Are you spending Thanksgiving in the hospital? If you were a patient of Happy's hospitalists, thirty twenty-nine (out of 60) of you got discharged yesterday, the day before Thanksgiving to eat your holiday Thanksgiving meal at home, instead of hospital food. It could have been 30, but the son of one patient "wasn't ready" setting up the home for pappy to come home.
That's got to be close to a record. If you're a patient, you should want to be discharged before spending Thanksgiving in the hospital. Why? Thanksgiving and Christmas are the two days of the year where community hospitals turn into de facto VA hospital systems. Nothing happens on these major holiday weekends. You could spend an entire weekend waiting to get your biopsy or waiting for a nursing home to staff one RN to accept you for transfer on Monday. Holiday weekends are the king of inefficient hospital care. Like I said, they become a de facto VA hospital.
Spending Thanksgiving in the hospital is the last thing doctors want to do. They, like everyone else, strive to be at home spending time with their family. Look for more and more doctors who become employed to have contracts specifying paid holidays off. It's the VA mentality in full effect. In Happy's group, we have a rotating call schedule for Thanksgiving and Christmas. Right now, I am in the middle of a seven day hospital rotation. But I'm not working today. A partner of mine is at the hospital seeing my patients.
They've never seen any of my patients. They are going to see them for one day. Then I return tomorrow to take over. They're just going to keep them alive. It's a good thing I discharged 10 of my 15 patients yesterday so my patients don't have to spend Thanksgiving in the hospital. Some of them may be back by the weekend with their partially treated end of life heart failure or COPD. So what. I can't control how much they choose to smoke or how much salty ham they decide to eat. Perhaps once bundled care arrives, it will have holiday exclusion clauses.
My partners may come in at 4 am, round in the dead of night before any family can show up and be gone by nine in the morning. The only required in house hospitalist in Happy's group is the long call hospitalist who carries the code pager. Everyone else is free to come and go as they please. We got rid of our time clock last year.
As for the subspecialists, many of them will be running around with their heads cut off. Many of them utilize nurse practitioners and physician assistants, who have Thanksgiving Day off, to take care of their daily pages, history and physical examination and discharge summary. Many of them may reach their boiling point of frustration doing doctor stuff they do only two times a year. I'm glad I'm not spending Thanksgiving in the hospital. The doctors are just trying to get the heck out. The nurses are operating on a skeleton staff and there are only two janitors cleaning 300 beds.
If you're a patient spending Thanksgiving in the hospital, just hunker down for the weekend and enjoy what VA patients experience everyday of their lives. If you have the opportunity to get out, take it. Run walker like you've never run walker'd before. But don't come back to the ER until Monday, 'cause nothin's gonna happen 'till then anyway.
To all the doctors, nurses, and everyone else spending time in the hospital on Thanksgiving, thank you. I'll probably be doing it next year. Dr Wes once said it best. You can tell who's really important in the hospital by asking yourself how many administrators show up for work on the weekends, or in this case show up for Thanksgiving in the hospital. What's 0 + 0?
