* bleeeeep bleeeeep bleeeeep *
It was 11:57PM on the alarm clock last night. I peeled my head from the pillow and felt my heart racing from the adrenaline surge that usurped by Stage IV REM sleep. I fumbled for the pacer and pressed the button. Glorious silence ensued as I caught my breath. Reading the pager, I noticed it was the nurse caring for my patient calling. I dialed the phone.
"This is Doctor Fisher. I'm returning Sally's call (not her real name)."
"Just a moment."
Some cheesy commercial played in the background with some canned music that I had heard a thousand times before. 'Damn, why don't they just play some soft classical music?' I thought to myself. Just then, a voice answered.
"This is Sally..."
"Sally, Dr. Fisher, returning your call..."
"Yes, Mr. Faachamatacheesedip is having trouble sleeping. Can he have a sleeping pill?"
My heart raced again, but I kept my composure and acquiesced. Sure." Then I prescribed a sleeping pill as requested and the nice nurse thanked me and I was back to lying an bed, staring at the ceiling, thinking about ways to cut health care costs. I do that sometimes. Especially when I've been awakened for a sleeping pill.
Every day, countless times across the country, thousands of doctors prescribe tylenol and sleeping pills and countless other "preventative" medications just so they don't get these calls at night. I wondered how many millions of dollars could be saved, but realized with the savings comes a price: the need to make another call to the doctor. Would this really save money? Hard to tell. Would doctors sleep worse? Probably.
Better still, what if we allowed patients to take their own chronic medications that they have been using for years when they have already paid for when they come in the hospital for routine procedures? These medications could be registered on the patient's electronic medical record and designated as "self-adminstered" to assure that the nurses and doctors caring for the patient knew which medications they were actively taking during their medication reconcilation process performed when they enter the hospital.
But alas, the hospital would lose money. "Patient safety might be compromised," they'll say!
But I say, maybe some simple ideas like this could save real money in the long run for our over-priced health care system. Call it "B.Y.O.P.:" Bring Your Own Pills.
And then maybe, just maybe, our system could save some real money, bit by bit. And patients could take their OWN sleeping pills so the doctor could get another wink of sleep each night.