Kym's Drive-By Mastectomy

In my brief career in obstetrics (in the early '90s), HMOs were coming into fashion. The big patient advocacy kerfuffle was all about "drive-by deliveries" -- where the HMOs were pushing to get new mothers out of the hospital in 24 hours.

How times have changed! Kym's 7:30am mastectomy and the first phase of reconstruction went off without a hitch. She rolled out of the OR before noon and we rolled into our driveway at 4:30pm -- exactly 11 hours after we arrived at Suburban Hospital in the pre-dawn darkness.

Our surgeons both encouraged us to go home without an overnight stay if we felt ready for it. Kym never had a Foley catheter -- they just told her to call if she couldn't void by 8pm.

But in contrast to the cost-constraint HMO mentality of the '90s, the focus was all on quality and outcomes optimization. The routine use of catheters in surgery ends up increasing the risk of infection. And spending more time at the hospital increases the risk of hospital-acquired infections too.

It turns out that quality care and cost-effective care aren't necessarily mutually exclusive.

We were thrilled to be home eating our own food and pampering Kym. We couldn't be happier with the care we received from the physicians and staff at Suburban. They focused on getting the job done and treating Kym with respect and care -- including respecting her OCD issues (more on that another day).

We are home, Kym is enjoying her meds, and we are so very grateful for the prayers and support of friends and colleagues.