Wednesday, May 5, 2010

Healthcare, Twin Cities style

As many blog readers have surmised, the Voice of Reason is on injured reserve. She has a broken fibula, near the ankle, as a result of a ski incident. She was skiing at Loveland, CO with her sisters, Jeremiah Johnstone and the Colorado Kid when she fell. She would have you believe she had just stuck and landed a jump involving a one and a half and a daffy and fell avoiding a kid on a snowboard. Uh huh. Anyway we thought it was a sprain and applied the RICE technique but the pain persisted after the normal two week sprained ankle window. My treacherous ankles have failed me in a number of sports involving leaping into the air then (this is the tricky part) landing. Both have been casted so, even though my medical degree is nonexistent, I know a thing or two about torn ankle ligaments. After another two weeks, (and a 20 mile kayak paddle) now 4 weeks removed from the ski fall, she went to her family practice doc, who x-rayed the foot and pronounced it broken. The VOR's dad, TheLegend, pronounced it as a classic case of Johnstone-itis, the tendency to ignore injuries and not go to the doctor until well past the time that a normal person would give in. Her GP referred her to the orthopedic specialist and this is where the fun begins.

Two weeks ago she managed to get an ortho appointment two days after the GP referral by offering to pick up her xrays and deliver them to the ortho office. The xray joint gave her a CD. I understand that people are actually able to use a miracle device called the internet to transfer information on a CD but I guess that was not the case in this instance. She saw the ortho doc, who consulted with her for 30 seconds, put her in an air cast, and told her he needed to see a CT scan. She was also given a prescription for inflammation which apparently took a week to kick in and was not compatible with Ibuprofen. When she complained to the ortho nurse she was told that she should have know that, and that her pharmacist should have informed her. But lets move on to the CT scan.

The CT scan got scheduled for 5 days after the ortho visit, rather than one day, because because of the impenetrable barrier of the Red River. Apparently the computers at Blue Cross/Blue shield of North Dakota don't speak the same language as the Minnesota ones, or got waylaid by the Red River, and approval was delayed. Once the CT scan actually took place, on a Tuesday, the VOR was told that she would be called with the results on Friday. The results would indicate whether the break was healing properly or surgery would be needed. This is obviously something that a patient would want to know but after no call on Friday she spoke with the nursing coordinator at the ortho joint, who told her that the very first opportunity that they would have to check things out would be Tuesday and that he would call then. That was yesterday.

No call yesterday. I've got a number of questions. The first one would be why the hell is the customer service so bad? Patty and Selma, Homer Simpson's sister in law's, who work for the Department of Motor Vehicles in fictional Springfield, seem to offer better customer service than these yahoos. I also wonder why the technology seems to be so lacking in the healthcare field. In the printing industry we exchange gigantic full color files as a matter of course. Can't a stinkin' black and white X-ray be sent electronically, rather than having the patient drive 25 miles during rush hour to pick up a damn CD? And why the hell can't the other players in the system just do what they say they are going to do? I've always found that if you gave folks a promise date that you knew you could meet and then bettered it, they were pretty happy. If you just pull something out of your ass and then ignore it, that tends to piss people off. How difficult can it be to look at an image and figure out what's going on? My guess is that they have only seen thousands of this very thing over the years. In the enlightened world of healthcare tranparency, how can a person make a decision on their care if they can't even get their own health information? I'd be tempted to grab the scan, tell both the ortho and the CT place to stick it, and start over with a clinic that has a proven reputation.

All the VOR wants is to find out when she can get back to yoga, bicycling, and proper kayaking. We have been removing the air cast, wrapping the ankle, and stuffing her in the kayak for a few weeks now. She can't use her left foot to push off on the right side paddle stroke and it has her imbalanced and is frankly driving her nuts. Being a vengeful person by nature, I'd like to figure out a bit of payback for these characters to even things up but nothing comes to mind. Suggestions would be appreciated. I would also like to hear the lame excuses for these failures but I don't expect that either. Overworked, understaffed, not enough time in the day, malpractice worries, blah, blah, blah.

Do me a favor. Start your timer and look up a name in your cell phone directory. Pretend to dial the number and when the pretend person answers, say "I'm sorry Ms VOR but the doctor has gotten a bit behind and hasn't had a chance to look at your CT scan. We will be in touch just as soon as he reviews it, which should be in a couple days". Then hit stop. It took me 36 seconds to do that. That's a pretty small amount of time to spend to make sure that your customer is in the loop and would also prevent the customers Significant Other from writing scathing, sarcastic, and critical blog posts about your organization.


Silbs said...

Relax, it is excellent training for what is in store for us all.

DaveO said...

Actually the response came yesterday. It was the extremely satisfying, "wear the cast for another month and then we'll do another CT scan and decide whether we need surgery or not at that point". Kinda like my job. 'Yes' is the best answer with 'no' being a close second. 'Maybe' means I get to piss away a bunch of time working on it with no assurance of a 'yes' in the end.

Lew Miller said...

Well said Dave! The only thing worse than the non health care service that you have experienced is a work comp "we are going to screw every which way we can" accident.

Lew Miller