Wednesday, October 14, 2009

A beef about hospital food


Now that I'm safely back home, and able to eat what I wish (within dietary and medical reason, of course!), I find myself at a loss to explain or understand just why hospital food was so dreary, tasteless and unsatisfying. I'd compare it to a crime, except that no self-respecting criminal would inflict such food on his victims!

I can't understand the economics of it. A hospital stay costs a minimum (in the USA) of several hundred dollars per day, more in special environments such as Intensive Care or Cardiac Care. At those prices, the hospital administration must surely have several dollars per day to spare to feed their patients - more than that. However, the amount they spend on the dreary, nauseating splodge they dish up can't be more than a dollar or two per portion, not buying and preparing in bulk as they surely are. Airline food's tastier, fresher and more edible than the hospital equivalent, and airlines are in business to make a profit out of every cent they spend! If they can prepare meals so much better than hospitals, why can't the latter learn something from them?

I can't understand the logistics, either. The hospital where I stayed offered a white or wheat roll, or a slice of bread, with every meal - usually arriving wet with steam or the juices from other foods, so that they were falling apart and had a glue-like texture on one's fingers and in one's mouth. To call them 'tasteless' is a disservice to that term! Far better quality 'gourmet' rolls larger in size and baked with various flours, seeds, cheeses, etc., can be had at any local supermarket's deli counter for about 70c each. Given the easy on-demand availability of such bread, why serve tasteless, gooey alternatives that probably cost at least as much?

For a brief home-made supper tonight, I made a whole-wheat bread sandwich of roast chicken and salad greens, accompanied by a glass of passion-fruit juice cut 75%:25% with water to ease a slight over-sweetness of the juice. Very tasty, very easy to prepare, easily compliant with calorie, carbohydrate, cholesterol and other considerations, and it probably cost me rather less to make in terms of ingredients than a hospital meal would have done.

So why do hospitals make such a hash of it? I've got a good mind to demand an itemized bill from my hospital here, analyze their cost of meals (as charged to me), work out what their actual cost probably was, and ask them to explain. Is my experience unique? How about you, readers? If any of you have been hospitalized over the past five years or so, how did you find the food? I'd love to hear from you in Comments.

Peter

15 comments:

On a Wing and a Whim said...

I would certainly request an itemized bill, but while it will enligten you to the true cost of your stay, it won't help with the food.

Consider: you mention gourmet rolls baked with various flours, seeds, and cheeses. Well, I can't digest lactose, along with a good chunk of the rest of the world. If your base option meal has cheese, you fail, and cause the patient gastrointestinal distress and pain not related to the original reason for admission. Extra seeds - if they're poppy, they'll throw the blood tests out of whack. If they're not, they still may stick and aggravate the throat of someone who can barely handle solid food.

For any given spice, you'll find people who don't like it, and picky eaters are even pickier and grumpier when in pain.. much less, some spices are anticoagulants. Meals should be baked without salt for all cardiac patients who really need to keep the hypertension down, without additional sugar to flux the diabetics, without anything containing major food allergies (like that passion-fruit juice you were drinking), and mass-produced for distribution all over the hospital suck that the hot things better not need to be hot, nor cold things stay cold, to be in edible form.

Put that together with the drive to reduce costs where patients aren't looking (lower quality ingredients in food as opposed to lower-quality medicine), and you get... cafeteria food, the hospital version.

Vonster said...

Years ago I slid into home base in a softball game and broke my wrist. I knew it was broken but went to the emergency room, you know back in the day when I could actually see a doctor and it wouldn't take six hours and wasn't flooded with illegals milking the system, but I digress.

A radiologist took an xray which took about 5 minutes. The doctor spent a grand total of like 2 minutes with me and diagnosed me as having a broken wrist. Duh. I knew that.

The nurse wrapped my arm and put a cast on it. Took maybe 10 minutes max. A week goes by and I get a bill from each of the following:

- Radiologist: $250 (Paid)
- Hospital: (Nurse, Emergency Room) $175 (Paid)
- Doctor: $50 processing fee, $800 service fee

The doctors itemized bill just listed "FX Navicular" under services. I called and asked them what that was and they said "That is your broken wrist." I said "What did the doctor do to earn $800? I knew I had a broken wrist." They couldn't answer my question and just told me to pay the processing fee and call it good.

I think they just thought I'd be turning it into my insurance and they'd just pay it. But I was paying for it myself and when I questioned it they knew it wasn't legit and took it off.

That was almost 15 years ago. The medical system certainly isn't great but having big gov control is will be even worse.

I say you get the itemized bill and scrutinize it.

Von

Unknown said...

I can't understand the economics of it. A hospital stay costs a minimum (in the USA) of several hundred dollars per day,...

I've been hospitalized several times in the last year, hundreds per day is cheap. Typically for me it's been 2k per day without special care. My last visit (due to yarfing up lots of blood) ended up costing 63k. Least I have insurance, otherwise I'd be really screwed.

Mikael said...

I've only been admited to any hospital twice. Once was for a concussion(snowboarding accident, second and last time I snowboarded), and I don't think I had any hospital food, as by the time I could get up and eat on my own, I didn't need to stay there anymore.

The second time was second degree burns(about 70% of my body) from sunburn in thailand. The thai hospital food consisted of a rice/vegetable/shrimp stirfry, a large(I do mean LARGE) pack of crackers/biscuits, about half a dozen citrus fruits(small, green and sweet, probably mandarines, possibly limes), a can of sweet milk, and a can of soda.

Every day, for every meal, only the crackers/biscuits and soda varied.

Wasn't so bad, even though I'm not fond of shrimp, I could easily eat myself full on fruit and biscuits. And the stirfry wasn't bad, I ate some of that too, it was served cold however...

Oh and 4 days in the hospital cost me ~$200, and my only complaint is that there was only cold water for washing(too cold, with my burns I couldn't use it) and the only pain meds they gave me was ibuprofen and paracetamol.

Donna said...

My daughter Penny was born at CHOMP (Community Hospital of the Monterey Peninsula) and that was the best hospital stay I've ever had... The food was gourmet. I would break my arm just to have their beef tips again; it was that good.

Unfortunately, we were living in Germany when I came down with pneumonia and the German hospital food left a lot to be desired. I think the hospital took its cooking lessons from the English as everything was boiled

John Peddie (Toronto) said...

Execrable hospital food seems to be legendary in North America. I can't understand why a society that can put a man on the moon can't feed people decently in a hospital.

It may be some combination of:

a) huge volumes
b) the need to make food bland, as there are a lot of sick people there who can't tolerate anything else that might be edibile
c) steam tables

I spent four weeks in one in the spring of 2008. I survived by bribing nurses to sneak me apples, cookies and donuts from the coffee shop, and basically discharged myself two days after surgery because I was starving.

I had dropped from 170 lbs. to 115, and figured I better get out under my own steam while I still could.

John Peddie (Toronto) said...

Should have added (I was in for cardiac stuff too): the most useful thing I learned was to read food labels before buying.

Apparently 80% of the sodium we consume comes from prepared / packaged foods.

Making proper, healthy food from scratch at home is a major step in the right direction.

Chip said...

This is good, if your complaining about the food then you are really on the mend. Hooray for you!!

Renaissance Man (minus the bayou :-)) said...

I currently work in a large hospital where we can house anywhere between 600-800 patients at a time. I am in the Cardiac ICU so we don't always see a lot of patients who can eat, but we definitely see enough. Feeding that many in-house patients can definitely be a challenge.

Our hospital food definitely has its ups and downs, and for the most part I agree with what you're saying. I have sampled our cuisine on occasion (I just ate the french toast breakfast, actually) and overall I would have to say it is usually bland and fairly tasteless, or just bad tasting. In reference to what On a Wing and a Whim said... you are absolutely right, many patients have particular tastes, dietary considerations, and food allergies that must be taken into account. However, we have at least 15 different types of diets that can be ordered, not to mention all of the sub-selections that can be added as well (calorie restrictions, food allergies, etc.) They have transitioned our hospital to a system that is more room service based where patients who are awake/alert/oriented can order their own food from a menu, and the meal prepared for a patient the way they have requested it generally tastes okay. Patients who are ordered a standard diet and are unable to use the menu generally receive subpar food because it is the mass-produced blandness that leaves the patient wanting. We also have different menus for different diets. Patients on a regular diet can order a full blown cheeseburger, whereas patients on a cardiac diet can only order a hamburger. Patients on a transitional diet can order mashed potatoes, soups, or jello. (Yum!)

The other problem you mentioned about wet/soggy food is a consistent problem across the board. There are a myriad of issues that can affect that; patient to staff ratio, emergent issues occurring at meal times, patient tests occurring at meal times (such as CTs, MRIs, etc.), and of course anytime you put hot food next to cold food, the temperatures will begin to equalize, and if you don't get the tray in front of you until about 30-45 minutes after it was made, things can get gross really fast. But it sounds like you already know about that. ;-)

Overall I think a lot of hospitals are realizing this problem based on patient feedback. I know that our hospital does seem to be moving in the right direction; giving patients the choice of what food they want to eat based on a menu relative to the physician's ordered diet is definitely helpful in making sure the patient will hopefully get something they will like to eat. I would definitely attempt to give feedback to the hospital about the quality of their food, as well as your overall experience. Most hospitals want to improve their overall patient satisfaction because then they can use that as an advertising/selling point in an attempt to get more patients to come there. Hopefully the next time you are forced to deal with hospital food the experience won't be quite as tramatic.

Very glad you are doing well and glad to have you back on the information superhighway!! Your presence was definitely missed. Occasionally even people working at hospitals are in need of some outside entertainment. :-)

HankH said...

Last time I was hospitalized, it was for blowing out my Achilles tendon. When I woke up from surgery, I was starving but 'Nurse Ratchet' would only let me eat jello or whatever. I made an executive decision and had my wonderful wife fetch me two sandwiches from a Chik Fil A that was located on the ground floor of the hospital. I wish you could have seen the nurse's face who walked in as I was just finished the inhalation of those tasty chicken sandwiches.
I've always thought that the bad food probably encourages people to get their butts home a little sooner;)

Fly To Your Dreams said...

My wife's been in the hospital three times in the past four years for the birthing of our three kids. Each stay was at least a day or two, so we enjoyed lots of hospital food.

Fortunately, our hospital of choice has a system similar to the one described by non-Bayou Renaissance Man; my wife was able to order off a fairly expansive menu, though items that required more preparation (salmon, for example) were limited to times when the full kitchen was opened. I had an identical menu, though with cash prices. I'd say most of the prices were reasonable. Maybe a dollar or two more than I'd expect to pay for some items, but overall they were comparable to Applebee's or a similar restaurant, with similar food quality.

I still don't know why it costs $15,000 to $20,000 to have a baby with natural labor and childbirth followed by a 48hr hospital stay though. But my wife (who worked in the medical field prior to having kids) keeps telling me it's normal, and I keep scratching my head and wondering why?

Stranger said...

Well, it takes a COOK to prepare satisfactory hospital food. Most hospitals do not have cooks, they have "dieticians." Which is a PC term for a no-talent food abuser. At least the Waffle House teaches cooks to fry an egg.

And it costs $15,000 to fotch a baby because - rounded, and in the most likely order of importance, it comes to $750 for hospital profit, $1200 for insurance, $800 for doctor and nursing care, $300 for room and board, $3,400 for the delivery room and the use of and demurrage on neo-natal equipment, and $8,600 for Federally mandated procedures and record keeping.

Peter's Quadruple Bype is probably billed at $150,000 plus, and of that $93,000 goes for Federally mandated stuff. Almost none of which will ever do much of anything except keep the anthill stirring.

(No, I am not an MD. Daughter and granddaughter are RN/Admin types.)

Stranger

Manmountain Dense said...

They want your ass out of there, and if you are well enough to notice the bad food it means you are about ready to go home.

That, and hospitals feed a lot of old people. Ever been to Old Country Buffet? Lots of old people like bland food. In fact, they will complain about flavorful food.

Rachel Leigh Smith said...

Just because a hospital bills for that much doesn't mean that's what they actually get paid. What they get paid is significantly less than what's billed, thanks to Medicare and federal regs. At most they'll collect 2/3rd's of any given bill.

Part of the reason that it costs so much is covering for all those idiots and illegals who use the ER as a PCP's office. And part of is they charge more to private insurance and cash patients to make up for the shortfalls caused by the pathetic Medicare and absurdly pathetic Medicaid payments.

The food at Cabrini is better than the food at Rapides.

Alison said...

Three hospitalizations this year and when I could finally start to eat again, what they brought was in the realm of, but why would I want to? They brought me canned chicken broth with a little extra chicken added--three.days.in.a.row, giving me no second option. It made no sense.

Right after the last hospitalization the place announced a partnership with the owner of my favorite restaurant (!) to totally redo their food offerings. Gimme my colon back, I want a do-over!