Get well soon.

• Author: Peters, Charles
• Position: TILTING at windmills

Another old friend, Dr. Ronald Glasser, recently underwent a hip operation, followed by a stay in the hospital limited to two days by his insurance company. This led him to reflect on what has gone wrong with the practice of medicine in recent years:

"Ten years ago, the standard admission for a hip replacement was a seven- to ten-day affair with inpatient physical therapy twice a day throughout the admission. But it isn't just hips. In the early 1990s, if you had a gall bladder removed you stayed in the hospital eight days. Now, if you have your gall bladder removed at eight in the morning, you are sent home at noon. Ten years ago, open-heart surgery meant a minimum of ten clays in the hospital; now, if you have a mitral or aortic valve replaced, you are sent home on day four. If you have breast cancer and a mastectomy to be followed by outpatient chemotherapy and radiation, you are home within eighteen hours of the mastectomy, drains and all. If you have a radical prostectomy for prostate cancer, you are home on day three with a bladder catheter in place and instructions for your wife or daughter on how to handle the indwelling catheter and how to clean the urine bag so you don't develop a bladder infection. Have a laminectomy on Tuesday for a slipped disc and you are home Thursday. Forget about being able to bend to pick up something from the floor, and forget about being able to turn over in bed. While I and my hip, and apparently everyone else, weren't looking or paying attention, patient care in America had undergone a profound change.

"The facts about early discharges are quite stunning. The average length of stay following admissions to a hospital are not only less than a quarter of what they were ten years ago; they are also on average four to six days less per surgical procedure in America than in Canada, Germany, or France.

"By the end of the 1990s, hospital administrators began to decrease their...