Tuesday, June 7, 2016

Is It Just Me Or...

I'm just curious if other people in other parts of the country have the same low quality of health care that I do.  Last week I felt like both hips popped out of their sockets, so I tried to set up an appointment with the doctor for the same day, but didn't get in until the following week.  Of course, the day of my appointment, my hips and legs were fine, but I had another, unrelated, excruciatingly painful condition that made it hard to walk.  I didn't think I could make it to the doctor's office when I could barely make it from the couch to the bathroom.

But I pushed through it and took my cane with me.  Right off the bat I had my usual problem with people blocking the sign in sheet, so I had to stand there in my pain until I could get someone's attention and ask them to move aside. Despite me signing a paper saying that my address, phone, and insurance have not changed, the receptionist decided to make me fill out more forms with all the same friggin' information they already have in their computer.  I was shaking so bad from the pain that I could barely write.  They kept calling me up to the front desk repeatedly when it was clear that I could barely walk.

They called someone's first name and led her back.  After several minutes, they returned and called out the first and last name, because they had accidentally taken all the vitals for the wrong person.

They called me back and the nurse ordered me to get up on the scale when I was carrying a clipboard, a purse that probably weighed five pounds, and a cane.  I tried setting everything down first, and he got annoyed with me.  I guess he didn't want an accurate weight.  People move slowly when they are in pain and medical offices move like the Indy 500, so I wasn't exactly in the best place for my condition.  He ordered me to sit down and I looked at the chair with a horrified expression.  It hit him that getting me to sit in that tight corner in that hard chair would be an ordeal, so he took my vitals in a more comfortable chair in the examining room.

He asked why I was there, and I told him the original reason for my appointment, but before I could explain what my problem was today, he cut me off and wouldn't let me give him more than one reason.  He shoved two more forms for me to fill out in my face and scurried out of the room as if he didn't want to hear anymore.  It was imperative that I explain that the symptoms they saw today were not what I needed to get diagnosed and treated.  I hoped the P.A. would give me a chance to explain before jumping to conclusions when he came in.  It's hard to see actual doctors around here.  I almost always see a physician's assistant.

When the P.A. arrived, he discovered that the computer wasn't working.  I was trying to explain my two health problems to him while he was crawling around on the floor plugging in the computer.  Then he was having to fill in all these forms just to get to my file.  I didn't know how much he was actually hearing of what I was saying.  This particular guy is really bad about spending our entire appointment typing on the computer and not examining me.  They never have had me change into a gown, and they have never done any physical exam beyond checking my blood pressure, body temp, and pulse.  They just have me sit in a chair in my clothes and ask questions that usually have nothing to do with my problem.  It seems they are more concerned about filling out paperwork than examining the patient like they did in the good old days.

He immediately began filling out forms for me to get x-rays and blood work, which I knew was going to happen.  He also brought up physical therapy, but I've had that done in the past when my arms failed me, and it didn't help beyond the first day.  The only reason why I kept going was because my P.T. was the only person in my town I knew who owned a horse besides my neighbors and actually rode it, so we had a lot to talk about.

He did finally pull himself away from all the forms and computer to do some basic tests to determine which movements caused me pain, but the exam was worthless because I didn't have leg or hip pain today.  He did say that it was important that I come in on the same day I have the pain, but he didn't tell me how I can get their scheduling department to respect that.

Each time we discussed a different health problem, he'd say he had a prescription for that.  However, by the time I got home with my reams of paperwork, I discovered that he had only actually prescribed one out of three of the prescriptions he said he would give me.  He forgot about the other two.

He asked why I needed the cane after I had just explained twice that I can be pain-free and moving fine one minute, and then unable to put any weight on my leg or both legs the next minute, so I carry the cane just in case.  I get tired of having to crawl back into the house when my leg gives out on me down at the barn.  Also, the cane helps me get down into and up out of chairs, up and down stairs, and in and out of my truck, which has no running board.  I almost could not make the doctor's appointment because I couldn't perform the physical movements needed to climb into the cab without pushing off of the cane with one hand and pulling up with the other hand on the door frame handle.

I think he was skeptical about the level of pain I had because I've suffered through it for months before seeing a doctor.  I didn't explain that I have little faith in the medical field and I'd rather be out riding my horses on my good days than sitting in doctor's offices and laboratories filling out paperwork.

I did run through a list of ideas that various people have brought up to me, including readers of this blog, to see if he agreed with any of them, and he felt that Sciatica was a reasonable diagnosis, but we won't know until he sees the x-rays of my back.  Since I've had problems in the past with losing the use of my arms too, my back is definitely looking suspect.  I'm hoping all my years of riding out spooks on horseback is not coming back to bite me.

Anyway, I got to the check-out counter and they gave me more paperwork.  Then I attempted to turn in the paperwork the first receptionist gave me, and she pointed out that I still had at least a dozen more pages to fill in.  I said, "Come on!  I'm dying here.  I can't do this.  I came here for help because I'm in pain.  I can barely stand and sit.  I need to be lying down."

So, she highlighted the bare minimum that I could fill out, and then let me take the rest home to bring back the next time I'm in the office.  I have a one month follow-up in addition to the lab and imaging appointments, so it looks like I've descended back into medical care hell and still don't have anything to help me with the pain.

This is what I mean when I say that seeing doctors is a waste of time.  It literally takes weeks, sometimes months or years, to get a diagnosis and treatment, and most of the time everything is inconclusive, so you get nothing but huge medical bills, and no resolution for your problem.  I ended up just going home and raiding my husband's medicine cabinet for pain pills.

One thing that drives me nuts is that I have had an essential tremor since I was in my 20's, and the nurses and doctors always zero in on that because it's very visible.  I can't tell you how many times I've found myself going down the road of being diagnosed with Parkinson's Disease when all they had to do was check all those stupid forms I've filled out a hundred times or ask me, and they'd know it was just an essential tremor.  I mean, what's the use of all that paperwork if nobody actually reads it?

So, I'm wondering if this is just the state of current medical care everywhere or if it is possible for me to get better care elsewhere.  What do you think?


Brenda said...

Well, I know you asked for input from readers all around and I'm in the same state as you, but I have a lot of the same issues with healthcare and healthcare providers as you, which I know you've read on my blog. It makes you wonder why people get into that business, doesn't it? You'd think it was to help people, but I wonder if it's just for the money. They all spend the entire time on the computer and asking you the same questions the nurse, the PA student did and then they start asking about when was the last time you had this done or when was the last time you had that done. I'm in your office because I'm in so much pain from my knee that I can barely walk so why are you asking about when was the last time I had my teeth "floated", to use an equine term. Lol.

When I was taking my EMS class way back when, my instructor was a captain with the Mesa FD and he was telling us about burn-out and one firefighter who had it bad, but was still working. He said that if he ever got to the point where he was just on automatic pilot and didn't care about the patients anymore, it was time to leave the job. I think some people shouldn't be on the job to begin with. Not just FD but any job that requires a lot of interaction with people.

Stephanie Ford said...

I'm in southern IN and I couldn't imagine dealing with the issues you've had with healthcare providers. I could just be lucky and have amazing doctors, but neither my regular physician nor chiropractor have ever made me wait more than 24 hours to be seen for a serious illness or injury. My regular physician has called in prescriptions for me after talking to me about my symptoms, granted I do see her regularly (once or twice a year) for an existing condition so she is very familiar with my history. Both my physician and chiropractor know my hobbies and my tendency to injure myself doing them and have always been so wonderful getting me in for treatment, especially my chiropractor (he's amazing) Sometimes there's a wait but I kind of expect that when he squeezes me into an already busy day. I feel very fortunate

Linda said...

My husband and I own a practice--psychiatry--and I can tell you, legally we are required to have patients fill out a lot of paperwork. The insurance companies won't pay the patient's bill without the correct boxes filled in and notes made--and they're trying harder and harder to deny claims.

That said, we are minimalists in many ways. Patients don't have to sign in and we don't require any extra paperwork if their insurance is still the same. We're pretty laid back. Also, my husband NEVER does paperwork while the client is in the office. Other psychiatrists do, and we're told they barely look up from their computers. My husband takes it all home with him, and on his days off, he fills in all the paperwork and dictates his notes & then faxes them to referring providers, etc. It usually takes him at least one full day of one of his days off. Plus, patients call every day of the week 24/7 for RX refills and questions and/or needing help. Even when we go on vacation, my husband and I return phone calls. When we were in Norway...Hawaii...Canada--didn't matter--we'd be up late using Skype to connect with patients. Docs don't get paid for any of that stuff--notes, charts, phone calls, etc. It's all built in to the overall cost.

Having a private practice is very hard and we wonder, sometimes, if it's worth it. He could make more working for an institution, plus his time off would be 100% off and he'd get benefits--health and retirement. Plus, I wouldn't have to work anymore! Yay! As of now, we have a $9,000 deductible on our health insurance, just to be able to afford it, so we NEVER go to the doctor. LOL.

But he likes practicing psychiatry his way--taking his time with patients and not herding them in and out in 15 minute increments. (That's how they maximize reimbursement) It's better for his soul, better for patients, and he's willing to do the extra time to accomplish those things.

Nuzzling Muzzles said...

Brenda - I've noticed that the majority of veterinarians around here operate their businesses the same way, so I suspected that people doctors in this area are probably being influenced to run their businesses in a similar manner. When I lived in Nevada, I received excellent health care with just a few lemons sprinkled in here and there. Our biggest problem was a shortage of doctors, so there were long waits, but at least once I did get in, the doctors listened and worked with me in finding a solution. Here, it feel like I'm on a conveyor belt and all they want to do is collect information, and not give anything back in return.

Stephanie - Thanks for telling me where you are and your experiences. Knowing the patients' jobs and hobbies is a really important part of health care, because it tells you a lot about how they move their bodies. I told my P.A. that I shovel a lot of manure and take tons of it to the dump and shovel it back out. He just said, "Can't you sell that instead?" I don't think he got the point of what I was saying.

Linda - I suspected the insurance companies had a lot to do with all this paperwork. Thank God for people like you and your husband. I'm amazed that you work while on vacation. When my current vet was away on vacation, she brought in a substitute vet who knew how she conducted her business really well. I can't imagine being a psychiatrist and not getting a real break from your patients. He must really care about them.

Brenda said...

Yeah. One of the things that really bothers me, that you and I have in common...the knee and walking issue. "You" know why I'm at the doctor today so why do you keep shuffling me around and make me walk from here to there and back over there, then not do a thing for me except cost me a boatload of money and cause me more pain? My last trip to the doctor, he was going to order a big bunch of tests. Literally, six or so tests that had nothing to do with my chief complaint. The only thing that prevented them from doing the tests is finding out that the hospital across the street, with whom they are affiliated with, had already done the same exact tests only about 2 weeks prior and they could access the results through a website. Good grief!

Nuzzling Muzzles said...

Brenda - That is so ridiculous. I'm glad you caught the duplication. That would have caused problems with your health insurance. But that's definitely more proof that no one really reads our records. I suspect that the people who work in the field are drowning in all this required paperwork, and bureaucracy is causing the demise of quality health care.

Cheryl Ann said...

I NEVER see my doctor here in California, on the PA. While I like the PA, sometimes I would like to SEE my doctor. Frankly, I have more luck at urgent care.

ellie k said...

Last week my back was so bad I was crying on the phone which I never do. The pain spec. Office crew and my drs office had the proper paper work in order and I was in the office in a matter of hours. When I got there I was called back in about ten minutes and walked out before my appointment time all finished and ready to go to lunch. I have a wonderful dr and can get in to see her on the day I call. She takes time to listen, asks about family and what I have been doing. Some people complain because she takes to long for your appointment and wants to go over every problem you may have. She took care of my husband and made sure he had every possible treatment or tests that might help. She cried with us when she told us he had cancer. I cannot say enough about her and know how lucky to have found one that really cares.