.D.
Leave a Comment