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After 35 years in public education as a high school English teacher and university administrator, I began my second life as a freelance writer, winning San Diego Society of Professional Journalist awards for my opinion columns in the former San Diego daily North County Times and the San Diego Free Press.

Monday, March 30, 2015

Our Weekend ER Getaway



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