10 dirtiest hospital secrets [chapter2]

3. "Good luck finding the person in charge."

Helen Haskell repeatedly told nurses something did not seem right with his son Lewis, who was recovering from surgery to repair a defect in the wall of his chest. For nearly two days following asking a veteran - or "participants" - when assessing first-year medical resident seemed off. But Haskell could not convince the right people that her son was deteriorating.

"It was like an alternate reality," he says. "I had no idea where to go." Thirty hours after her first child complained of severe pain, the South Carolina teen died of a perforated ulcer.


In a sea of blue gowns, calling attention to the right person can be difficult. Who's in Charge? Nurses do not report to doctors, but rather to a nursing supervisor. And your personal doctor has little say over radiology or the labs running your tests, which are administered by the hospital. Some facilities employ "hospitalists" - doctors who act as a key person to carry out the flow of information. Most hospitals now have rapid response teams - trained personnel that can run alongside the bed to assess a patient's decline. Haskell urges patients to know the hierarchy of the hospital, read the name tags, get the doctor's phone number and know how to get quick response team. If all else fails, demand a nursing supervisor - probably the most senior person that can be accessed quickly.

4. "Everything is negotiable, including the hospital bill.

When it comes to getting care, hospitals have to work hard for them. Medical bills are one of the leading causes of bankruptcy in the U.S., and when collectors are put on the case, they take up to 25% of what is claimed, according to Dr. Mark Friedman, founder of billing for consulting services Premium HealthCare. This leaves room for some negotiation.

If you are among the uninsured - which can pay up to three times more for procedures - not hurt to ask for a deduction. Some hospitals offer a 35% to 40% discount for uninsured patients, says Candice Butcher, CEO of Medical Billing Lawyers of America. Hospitals frequently work with patients that offer payment plans or discounts. But to succeed, you have to call the right door: Look for the office of patient accounts or the financial aid office.

If you do not have insurance and are scheduled for a colonoscopy in a week, Butcher suggests doing some research to find out how much of this procedure is typically run in your area. Health Blue Book site allows users to access health care prices by zip code. You can use that as a negotiating tool. But remember, "if the hospital agrees to your price, you have to get it in writing and signed it receives," says Butcher.