The hospitalizable patient as commodity: selling in a bear market.

Abstract

We have illustrated some factors affecting patients' salability, which become most apparent in a bear market, that is, when many patients are available, and buyers (other hospitals' wards) are at capacity. Emergency room staffs learn how to sell the patient, extolling desiderata, minimizing negatives (drugs, active child abuseneglect issues, criminal involvement, slightly askew laboratory values, the need for one-to-one staffing, a poor social support system, repeated noncompliance with treatment, no home to return to, aggressiveness, sexual acting-out, and so forth [2]). They also learn to work effectively with medical emergency room staff; develop relationships with staff of other hospitals (including hiring other hospitals' psychiatrists as moonlighters who may then help expedite transfers to their full-time facilities); poll all local hospitals daily for open beds (creating a commodity board atmosphere); and constantly involve higher levels of authority in affiliated systems and city and state burea...