It was booked on a day that all 38 beds in our intensive care unit. An emergency out of SURGERY was announced. At our University hospital, there were three intense stations, so I called my colleague, if you could take a patient. “Is the ventilation?”, she asked. “No,” I said. “What a pity! He would be ventilated, we would take him immediately!”
I was stunned. So much of the economic Thinking had resorted to? Ventilation saves lives, when patients are in a coma or a lung inflammation. On the other hand, the risk of developing a pneumonia increases with the ventilation time, and the cessation of the equipment is heavy. However, mechanically ventilated patients bring a lot of money. The remuneration increases at specified time intervals. From 24 hours after 95 hours, then the 58,000 to be paid in severely ill for about € 25,000. If on a Station, the “Case Mix Index” is not true – if so few patients have serious, profit – making diseases, then the temptation is over, the patient is probably over-rising.
I know of reports from other clinics, that even the Dying were still ventilated to the sound barrier to break through. Also, we did not supply the desired Numbers. The administration left it at a discrete Point, such as: “you need to encode your breaths better.” Now everyone knew that Less revenue will mean in the long term, fewer jobs. Then the work would be a burden. Therefore, this was sufficient, so the team thought members according to a ‘traffic light’ system with a stopwatch, to introduce. So that patients would be weaned to early from the ventilator.
I’ve mastered with others. But such experiences have brought me finally to quit my job as a senior physician and to complete a second training for the General practitioner. Many excellent colleagues who continue to try to make it under these conditions, the best possible medicine to stay – you don’t deserve to have this System. To me, the strong economic pressure is gone finally. I’m only on my Conscience. I see this as the daily liberation.
Are you a Doctor, or a doctor?
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2. Specialist designation and function
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