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Caveat Emptor

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If you have the means, you might want to consider hiring a private duty nurse, particularly for the night immediately following surgery. But, say several doctors, paying the extra freight for a room in a VIP unit buys you little beyond better food. "It's fine if there's nothing further that can be done for you," says one doctor, "but otherwise . . . "

Several years ago, a well-off 30-year-old divorcée who went to New York Hospital for a mastectomy decided to stay in the so-called Shah's Pavilion. A few days after the surgery, a nurse showed up with a purple pill. "What's this for?" asked the woman. "It's your medicine." "But yesterday you gave me a green pill." A quick, nervous shuffling of papers, then an embarrassed "Uh-oh, you're right. I'll be right back with it."

"You're definitely not guaranteed better care in that part of a hospital," says Baum. "We call it 'terminal importance.' If you reach a certain level of fame or importance, often medical care that might be given to others isn't given to you because the staff might not want to invade your space or bother you."

"If you're having an elective procedure, you don't want to get operated on at the end of the week, because not everyone is available on the weekend," says an internist affiliated with a city hospital. "Stay out of the hospital in late June and early July, because the first-year interns start then." Yes, those freshly minted med-school grads are backed up and supervised, "but," says the internist, "even the supervisors are new in their roles."

Of course, you often have no choice about the timing of the hospitalization. You're sick, maybe you've been injured. But if you can't control the timing, you can, in some instances, control the terms. Consider the fortyish woman who, on a snowy day a few winters ago, took a nasty spill in front of a Chinese restaurant. The owner called 911 and the woman was ferried to the E.R. at Roosevelt -- where she lay in pain on a gurney for several hours, ignored by the staff. Finally, in desperation, she got someone to roll her to the pay phone. She called the police, explaining that someone was being held hostage at the hospital. Within minutes, the cops showed up. The woman was treated immediately. "Well," says one doctor, "it is very important for a patient to speak up."


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