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Q: "Do you have your confirmation number?"

This was the question I was asked by the front desk staff of a hotel nestled amongst the goliaths of the Texas Medical Center.

Last weekend, after working a full 8 hour shift at the community hospital doing psychiatric consults, I drove 4 hours to Houston to see my Mom who had suffered a massive stroke. I arrived around 9:30pm. The hospital in question was a testament to old excess, suffering from entropy and bad management.

Anywhoo, while I was in the ICU with my sister and Mom, I logged onto my Hotels.com app and found a local hotel so that I could crash for a few hours before getting up to return to the hospital. I booked my room for a steal: 159 bucks plus tax. After watching my Mom fall in and out of consciousness for 2 hours, I gave my sister a hug and paid 10 bucks for 2 hours of parking and drove a few blocks to the hotel.

Upon arriving, I was told that Hotels.com hadn't faxed them my confirmation number. After a 90 minute fiasco of phone calls and ridiculousness, I went to my pseudo-cleaned smoky room and collapsed from exhaustion, pissed and frustrated.

What does this have to do with healthcare reform?

Hospitals are expensive. Hospitals in highly sought after areas are even more expensive. Hotels can be expensive. Hotels near expensive hospitals are unecessarily expensive...

Ask yourself: while the physicians and nursing staff at the hospital were top notch, could their abilities be provided in a much less expensive facility and in a much less expensive location (than The Medical Center of Houston?)

I think when we change our healthcare paradigm, everyone will see the insane amount of economic waste generated by our hospital systems. Empty hospital rooms, expensive parking, less nutritious foods, overworked yet underpaid staff. The cost: $500/day. Have you ever seen a $500/day hotel be so poorly run or poorly staffed?

Why not separate the service from the facility and see what happens to the quality of both? PSYCH promotes this approach; imagine a small bed and breakfast where my Mom could get her blood pressure meds and fluids, while the rest of us rented rooms down the hall. We could all go to breakfast together. Parking would be nominal. Our medical staff could leave to see other patients elsewhere or stay on the premises to monitor my Mom for a certain fee. Maybe it's marketed as a "TIA B&B" and the patients get together for rehab during the day while the families meet with the medical team to discuss treatment plans.

It's possible with PSYCH.

Think big.

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