Medical Waste

Getting the Best Care - September 30, 2015

When my husband was starting hospice care at home I met with the care coordinator from the hospice organization. This person asked me to confirm the current medications my husband was taking and quickly said something about making sure he had a full supply of everything at home. I told the person that he had plenty of medications and I could easily pick up refills at the local pharmacy which was two blocks from our home. The caseworker reassured me that the hospice organization would take care of it. I didn't ask for further information. The next day a sixty day supply of every medication my husband was taking arrived by express delivery. I was confused and annoyed. About a week later I was disgusted and horrified because my husband had passed away and I had hundreds of pills that had to go into a landfill. It was a terrible waste.

A problem you may face in our consumer driven healthcare system is that programs designed to help make things more efficient for patients sometimes lead to waste. A client of mine recently asked me to throw away several hundred catheters because the doctor ordered 200 to be delivered to her home every other week. She uses less than 20 a week. I let my client know that there are organizations that will take donations of unused, unopened medical supplies and redistribute them to medical facilities in third world countries and offered to donate them for her. I also strongly encouraged that she contact the company that delivered the products as well as her doctor and insist that fewer be sent to her. If you are concerned about waste and reducing what goes into landfills and your healthcare provider is suggesting a program that will automatically deliver a medical supply, there are some steps you can take to help minimize waste.

First, whenever a healthcare provider talks to you about home delivery make sure you ask a lot of questions about how it works. Often it is not the doctor or the healthcare provider but the representative from the organization that provides the delivery that may convince you to agree to more than what you need. When my husband was receiving liquid nutrition through a j-tube the representative at the company that provided home delivery questioned me about by husband's eating habits prior to being sick and based on that information chose to have a lot more liquid nutrition sent to our home than he ever used. I questioned that representative but he assured me that it was better to be safe than sorry and since our insurance was paying for it there was nothing to worry about. I ended up donating cases of liquid nutrition to a local non-profit that helps uninsured cancer patients. While I'm glad it was used, it was wasteful and unnecessary for our insurance to pay for it all. If I had it to do over again I would have insisted that the provider send the minimum amount and then ask for more if necessary. Many times you can insist on trying less first and then ordering more if necessary.

If you do find that you are receiving too much of a medical supply it is important to let your doctor know about it. The doctor is in a position to change the order so that less is delivered to you. However it is also important that the doctor knows how much the patient is actually using. For example my client's doctor may believe that she is using many more catheters and that may impact the treatment options prescribed. As I've written before it's important that physicians have a very clear and accurate picture of what is happening for the patient. It is the best way for the patient to get good medical care.

When you do find that you have too many supplies you can often find organizations that will take donations of unused, unopened products. In the San Francisco Bay Area I have found the following organizations that can take donations of many kinds of medical goods. I strongly recommend you call any group first and confirm that the organization accepts the items you have.

http://vidausa.org/medical-supply-donations/

http://rampusa.org/how-and-where-to-donate-medications/

http://homecares.org/

http://www.cidsanmateo.org/

Most organizations cannot accept unused medications, although some do. What I have found is that it depends on what the medications are. Also you may find that animal shelters can accept some medications as well. Unfortunately what can and cannot be accepted changes frequently so you may have to contact several organizations before you can find one that will accept the donation of unused medications. If you cannot find a place to donate unused medication, take them to a local police department. The police can make sure that medications are disposed of safely. Flushing or dumping them down the drain can contaminate local water supplies.

When you are coping with major illness, environmental issues may not be on the forefront of your mind. As always your priority is to take care of the patient. However if you do find that you are facing a wasteful situation and want to do something about it, speaking up and finding ways to reallocate it may make you feel better.

Story shared with permission.