Wednesday, August 04, 2010

// // 12 comments

Hospital, 50% End of Season Sale

by Reb Akiva at Mystical Paths

My son decided to try a physics experiment last night. He accelerated his Ripstick (2 wheel skateboard device) to a good speed, then had it stop (due to impact with a stick) instantly. He hypothesized his body would stop with the Ripstick stopping.

His found his hypothesis in error as his body continued in motion until stopped by friction with the ground.  As something had to absorb the energy of the motion, he chose his wrist to protect other more critical parts of the body.  And…ouch, off to the hospital we go.

A friend showed me a back road into Jerusalem that happens to pass by Haddasah Hospital, so I head that way as the fastest to get there. This was, thank G-d, my first visit to Hadassah’s emergency room (I’ve been to Shaarei Tzedek in Jerusalem previously.)

First, getting to the emergency room is an exercise in Israeli security versus urgency.  The entry gate to the hospital comes with a guard booth.  Each car is briefly checked, including ambulances!  This isn’t a long wait, the guards are doing their job reasonably quickly.  But if that ambulance has a critical case, another 2 minutes?

When you get around to the back of the building there’s another guard post for the driveway up to the emergency room.  There you have to explain why you need to drive up (as opposed to walking your sick patient through the parking lot, through the main entrance, across the entry building [more on this later], and over to emergency).  Here ambulances are waved through.

At the top of the driveway is a courtyard and entrance to emergency.  But there is another guard post there!  Another brief check and a warning to take your patient in and get your car out.

So I take my son up, drop him off alone in crying pain with a broken arm, and take my car off to a parking lot a 1/4 mile away.  Heading to the main entrance building I find….a shopping mall!  The only way in to Hadassah Hospital and the emergency room is through a shopping mall!

P1010479 So my son’s sitting in an emergency room in screaming pain (and of course they can’t start to treat him till I get there and do paperwork and so forth), and I’m trying to find my way in to the hospital!  First floor nothing, oh there’s a sign Hospital, Up.  Second floor of the mall, hospital to the left or right?  (That’s clear, not.)

P1010480Oh good, a map.  You are here…medical treatment is here.  The only way to it…past every single store in the mall.  Don’t mind me bleeding on your merchandise.

P1010481Hospital to your left, bagels and latte’, have a seat.  Please, no body fluids on the tables.

Kosher L’Mehadrin!   (The latte’, not the bones.)

P1010487We are wheelchair accessible for your shopping pleasure. Perhaps some cosmetics to hide your open wound?

P1010478

50% off!  Is that 50% medical treatment?

End of season sale! Special discounts for sunburn treatment, broken bones and serious insect bits.  Now stocking up for flu season.

P1010489Have you finished your treatment? Stop by for a latte’, a grilled sub sandwich, or even some quick grocery shopping at Supersol Express (now open!!!)

P1010490And finally, after another security check (metal detector, bag check) – because maybe you snuck in another way and avoided the mall, I was able to get the entrance to emergency.

Hadassah’s emergency room care is equivalent and perhaps better than US care (and I had a top rated US hospital near my home in the US).  They actually divide their emergency room into 4 separate ones: regular, ambulatory, trauma, and pediatric.  Ambulatory was relatively busy, the others not so much.  Pediatric was about 1/3 full. [For those who talk about discrimination in Israel, it’s worth nothing about half the patients were Arab Israeli’s or Arab residents of Jerusalem.  So was about 20% of the hospital staff.]

We had to do the standard paperwork and then went to pediatric.  They evaluated him on arrival and then we waited about 15 minutes for a quick doctors check.  They sent us to X-ray (with a paper to take to tell them what to do).

Our wait at X-ray was 5 minutes, 2 people in front of us.  They took the X-rays and sent us back saying “the X-ray results will be on the computer”, no waiting for physical X-rays to be carried back, and sent us back.  Back to pediatric ER, they sent us to the waiting room to wait for the results and doctors review.

After about 15 minutes of waiting my son started complaining of serious pain, made worse by trying to position the arm for x-rays.  We went back in to the pediatric ER desk, a few minutes later a doctor reviewed the chart and gave him a pain killer.  Back to waiting.

The wait was a decent hour and a half, the orthopedic doctor being a popular guy and serving all the ER’s (actually there were 2 of them on staff).

He saw my son, put on a cast, and told us to wait another hour to check for swelling (because we were relatively close in time to the accident, he wanted to make sure it wouldn’t swell up in the cast and cut off the blood flow).  It did swell, he opened up part of the cast and sent us home – to go back to an orthoped in 10 days.

Total ER time – 3 1/2 hours, 30 minutes to full evaluation, 2 hours to full treatment.  I never got out of the ER in the US in under 6 hours.  Ok, the mall business was pretty weird – an interesting way to supplement hospital income.

Hadassah Ein Kerem Hospital, Jerusalem, Israel
Helicopter Landing Pad at night

P1010497

12 comments:

Anonymous said...

DoNt knock that mall; the utility it provides is obvious to me: spending long hours in a hospital with a spouse before and after birth are definitely made easier when one needn't rely on hospital food or traveling by bus for 10 minutes to get out of the compound.

Akiva said...

Oh the mall is cool, it's being FORCED to walk through it for treatment that's annoying. I probably would have wandered over there while waiting for the x-ray results anyway.

But not being able to get IN to the hospital without going through it. A subtle form of extortion.

Dan Schwarz said...

Speedy recovery for your son - that's a tough way to learn about conservation of linear momentum! (Next time, may I suggest the Wikipedia page instead?)

Didn't know about any mall attached to the hospital ER - is this new in the last couple of years? We took a tour of Hadassah in 2008 and didn't notice a mall.

Is there any charge for ER visits at Hadassah? In the US I would be expecting a $1500 bill for that ER visit, X-ray and bone setting (mainly paid for by private insurance).

Akiva said...

Yeah, I've gotten those $1500 bills in the US, much of which is not covered by the insurance because it's deductible, non-network providers, etc.

Here it's about $50 unless you were referred - and if you go to your family doctor / pediatrician the next day he can write you an after-the-fact referral if the situation truly warranted a hospital visit (was an obvious emergency or a serious situation when the normal health clinic is closed). A broken arm clearly qualifies. Then it's around $15 if I remember correctly.

The rules differ depending on which of the 4 national plans you're under, and if you have extended coverage.

Net net, such costs are pretty minimal in Israel, but there's a flat 5% health tax on all earned income that is paying the bill.

just me said...

The Mall entrance is one way. Akiva, you can walk up the driveway to the entrance, avoiding the mall. It's across from the buss stops at the mall entrance.

The mall saves me from starving- I am often in Hadassah Ein Kerem. For work and for a sick family member. I've seen it from both sides and I'll tell you- Hadassah beats the heck out of the US er's. Tel Hashomer is fantastic, too.

Refuah Sheleimah to your son. (thanks for the physics chuckle!)

Dave said...

Firstly - That Hashem will give your son a speedy and complete recovery together with all Israel. Secondly - the biggest difference is that here you have a guard check you for security - in the US the first check is your credit rating!!! In Israel it's treatment first and promise to pay afterwards.

Akiva said...

Dave, not exactly. Big sign on the wall "if your insurance group (4 semi-private national insurance groups) doesn't pay, you will be responsible for your bill". And they don't start offering treatment until you go through admissions, where they check and see you are registered with a national insurance group. (If not do they take a credit card swipe or something, no idea.)

However, at least no (significant) deductibles, worries about in plan or out of plan doctors or hospitals, and getting 8 bills when done (from each kind of doctor involved, the x-ray practice group, the er doctors practice group, some radiologist who read the x-ray the next day, etc).

One thing I find interesting about Israeli hospitals is the somewhat self service aspect. They don't escort you, wheel you, or control you. They just say "go to x-ray". "Go to testing", etc. No "orderlies".

josh said...

Tel Hashomer has two malls but not through the main entrances Wolfson in Holon also has a mall that is similar to the Hadassah 'Vegas-style walk though the casino to get to the hotel front desk', but can also be avoided if you walk directly to the ER.

This week for the first time,
I took that back road to from Beit Shemesh to Haddasah. We went through the north side through an incredibly pleasant rural-like Ein Keren neighbourhood. Like a mix of Tzfat, Galil, Appalachian hill community.

Mezzuzah said...

B"H

Please publicize about a boy from Kiryat Malachi who needs Klal Yisrael's help right now. We're asking that this goes out on to all blogs. Slicha Mystical Paths, we didn't know how to contact you any other way. It would be chessed if you could make this a special place on your blog. Todah.
http://en.kerentzdaka.org/contents.asp?aid=42441

Ellen said...

Why am I thinking I would start at Terem for this? Would they handle the whole process for a broken bone, or send you on to a hospital anyway?

Refua sheleima, and may my query be theoretical for all....

Akiva said...

Terem doesn't do casts, for that you need an orthopedic doctor. They'll x-ray and splint and tell you to go to your kupah orthoped.

If something needs to be set NOW, Terem is just going to send you to the hospital (with an x-ray and in a splint).

Crazy Smade said...

May HaShem speed healing to your son and grant him a full recovery and the wisdom to henceforth avoid such "self-testing" experiments in physics. OUCH! I feel for him. Bone breaks really hurt.

That said, it seems your visit to the ER was better than the one my son had recently. Let's just say, you've only added to my desire to move to Israel.

I hope you're writing a book about your life in the Holy Land. That article was very well written and read like a book! Thanks for sharing!

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