You have choices among dialysis centers

SURVIVAL TIP: Your nephrologist (kidney doctor) will likely refer you to a dialysis unit, but patients have choices.

TransportIf your town or city offers more than one dialysis clinic and you are unhappy with your unit, take advantage of the opportunity to “travel”. Ask your unit to assist you in visiting another unit. Fresenius patients can call a central number, but my experience is that they only file requests. Operators do not answer questions about specific units. A flurry of faxes travel from office to office and take up to several days to secure confirmation. If your clinic is different, let us know in the comments below.

If you want to stay with the doctors who manage your unit, call the doctors’ office and ask what other units under their care meet your needs. Some units are full and cannot accept other patients. Sometimes shifts are full, but you might be able to get a different schedule. The clinic I chose wants patients to make the calls to see what units are available when we travel. I narrow down the clinics through web research and then call the preferred unit to ask if they can accommodate me. Often the clinic coordinator will provide helpful information in guiding me to a unit that can accommodate me.

While you are visiting another unit(s), ask patients about their experiences. Does one tech or memory stand out? People generally want to share negative experiences, so you’ll hear all about those. So ask about good experiences. If you have a specific concern, ask other patients their experiences with the same issue.

Many providers offer in-clinic and at home services. Size varies greatly, from the size of the unit to the size of the company that owns the unit.

Comparisons
Ascending GraphMedicare offers comparisons of units at https://www.medicare.gov/dialysisfacilitycompare/. Consider that at first glance, data can be misleading, however. Depending on the age of patients and other health concerns, units can get low scores that don’t accurately reflect the quality care they provide. Call your local kidney advocate to get help understanding the data. I did!

Major providers
Fresenius and Davita are the two largest dialysis providers, but they are by no means the only companies or necessarily the best in your area.

Fresenius was established in 1912 with the production of pharmaceuticals in Germany. The company began selling dialysis machines and dialyzers made in other countries in 1966. By 1974, Fresenius was making their own machines and dialyzers. Today, the company continues manufacturing and provides health services, such as hospitalists and other medical providers; pharmacy services for dialysis patients; outpatient labs; and urgent care centers. This publicly traded company provides dialysis treatments to many in-hospital units and sells their dialysis machines and dialyzers to other dialysis providers.

Did YOU KNOW that Fresenius Medical Care, DaVita Kidney Care, and Baxter Renal Care have clinics overseas?

DaVita began providing dialysis services in 1999 and is traded on the New York Stock Exchange. According to the website, DaVita focuses on patient care and outcomes. The website is easy to navigate and provides exceptional resources.

Smaller providers
The third largest company cares for 150-160,000 fewer patients than DaVita or Fresenius, respectively. The next seven care for significantly fewer patients. But this in no way suggests inferior care.

Dialysis Clinic, Inc., and Satellite Healthcare are both non-profit dialysis providers.

If you are not happy with your unit, ask around. Visit other units. Do you research. Make a list of your top requirements. Location? Doctors? Staff? Available shifts? Corporate ownership? One unit is not going to offer all you desire, but you will find one that provides care from staff and/or doctors you believe you can trust. Select the unit that best meets your needs. Dialysis is your lifeline.

If you or someone you care about is facing dialysis, share your experiences and concerns. This is a forum for learning and inspiration where we can ask questions and be honest with others in the same situation. What are your experiences and challenges with dialysis?

RESOURCES
http://www.freseniusmedicalcare.com/en/about-us/history/

http://fmcna.com/company-profile/

http://www.nephrologynews.com/largest-dialysis-providers-2016-poised-change/
http://catalyst.nejm.org/the-big-business-of-dialysis-care/

If you would like Beth, the Dialysis Gal, to speak to your group, reach out via e-mail or the comments.

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About dialysisgal

When I joined the 450,000 Americans on dialysis, I wondered what "normal" would be. Would people stare at my access and ask what was wrong? In this blog, I hope to save other patients and their families from the difficulties I have faced. I want to share my experiences, what I learned, had to ask and was shocked to find. I am not a medical professional, but I hope we can have a conversation to help you better understand what you or someone you love with chronic kidney disease (CKD) might expect while living with dialysis.
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