Thursday, May 28, 2009

How to choose a hospital PART 2

I have some additions and clarifications to my previous post.

To the above tips I add:

7) Find out which hospital closest to you has 24 hour cardiac catheterization capabilities. If you have a heart attack, you do not want to go to a hospital that is going to have to transfer you for this critical life-saving procedure. Time is muscle!

8) Pick a hospital with a pre-code team. What is a pre-code team? Usually when a patient "codes" i.e. heart stops or stops breathing, or both, a "code blue" is called where all available physicians who are part of the responding code team converge on the patient, with nurses, and respiratory therapists as part of the team (in many hospitals this is simply the ER doc running like a mad-man or mad-woman to the code). A pre-code team assess patients that are getting sicker BEFORE they code. And prevents them from coding in the first place. Not many hospitals have this. I would select one that does.


When asking if a there are hospitalists, you need to specify, "Do you have hospitalist in-hospital at night?" (some hospitalists take call from home - odd, I know, but that's why you need to specify).

While academic centers have residents taking care of you at night, you might be wary, but compared to not having anyone there at night, it is preferable. Though I would ideally want a hospital with intensivists (ICU specialists that are there 24 hours) and a pre-code team. And second to that would be having hospitalists overnight. An Academic center would be my third choice. In certain situations, academic centers may be superior - especially for unusual diseases, transplants, and state-of-the-art medical care.

I would like to thank minako for her suggestion for #7 above. An obvious omission on my part, I'm sure it will not be the last. I welcome your comments and suggestions.


  1. I believe a good ED will use thrombolytic therapy when I present with a hemorrhagic stroke.

  2. To anonymous: I hope not. You must be an ER doc because you use the term ED, which only Emergency Physicians and Bob Dole use. Your tongue-in-cheek response will only serve to confuse those who don't know that "stroke" means different things to different people - Different strokes for different folks. Okay, my bad, but I couldn't resist the pun. Anyway, for those who are not doctors, you do not want thrombolytics for a hemorrhagic stroke. Please disregard this comment.