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Do doctors get a financial reward for putting people on Hospice? [message #9662]

Sun, 11 August 2013 13:48

sparkles
Messages: 246
Registered: March 2008

Senior Member

Does anyone know if doctor offices or doctors get a financial reward or has a quota of how many
people they put on Hospice care? I do not mean this as sarcasm in any way, but I wonder if
anyone knows. My mother is having a doctor come from a place called Visiting Physicians here
in Michigan. The doctor has come a total of 5 times in the last year and probably has not spent
more than 2 hours total with her. I called the doctors office twice because she had a bad bed sore,
but they didn’t call back when they said, so about a week or so after my last call someone calls.
They ended up contacting a place that has nurses come, and we have the most wonderful nurse
coming that is helping my mother. The bed sores are healing quite well, but it takes a while. My
mother is 95 and isn’t eating hardly anything or drinking much, but she is still alert and knows what
is going on. This lady doctor came a couple days ago and said my mother is in more pain than she
says so she wants me to put her in Hospice care so Hospice can regulate her pain with medicine.
My mother is in pain when I move her legs or the nurse cleans the sores, but she is not in pain all
the time, and sure doesn’t need to have someone come regulate it. This doctor has threatened
to drop my mother as her patient and turn me over to adult protective services because she
said it is elder abuse. To me it would be murder if I let Hospice come. A couple months ago a
friend of mine got called in the middle of the night saying her husbands father was having a very
hard time and would be gone soon. When they got there they realized he was just having a hard
time, but far from dying, so they asked to give him something to calm him. The nurse came in, gave
him quite a bit of Morphine and before the man's son could get back from the bathroom he was dead.
A Hospice nurse from New York told me this happens all the time, they give them Morphine so the
drug slows down their system so it speeds up their death. Another nurse said someone she knew
just wouldn’t die so a nurse kept giving the person with cancer more Morphine each time until the
person died. A nurse once told me this happens all the time, an overdose of Morphine to speed up
a persons death. The doctor my mother deals with said I have until Monday at 2:00 to tell her which
Hospice I will go with or she will drop my mother from her care and she can find a different doctor. That
would be hard because there aren’t hardly any that do house calls any more, and this doctor knows
that. And if my mother is in so much pain, why didn’t she prescribe something for her, until I could get
Hospice help? Because this good doctor couldn’t care less about my mother, just meeting some quota
most likely. And if the good doctor has such concern for my mother why is she is willing to cut off all
help? This is why I am wondering if the doctors get a cut from the insurance companies or Hospice
people? If she goes on Hospice they just try to make someone comfortable and most likely hurry
along their dying. Saves them lots of money to just have someone die than take care of them. Now
before some thinks I am lumping everyone who works at Hospice in this category, I am not, but it does
happen much more frequently than people want to believe. There is no way on the planet my
mother needs to have pain regulated by Hospice, so I will refuse the care and let the good doctor
do whatever she wants.

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Re: Do doctors get a financial reward for putting people on Hospice? [message #9663 is a reply to message #9662]

Sun, 11 August 2013 16:32

Gary
Messages: 1025
Registered: August 2008
Location: Indiana

Senior Member

Hi Sage,

I will remember to pray for your mother.

My brother in law was dying with prostate cancer. You may have known him from the meetings as he knew a lot of people in the body.

Anyway, they had a situation where they brought in hospice. My wife was there most of the time with the family. The wife and daughter were told to give him morphine as he needed it. They would give him the amount and he would come to later and would recognize everyone and talk with us. A few days of this and the nurse showed up and said if he had even the slightest look of pain to give him more morphine. Then she started to check on him and it seemed like if he blinked an eye she would say he's in pain let's give him more. She kept feeding it to him all that morning and he died around noon sometime I think.

My wife and I both agreed that the nurse who was in a big rush caused his death by giving him way to much. There was a sister from the body who was present as a friend of the family and is a nurse now. She told my wife that they were giving him way to much morphine as it slows down the function of all the organs of the body leading to death.

I don't know if the doctor's get any financial reward but if something is terminal if anything they may make less money because they have to leave the office, and know they will not make as much. In their minds they think they are helping people get through the pain as they know they can do nothing else, so morphine is their answer to deal with it.

For one thing why would the lady doctor know or say she is in more pain? Only your mother would know this.

My personal opinion is I don't trust hospice because I have heard of this stuff from others. They show up with their morphine as the answer for pain, and it brings death on quicker.

The Lord bless you abundantly for being there for your mother, may God give you the peace of all understanding and wisdom in trying to discern what to do.

Gary

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Re: Do doctors get a financial reward for putting people on Hospice? [message #9664 is a reply to message #9663]

Sun, 11 August 2013 17:45

sparkles
Messages: 246
Registered: March 2008

Senior Member

The doctor says because she has dementia she doesn't probably realize how much pain the bedsores are. If it wasn't so serious it would be laughable to make such a ridiculous statement. My mother has a touch of dementia but in no means doesn't know what is going on. If something hurts she tells me. I asked her last night if she was in pain, and had her repeat my question because she is almost deaf, and she said no she wasn't and didn't want any pain pill. She has never been one to run for drugs whenever there was a little ache or pain. When she broke her hip/leg and had surgery 5 years ago she didn't even want to take the Vicodin for pain, but only a couple aspirin. And this was when we took her home from the hospital, not to a rehab place.

A friend of mine who lives in California said his mother was on Hospice a couple times, but after the last time they took her off they decided not to use them again, unless his mother was in extreme pain. She was never in pain and went to be with the Lord in God's time without Hospice help.

It would be frightening to be an old person who needs medical help now days. Makes a person wonder what will happen when the new health rules take effect.

Truly it is better to trust in the Lord.

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Re: Do doctors get a financial reward for putting people on Hospice? [message #9665 is a reply to message #9664]

Mon, 12 August 2013 04:15

GWB
Messages: 708
Registered: March 2008
Location: Louisville, Ky area

Senior Member

If you are the POA and the med is PRN, there is nothing they can do to prosecute if you do not agree with a nurse's assessment or a doctor. The POA has all rights to agree or disagree as to the route and the time a PRN (as needed) med is administered.

If you want to, google Resident's Rights in Long Term Care.

Also, google the signs of pain in general and for your mother's particular diagnosis.

Once hospice is involved, they will do what it takes to make the resident (patient) comfortable. They give Ativan for agitation and Morphine for pain. They give it SL ( sublingual; in liquid form in the side of the cheek.)

Some refer to this combination as the death cocktail. That is because it can be abused.

As a nurse, I make sure the family understands all of this.

There are doctors out there who will not "snow" people.

There are many who believe they are doing a service to hasten death.

Agitation, grimacing, excessive movement, moaning (duh) are all signs of pain.

With the right doctor, there is no reason your mother has to be given too much of anything.

Also, doctors are not reimbursed to give an order for the use of Hospice services. The doctor talks with the family and both parties must agree to use Hospice.

Once the order is written for Hospice, the doctor is involved " for comfort measures only." The patient must be a DNR.

Hope this helped.

[Updated on: Mon, 12 August 2013 11:16]

Shalom,

GWB

"Be still and know that I am God."

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Re: Do doctors get a financial reward for putting people on Hospice? [message #9666 is a reply to message #9665]

Mon, 12 August 2013 12:39

sparkles
Messages: 246
Registered: March 2008

Senior Member

Thanks for the information. My mother is at home and I take care of her. She is on no medications and never has been, so I am not in favour of some doctor thinking she knows how much pain my mother is in. I ask her if she is in pain and she says no, unless I move her legs that seem to hurt. Her nurse thinks it could be arthritis, or just a fear of hurting so she says it hurts. For a doctor to cut off all her help if I don't put her in Hospice to me is abuse and neglect. Why take it out on my mother because I don't want it? Nor would she. My family has never been one to run to a doctor or take a pill, even when she had a broken hip/leg that had surgery, most of the time she only took aspirin when I took her home from the hospital. She didn't want to go to a rehab place, so we got a hospital bed and took care of her here.
It is baffling to me that a person who is suppose to take care of the sick and elderly would drop all care unless I do what they say. She really cares, doesn't she? Is this what medical science has become? She can take her toys and go home and pout if she wants, but someday she will answer to Lord on why she refused to take care of someone in need. Hospice is my choice, not hers, nor will she pressure me into doing something that I have no witness from the Lord to allow, just the opposite, the witness I have is to absolutely not allow them access to my mother.

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Re: Do doctors get a financial reward for putting people on Hospice? [message #9667 is a reply to message #9666]

Mon, 12 August 2013 19:59

GWB
Messages: 708
Registered: March 2008
Location: Louisville, Ky area

Senior Member

We are taught that what a person says that their pain is, that is what it is.

Ask your mom what her pain is on a scale of 1-10 with ten being the worst amount of pain. If she says 0, then she has no pain! They can't tell a person they have pain when they don't!

Is she alert and oriented X 3? Does she know person, place, and time? If so, she is alert enough to know her pain level.

If you and your mom desire, get a second opinion. Find someone who has had a good experience with their doctor.

Many doctors are obnoxious. However, there are many caring ones, who are not on a power trip.

Sorry this has been such a bad experience for you.

If it were me, you have every right to find another doctor who will help you.

Also, be very proactive and don't let anyone intimidate you. You and your mom have rights. Don't let someone push you around. In the end, it is about your mom and not them.

Doctors and nurses are reportable too!

[Updated on: Mon, 12 August 2013 20:04]

Shalom,

GWB

"Be still and know that I am God."

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Re: Do doctors get a financial reward for putting people on Hospice? [message #9668 is a reply to message #9667]

Tue, 13 August 2013 01:28

sparkles
Messages: 246
Registered: March 2008

Senior Member

I called the doctors supervisor today and made a formal complaint against her. For her to threaten me with dropping my mother from her care is just plain pathetic. It would be one thing if my mother was abusive toward her, or even actually was in a lot of pain. Generally I couldn't care less if someone hassles me, but this is not about me, but my mother getting help.
As far as the pain, all I do is ask my mother if she is in pain and if she says yes then I know she is. Even then I'll ask if she wants an aspirin, and she usually says no, she doesn't need it. My mother may not know the time or the day, but she doesn't have to, everyday is the same. And even if she didn't know the place or person doesn't mean she wouldn't know if she has pain.
Anyway, after I reported the doctor to her supervisor it was decided my mother would get a different doctor from their organization. I asked if they could be have a little compassion and be willing to work with us. Not sure they will, and don't really care what they think of me as I will do what I believe my mother wants. I just want the nurse she has to be able to come every other week, I couldn't care less about the doctor. They have done nothing for her(which is fine with me) but we have a contract that they have to come at least once every 3 months or I'd just as soon they never come unless we would need them for some reason.
I am sure there are a lot of kind, compassionate doctors out there who do want to help people, but with Obamacare coming and the big push for Hospice, sure makes me wonder how close euthanasia is. And even if a hospice person or nurse or doctor thinks they are helping at the end of a persons life by hurrying along death by giving morphine I believe it is still murder, no matter the intent. Just cause someone has a medical license doesn't give them that right, no more than a family member can shoot them with a gun or an overdose of drugs, murder is murder.

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Re: Do doctors get a financial reward for putting people on Hospice? [message #9669 is a reply to message #9668]

Tue, 13 August 2013 02:01

GWB
Messages: 708
Registered: March 2008
Location: Louisville, Ky area

Senior Member

I know. So many people don't care about old people, let alone babes in the womb.

It sounds like you did a good job looking into the situation today.

I really hope this gets worked out for your mother's sake.

If I think of anything else, I will let you know.

Shalom,

GWB

"Be still and know that I am God."

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Re: Do doctors get a financial reward for putting people on Hospice? [message #9670 is a reply to message #9668]

Tue, 13 August 2013 04:34

Gary
Messages: 1025
Registered: August 2008
Location: Indiana

Senior Member

Quote:

I am sure there are a lot of kind, compassionate doctors out there who do want to help people, but with Obamacare coming and the big push for Hospice, sure makes me wonder how close euthanasia is. And even if a hospice person or nurse or doctor thinks they are helping at the end of a persons life by hurrying along death by giving morphine I believe it is still murder, no matter the intent. Just cause someone has a medical license doesn't give them that right, no more than a family member can shoot them with a gun or an overdose of drugs, murder is murder.

I agree with this entirely. The thing is our generation is next in line, so to speak, that a lot of these things will be forced on us. Many think they will be getting help when in reality they will be removing people with their morphine and other drugs. I can see where in the background removing the elderly is a plan to help with the social security crisis. At least that's my thought on this.

I already see this thing with getting a vaccine shot every year as a big deal with medical science. Their giving people shots now in the grocery store around here.
I have never gotten a flu shot and the Lord keeps me. My neighbors and others I know who get the shot end up getting the flu. I don't like all of this stuff being forced upon us. With Obamacare I think its better to just pay the fine.

Anyway I was praying this evening and the Lord reminded me of an old song we use to sing:

How Great is our God,
How Great is His name,
He's the Greatest one, forever the same,
He rolled back the waters of the mighty Red Sea,

And He said, I'll lead you'
Put your "trust" in "Me".

Gary

[Updated on: Tue, 13 August 2013 04:40]

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