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Opinion: Patients deserve better dialysis care in California

With all the focus on health care this year, I wish the issue of “quality” care received more attention, especially for the 66,000 Californians like myself who depend on dialysis.
Dialysis is a life-saving treatment for people whose kidneys have failed, requiring them to go to a clinic three days a week to have their blood removed, cleaned and put back into their bodies. This grueling and tedious process lasts from three to four hours each time, and side effects may continue for a couple of days.
But the quality of care in dialysis clinics was often so poor that I swore never to return. I’ve been on and off dialysis for more than 15 years and one of my worst experiences came in 2011 when I finished my treatment and was told my wound had stopped bleeding and I could leave.
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Just as I stood up, however, blood started running down my arm like it was coming out of a faucet. My wound hadn’t closed because I was rushed out of my chair to make room for the next patient. The caregiver ran over to help and we applied pressure to the wound until the blood clotted. I could have bled to death.
It was so scary and I didn’t want to go through that anymore. Not long after, I asked my doctor if I could do dialysis at home. I went through the training, and now I hook myself up and run the machine. Although I got an infection from home dialysis that sent me to the emergency room two years ago, I’d rather take that chance than have to endure another day in an understaffed dialysis clinic.
Not every dialysis patient, though, can be treated at home. That’s why I support a bill to improve dialysis care in California. SB 349, the Dialysis Patient Safety Act, would require safer staffing levels in clinics, allow more time for patients to recover and for workers to disinfect equipment, and mandate annual inspections of clinics. Currently, clinics are inspected on average only once every five to six years.
The bill is gaining momentum. It passed the Senate in May and the Assembly Health Committee on a bipartisan basis last month. The California NAACP recently endorsed it, and SB 349 awaits a vote in the Senate Appropriations Committee sometime in August.
But the dialysis industry is coming out swinging against the bill. I guess that’s to be expected when the two largest dialysis corporations — DaVita and Fresenius — fear the $3.9 billion in combined annual profits from dialysis in the United States they made last year are being threatened.
I’ve heard their claims that this bill would lead companies to close some of their clinics, forcing patients to get treated in emergency rooms. But it’s not true. These two dialysis giants have more than enough to cover any costs from the legislation, and still make a lot of money. It’s just that they value their profits more than their patients.
I’ve seen how chaotic a dialysis clinic can be. Workers report caring for as many as 12 patients at a time, even though the companies say their goal is no more than four patients per worker. With everyone hustling around, it is only going to cause problems. We already know infections are the second leading cause of death for dialysis patients, and a clinic with workers who are overwhelmed isn’t going to get that under control anytime soon.
It’s time to improve patient care in California’s 570 dialysis clinics and reassure patients like me that we can be safe.
Holmes is a resident of Oakland.

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