The Rehabilitation Facility Sham by Steve Mussey MD

If you are seriously ill or injured, you will likely spend most of your recovery days in a “Rehabilitation Facility,” far from your original hospital and doctor team. It is a system which is inefficient and poorly designed. One hospital may feed ten facilities of varying competence, spread out over wide areas.

How did we get here?

Years ago, an elderly sick patient might spend many days or weeks in the hospital.

After major surgeries, even a couple of weeks were typical.

This made sense. A full hospital staff and physician team of all specialties could intervene at the first hint of trouble. Even late at night, CT scans and STAT labs could easily detect danger. A doctor could rush to assess you on a moment’s notice.

Fevers, wound problems, shortness of breath, chest pain or other problems could be quickly managed.

Then, something changed.

We convinced ourselves hospital stays were too expensive and actually led to more complications.

Soon, hospital stays became very short, extremely busy, and even more ridiculously expensive.

To put it simply, a hospital day turned into an action-packed, whiz-bang adventure of pricey imaging, procedures, and surgical interventions.

Now, after one or two days of a typical stay, every super-cool thing has been done. There is nothing else to do.

“We’ve run out of expensive things. Time for you to leave….. NOW!”

But, where do you go? You can barely eat or walk. You still need several weeks of IV antibiotics. You also have a couple of tubes still draining fluids.

Enter: The Rehabilitation Facility! What a wondrous development!

Remember that old depressing under-staffed nursing home down the street? Well… The owners spruced it up a bit, added a little physical therapy, found a desperate doctor-designated nurse practitioner to be a medical director and… POOF!!!… Instant Rehabilitation Center!

Okay… It’s still under-staffed and depressing, but now it’s a REHAB Facility!

They’re everywhere!

What better place to recover, far from the skilled team of specialists who managed your complex conditions and did your intricate surgery? Here you can avoid pesky imaging, laboratory and doctor evaluation.

When you become a bit unstable late in the evening, you can do so in uninterrupted peace and quiet.

Don’t worry! All bleeding stops! You’ll be fine.

Sure, none of the specialists come to the Rehab Hospital. Your surgeon would never set foot in the place. No Cardiologist or other specialist has ever seen the inside of the facility.

In fact, your entire original doctor team has no idea where you are.

The facility doctor….uh… I mean facility Nurse Practitioner can visit you in the next couple of days.

Just try to hang on!

If it gets really, really bad and you stop breathing, they’ll send you to the Emergency Room in that distant hospital which sent you here.

So stop panicking!