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Sunday, June 27, 2010

The forgotten Patient

I find I have no choice but to talk about the economy on this RT blog. I find I must do this considering we have been running on an extremely low census the past several months here at Shoreline. I'm talking half the hospital is closed kind of slow. I'm talking, like, 10 total patients kind of slow.

I'm talking many RTs and RNs who were living pay check to pay check before the recession hit are now finding themselves in a serious rough spot. Some are wondering if we will be able to pay our bills. Some are not paying them. Some of us have already become statistics.

Other hospitals in this area of Michigan are also experiencing a low census, although some of the larger hospitals have yet to get to the point where they have had to lay off RTs, some have been sent home early, and few hours are available for the pool RTs.

If you would have asked me two years ago how the recession would effect the medical profession, I would have predicted fewer elective surgical procedures, but I never would have predicted what is going on right now.

I think that not only are there fewer elective surgeries, I think there are a few people who require surgery who are staying home and suffering. In fact, I think there might be many people like this. I think there are many chest pain sufferers who are being modest and biting the bullet instead. I think there are COPD patients who are staying home until they can't stand the agony anymore.

Hence, I expect that some day soon we are going to be hit hard. The patients we get are going to be patients in critical condition; chronic lungers and asthmatics who have not taken their controller meds because they can't afford them, and chest pain folks who are coming in with the big one or a stroke because they ran out of their blood pressure medicine.

Sure, I bet, in this way, the recession may be responsible for many deaths this way. It will be slow, insidious, and agonizing. And yet it will not be seen, and therefore it will not be noticed, nor recorded in the annuls of history.

Yes, the recession is effecting the medical field. Since hospitals have little money, they are making do with what they have, and they are not expanding, not adding on, not making repairs, and not giving raises.

Actually, one hospital in my region is spending millions on room repairs, yet the money is from outside groups and donations. So, since no money is being spent this way, local contractors are not getting contracted out. They are -- the contractors -- having a lull time too.

And so they are losing jobs, and, with their jobs, they are losing their health insurances. And with no health insurance, they stay home when they get sick. Sometimes this is fine, yet sometimes this can increase morbidity and mortality.

So the lull has lasted a while now. Instead of having 2 RTs working during the day shift, we have been doing 8 hour shifts three days a week. Sure we have vacation hours we can use, yet those will die out some day. This cannot continue too much longer. Bills need to be paid.

Actually, I wrote before how those of us who live frugally as though we are always in a recession don't have to fret so much. Yet look around at all the people who have 2 cars that are rented, a camper that is rented, a house that is too extravagant for their income. These folks have been living above their means, check to check, assuming the recession would never come.

Those folks are the ones being the hardest hit. Those folks did not prepare. Those folks are the ones who bought houses they couldn't afford and are thus going to have no choice but to file for bankruptcy.

Temporary jobs can keep an economy going for a while, yet will it pull us out of the recession altogether? What happens when those bridges are done? What happens when those dams are built? What happens when roads are repaired? What happens when that shrimp farm research in Florida is finished? (These are all things in the Obama Stimulus Plan).

And what happens when the Bush Tax cuts expire? Some economists write that some business people will continue to spend until those tax cuts expire, because they expect the economy will hit the skids at that time. And then the economy will slip into a prolonged recession or even a depression as they make cuts and further stop spending.

Yet some predict the Obama stimulus will eventually pull us out. What we do know is the business cycle history proves that the economic lull will end at some point. What we don't know is how long it will last. The Great Depression was the longest economic lull in history. Some say FDR got us out of it. Yet some say he prolonged it. Yet FDR was popular, and Obama is copying his economic strategy.

One of the neatest things about an economy is that most people only look at what they see. The job of the economist is to look at what is not seen as well as what is seen. For example, say you have three men. Man A is the owner of a shoe business. Man B just filed for unemployment. Man C sells suit coats for $100.

Man A is planning to buy a new suit coat. He has the $100. The public has empathy for Man B, so they encourage their Senators to sign a bill raising man As taxes by $100 so they can help out Man B. Since man A has to pay $100 in taxes, he can no longer afford to buy a new suit coat. While the unemployed man is being helped with that $100 and we are all happy about that, Man C is actually the forgotten man here. He will lose business, because during a recession people find better ways to spend money than buying things like suit coats and entertainment and other such things.

I imagine many medical care workers are forgotten men and women. Yes it's true many are still working, yet we are not getting raises to keep up with inflation, and we are not getting all our hours. So we cannot spend money on things like, say, suit coats. So man C suffers even more. He cannot pay for his hernia repair.

And, another forgotten man is the RT Student who has a family and bills to pay and just spent $100,000 to get through RT school and now he can't find a job. What is he to do? He in essence becomes man D. So, if man D has asthma, and he has an asthma attack, he might stay home because he can't afford the $50 nebulizer treatment, or the $100 mandatory ER Room fee, or the $500 for a chest x-ray.

He thus becomes the forgotten patient. We do not see him, yet he exists He is in agony. He is suffering. Yet he does not become a statistic because we do not see him. Some day, though, he will enter the doors of some ER room. The question is: in what condition will he enter this door when we finally do see man D.

It is the job of economists to see man A through D. It is the job of those in Washington to heed the advice of the true economists, and not make rash decisions based on sympathy for the men who are suffering that we do see.

Lest the recession will continue, and we RTs will continue to work during lull times, and one day all those forgotten man Ds will come strolling through those ER doors and it won't be pretty.

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