William Southern, MD
William Southern, MD, associate professor of clinical medicine, chief, division of hospital medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York.
You’ve been at the hospital healing from an illness, injury or procedure for several days or longer…and your doctor tells you that you need to stay a few more days until, say, your fever gets lower, your breathing improves or your appetite increases.
A few more days?!
Will your health insurance cover a few more days?
And what about all the work at your job that has been piling up and your family members who are really burning up time visiting you?
Not to mention, you’re sick of eating Jell-o and lying in a cold, dim room with strangers who keep coughing.
When your doctor tells you that you need to stay longer in a hospital than you would like to, there are many pressing reasons not to listen. But a new study shows exactly why it’s critical that you do…
After examining medical records, researchers at Albert Einstein College of Medicine and Montefiore Medical Center in Bronx, New York, discovered that patients who left the hospital before their doctors advised them to were nearly twice as likely to either be readmitted or to die in the month following their discharge, compared with similar patients who followed the doctors’ orders.
To learn more about the results, I called lead investigator William Southern, MD, chief of the division of hospital medicine at both the college and the medical center.
While the study didn’t focus on why leaving early may be so dangerous, it’s likely that at least some of the patients didn’t stay in the hospital long enough to finish their treatments and/or didn’t seek appropriate follow-up care once they left, said Dr. Southern.
How come a patient would leave the hospital before a doctor recommends it? “Some young doctors—residents—may not have fully explained the risks involved with leaving early. Plus, some of these patients likely left for altruistic reasons—to take care of an elderly family member or even a pet, for example—while others probably needed to tend to financial realities such as getting back to their jobs or picking up Social Security checks,” said Dr. Southern. It’s also possible that some patients left simply because their insurance wouldn’t cover—or wouldn’t totally cover—the extra time in the hospital, and they couldn’t afford the out-of-pocket costs.
But wait a second…can’t a longer hospital stay actually prove dangerous to patients, with hospital-acquired infections accounting for 99,000 deaths among Americans each year? I challenged Dr. Southern on that point. He was quick to acknowledge that potential hazard but said that when a doctor recommends staying, the benefits of doing so almost always outweigh the risks.
The take-away: The next time you’re eager to leave the hospital and your doctor tells you to lie back down, call the people in your personal support system to help you with any pressing matters (such as a taking care of a family member or pet or handling a financial matter) and then stay put until your doctor gives you the OK—try to think of it as a mini-vacation where all you have to do is relax! That’s how you can increase your odds of truly recovering.