Late Saturday afternoon, after we enjoyed a couple of Subway
sandwiches, my wife fell ill. She began to experience flu-like symptoms, with a 102°
fever, nausea and the onset of chills. Weakened by her mysterious illness she
was unable to walk, prompting my 911 call. The EMT team arrived at our front
door in minutes. A half hour later she was in bed in an emergency room.
We could not have asked for better treatment from the EMT
team. Their professionalism was matched by their exceptional courtesy.
Unfortunately, Karen's experience in the ER became a sad example of a healthcare
system organized for efficiency, rather than effectiveness.
Emergency rooms, of course, are invariably busy. Those with
life-threatening illnesses and injuries must always come first. Karen's life
was not in immediate danger. So, while we were not happy with the five hours it
took to do tests leading to a diagnosis of a urinary tract infection, the "code
blue" announcement we heard on the intercom reminded us of the hospital's priorities.
A courteous nurse, with a fine sense of humor, who administered the intravenous
antibiotic, helped the medicine go down.
Arriving home after midnight, we breathed a sigh of relief, looking
forward to sleeping late the following day. But a call in the morning from the
doctor who treated her began our encounter with a dysfunctional patient care system.
The doctor told Karen her tests showed bacteria in her blood. He asked her to
return to the ER for more antibiotics.
An hour later we returned to ER, only to learn the doctor
who called was gone for the day and left no notes about Karen's diagnosis or recommended
treatment. The doctor who replaced him had no clue about why Karen was there.
He began asking her every question about her symptoms that had been asked and
answered the night before. I told him what the doctor had told Karen that
morning, as well as his diagnosis and the treatment she received. I had apparently
become, without benefit of credentials, the consulting physician.
My patience ran out. I asked the replacement doctor if he
could contact the other doctor. I also asked why there was no record of her treatment
ten hours earlier. At that point the replacement doctor became defensive,
blaming the absence of the records on some mysterious computer problem or error
by the other doctor. There was no apology until I asked him for one. He promised
to call the other doctor at home.
An hour passed after he left the room. That did
it. We told the nurse we were leaving. We would make an appointment to see Karen's
primary doctor in the morning. The replacement doctor suddenly reappeared, telling
us he had spoken with the other doctor, who told them of the antibiotic order he
had made but couldn't be found. Karen agreed to stay for the antibiotics.
It was then we met a nurse who made our day. Courteous and
professional, she completed the intravenous antibiotics quickly, bringing
smiles to our faces after a miserable nine hours imprisoned in ER over the
previous 24.
Except for the doctor with questionable people skills, we
were treated with courtesy, respect and professionalism by every staff member we
met. Reflecting on the downside of the experience, it struck me that the
primary problem with Karen's treatment is a healthcare system that treats patients
as assembly-line products.
While some refuse to acknowledge the facts, Obamacare has been
a great success in bringing better and less costly healthcare to millions of previously
uninsured Americans. But our encounter with it last weekend shows there's a lot
more to be done to improve patient care. Politicians should turn their
attention to that.
Contact Richard Riehl at richard_riehl@yahoo.com
