Great Doctors Are No Better
Than The Staff
Who Surround Them
I doubt anyone includes hospitals in their top ten list of most desirable places to visit but whether by accident or pre-planning, it is a visit everyone makes, probably more than once.
Not counting my birthday, I’ve been in the hospital six times myself and I’m neither sickly nor accident prone. Hospital visits happen quite normally. It’s inevitable so it only makes sense to know your hospitals before you go.
That isn’t a choice we usually make but maybe it should be.
When looking for good medical care, most begin by asking folks to recommend doctors. It’s not a bad plan but that It isn’t the best strategy.
GP’s and specialists are usually attached to a hospital. If you need hospital care, it will be done in whichever hospital the doctor is contracted with. Once you’ve picked your doctor, you’re locked in which means choosing a doctor is choosing a hospital. They come together as a package so you might ask about hospitals as well as doctors when investigating.
After experience with a few different hospitals, I now ask for doctors who have excellent reviews and who work in hospitals with the same reputation. A doctor, any doctor, can be great but their performance is no better than the staff who surround him or her and hospitals, like doctors, aren’t all equal.
One procedure, even a minor procedure, involves many people and processes. All you need is one weak link and you have a formula for undesirable outcomes.
When weak links are apparent, it is scary to watch. And you’re witnessing the whole thing except when you’re out.
Tale of two hospitals
I’ve used two hospitals over the past year. One, Umhlanga Rocks Hospital, I’ve been in three different times. The other, Gateway Private Hospital, I visited just a few days ago for vascular surgery and what a difference. The experience at Gateway gave me some interesting insights and spurred me to write this comparison.
The two hospitals are so close geographically you could throw a stone from one and almost hit the other. But geography is the only metric in which they are close.
Gateway is relatively new so in the early days, Umhlanga was the closest hospital for folks in our area. It made logistical sense to go there.
The differences between the two institutions are numerous and they diverge significantly as the following comparisons will show. All these observations are based on personal experience. I’ve been in both hospitals. My wife has been in both hospitals. I know others who have been in both hospitals and there’s consensus. One is stellar, the other not so much!
Admissions Umhlanga Rocks Hospital
I was admitted to Umhlanga a little over a year ago (June 2017) and it wasn’t an easy experience. I visited the admissions department several weeks before the date of my procedure because I was going out-of-town and would only return just before the scheduled event. I handed in all my paperwork, left the pertinent details and signed consent.
The admissions officer said there were still a couple of things needed but what he didn’t make clear was that I had to do the footwork to get them done. This was unusual. In every admission before this – in any hospital – I did nothing apart from providing my details and signature. I didn’t expect to do more this time and why should I.
Hospitals provide paid services. Patients are customers. Admissions is part of the service they provide.
Because the admission process wasn’t completed, my procedure was delayed and I only found out the day before. It cost me time and anxiety, and the hospital money.
Admissions Gateway Private Hospital
Gateway, on the other hand, was a breeze. I provided my details over the telephone and afterward, they did all the work.
My first visit to the admissions department was on the day of my procedure. I did nothing. They even called me the day before to make sure I knew what time to be there. They were organized, efficient and very helpful.
Admittedly, admissions isn’t where the medical magic happens but it provides more than a first impression. If admissions is chaotic, what can you expect next?
It’s a fact. Hospitals are collecting points for germs and disease of all kinds and it takes a persistent and diligent effort to keep these contagions under control. A dirty hospital is a dangerous hospital so cleaning staff are an important line of defense.
Admittedly, I’m a bit obsessive. As a confessed clean freak, I routinely over-wash my hands but in a hospital, you can’t be too clean. Anything, everything is a potential carrier so it was really great that the staff at Gateway came into my room not once but several times a day mopping, wiping surfaces, emptying bins and keeping the room neat and tidy.
And I was the only patient in the room! Wow!!
Gateway seems to understand that cleaning is not a budgetary item to skimp on and I am very happy about that.
Unfortunately, I can’t make a direct comparison with Umhlanga other than to say that whatever cleaning they did, and I’m sure they cleaned, it made no impression. There was nothing memorable about it and as a clean freak, I notice.
But that brings me to the next observation. Space.
Everything at Gateway is big and well-appointed.
The foyer is spacious and beautiful. The design is classy. There’s plenty of room to move around and places to sit. Five star all the way. They even have a doorman dressed in tucks and a tall hat. My wife really likes that.
But that’s not all.
Unlike Umhlanga, the lifts are huge and they actually move at a reasonable pace. You don’t hear motors humming and chains scraping cogs. And you don’t share lifts with gurneys.
Rooms and OR’s
I didn’t actually measure but my impression was that the three-bed room in Umhlanga was actually smaller than the two-bed room in Gateway. The same is true of the operating theatres and you don’t need a tape measure to see it.
I’ve been in three theatres in Umhlanga and they were all small, cramped spaces and a bit dingy too. Cavelike!
Very different in Gateway. It was like rolling into an IMAX. Huge! Well lit and sparkling too. No one wants to spend time in an operating theatre but if you can’t avoid it, at least find one that looks more inviting than a cave.
I don’t know how to say this without sounding a bit dramatic but Gateway is so far ahead of the standards anywhere in the world that it deserves special mention.
The staff are switched on and interested, not just in the job or in keeping the job but in you, the patient. Very self-assured. They speak directly to you and act with confidence.
If they don’t know what they’re doing, it doesn’t show.
They were attentive, interested, friendly, cheerful, helpful and watchful. Every person at every point in the pre-op process verified exactly what procedure I was having and what body part was involved. They made sure they had the right information and that my expectation agreed with the information they had.
They were just as interested after the procedure too. The night nurse made a point of asking me every two hours if I was ready for my pain meds. As it happened, I didn’t need anything till 3 AM but when I called, she was there right away and administered my injection with a smile.
At Umhlanga, the nurse mentioned pain meds only once and very early on, long before I needed it. When I did call for it, it came with attitude and irritation. Taking the meds was more painful than leaving it.
Mindset and outlook
The biggest difference in personnel was mindset or maybe you could call it outlook. At Umhlanga, staff had one of two attitudes: sometimes out-to-lunch completely, totally unaware of the patient’s state or what was coming next. Casual, disinterested. Or they were very concerned but not for the patient. They were more worried about how the doctor might respond or what the higher-ups might think.
In fact, I’ve never gotten the impression that doctors and hospital staff at Umhlanga shared a lot of respect. Staff were treated poorly, which breeds its own special kind of neglect.
On one visit to Umhlanga, I witnessed a doctor go into a shouting tirade toward the ICU nursing staff IN the ICU. Everyone heard it.
Begs the question. If the staff deserved a scolding of that magnitude, why were they there at all? If the doctor couldn’t handle the situation better, why was he there?
I’m sure the staff at Umhlanga are qualified and for the most part decent people but there’s something missing. Hope they get that right.
But more to the point, at Gateway, personnel were focused on the same thing, the patient. They treated each other with respect, spoke to each other with respect and managed the patients according to procedure. Everything was professional.
I never take valuables with me to the hospital. No phone, no tablet and only enough money for a cappuccino from the restaurant. I don’t even take a watch so I never know what time it is.
That’s significant because I rarely sleep well in hospitals. The instinct is to constantly check the time.
I know it’s a small matter but Gateway has a clock on the wall! In the wee hours of the morning, when you’re wide awake (no one sleeps well in a hospital) and wondering what time it is, you can always check the clock if you’re at Gateway. If you’re at Umhlanga you’re out of luck. There’s no clock.
Knowing what time it is doesn’t make the time go by any faster but it is nice to know how much longer you have to sit and wait.
Checking out at Umhlanga can be another bottleneck. You might be told at 8 AM you’re being released but you can count on being there for lunch before that happens. Filling scripts, removing IV needles, finalizing paperwork can take forever.
Maybe Umhlanga is overrun with patients. Maybe it’s understaffed. I don’t know but I do know from experience that the time between to decision to release and the actual release can be an eternity.
At Gateway, things were surprisingly different. After the doctor said I could be released, I naturally expected a lag time. A nurse came through a few minutes later and I asked if the IV could be removed. I was thinking eventually, in the next hour or so. What a surprise! It was done immediately! Right then! No waiting, no hesitation.
A few minutes later, another nurse came through with a printed script for me to have filled at the chemist on the way out, and a card noting the time and date of my followup appointment.
Was I hallucinating? Were the drugs still coursing? Apparently not. I was home and in familiar surrounds shortly after 9 AM!
After all the positive comments, I do have one complaint. The beds are horrible! Raise them, lower them, tilt them either way, or change the configuration completely and the result is the same. Back pain city. Very little lumbar support and by the middle of the night you’re feeling it.
In fairness, though, Gateway beds are the usual. Hospital beds are notoriously difficult to sleep on. If they don’t inject you with powerful sleep-inducing drugs, you might not rest till you get home.
The beds need a redesign and when they get that right, they’ll have a hard time keeping people away! In Gateway’s case, situated in Umhlanga, it could become a destination of choice for internationals seeking quality medical care at affordable prices.
The next time you’re referred to a doctor, ask what hospital they use before making any commitments. You’ll be glad you did and I heartily recommend Gateway.