Navigating Healthcare Today

 

So one of my best friends recently had a hip replacement. A few weeks later, he developed severe pain in the hip along with redness, tenderness, and drainage from the wound incision. He thought he had a wound infection and called his surgeon’s office to see what he should do. The receptionist he spoke to told him the next available appointment was six days later. So he took it! He didn’t tell the phone operator that he needed the doctor or his assistant to call him back as soon as possible. It is hard to believe, but many people are afraid to argue with the peons paid to block access to medical care.

So he fell the night before his appointment and couldn’t get up. He crawled to his cell phone and waited while the EMTs called a locksmith to drill his door and take him to the hospital next to the doctor’s office. He had a severe joint infection and, as I write, is in surgery for removal of the hip prosthesis and replacement of a new joint.

I offered to be involved in his care, but he resisted. Fortunately, another friend, who is a retired police detective, has had more acceptance from him and has been great at getting to the bottom of the situation. She is truly great at interrogation and has a bull—- meter second to none. Unfortunately, that is what is needed sometimes to get good care.

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  1. kedavis Coolidge
    kedavis
    @kedavis

    6 days?  I can’t imagine someone not going to a hospital ER in a situation like that.  I did that just for my gall stones, and I wasn’t even leaking from an incision!  Good thing too, because I was admitted as “emergent” and had surgery the next morning.  Otherwise I might have had to deal with it for a week while trying to get an outpatient surgery appointment.

    • #1
  2. navyjag Coolidge
    navyjag
    @navyjag

    You M.D.’s have the toughest job on the planet.  Trained to save lives but now have to deal with government and insurance B.S. to get your jobs done. Never thought about that profession. Can’t stand the sight of blood. 

    • #2
  3. MarciN Member
    MarciN
    @MarciN

    It must be infuriating to a doctor hearing this. 

    • #3
  4. Ekosj Member
    Ekosj
    @Ekosj

    MarciN (View Comment):

    It must be infuriating to a doctor hearing this.

    Is it?   They’re the ones who hired the peons who “block access to healthcare”.    Don’t they know what happens in their own offices?    Don’t Doctors get sick too.   Don’t they know what it’s like on the other side of the desk?    Or is there the VIP members-only line for other Docs?

    • #4
  5. OldPhil Coolidge
    OldPhil
    @OldPhil

    I had my hip replacement almost 6 months ago and the surgeon was explicit about reporting ANY pain or discomfort with the incision or the hip. He told me to call for an antibiotic prescription before any dental work (“the mouth is the dirtiest part of the body” was interesting).

    So far, so good, knock on wood.

    • #5
  6. JustmeinAZ Member
    JustmeinAZ
    @JustmeinAZ

    I”m sorry but he really should have been more insistent. Every surgeon I’ve been involved with in the last year has drummed into me to call immediately regarding pain and possible infection.

    • #6
  7. Blondie Thatcher
    Blondie
    @Blondie

    Yep. I’m gonna have to put this one on your friend. The front office people aren’t always the sharpest knives in the drawer. Most of the surgeons I have worked with are adamant about things like your friend is going through. Hope he can make a full recovery. 

    • #7
  8. kedavis Coolidge
    kedavis
    @kedavis

    Blondie (View Comment):

    Yep. I’m gonna have to put this one on your friend. The front office people aren’t always the sharpest knives in the drawer. Most of the surgeons I have worked with are adamant about things like your friend is going through. Hope he can make a full recovery.

    And any front-office person who stood in the way needs a swift kick in the butt some re-training.

    Okay, they need both.

    • #8
  9. Southern Pessimist Member
    Southern Pessimist
    @SouthernPessimist

    Ekosj (View Comment):

    MarciN (View Comment):

    It must be infuriating to a doctor hearing this.

    Is it? They’re the ones who hired the peons who “block access to healthcare”. Don’t they know what happens in their own offices? Don’t Doctors get sick too. Don’t they know what it’s like on the other side of the desk? Or is there the VIP members-only line for other Docs?

    I agree with the other ricoteers who responded to your comment. I am sure the surgeon gave him instructions on how to circumnavigate the usual barriers but he didn’t pay close attention and felt uncomfortable trying to bypass a phone receptionist. It could have killed him but he wasn’t sure if he should rock the boat, so to speak. He is now in the recovery room from his major revision surgery and will be sent to a rehab hospital in a few days.

    • #9
  10. Zafar Member
    Zafar
    @Zafar

    kedavis (View Comment):

    6 days? I can’t imagine someone not going to a hospital ER in a situation like that.

    Exactly.  What’s a surgeon’s office going to do without an operating theatre out back that’s prepped and ready to go?

    And any front-office person who stood in the way needs a swift kick in the butt some re-training.

    “Sir, go to the emergency room right away”??

    • #10
  11. Southern Pessimist Member
    Southern Pessimist
    @SouthernPessimist

    Zafar (View Comment):

    kedavis (View Comment):

    6 days? I can’t imagine someone not going to a hospital ER in a situation like that.

    Exactly. What’s a surgeon’s office going to do without an operating theatre out back that’s prepped and ready to go?

    And any front-office person who stood in the way needs a swift kick in the butt some re-training.

    “Sir, go to the emergency room right away”??

    I may be too far removed from medical care to be sure this is still true, but I think if you insist that a physician or his assistant call you back as soon as possible, you should hear from someone within a few hours and in most circumstances that is soon enough. Every physician has a voice activated phone system that states that if this is an emergency, hang up and call someone who cares. Or something like that.

    • #11
  12. Southern Pessimist Member
    Southern Pessimist
    @SouthernPessimist

    I had volunteered to go to his doctor appointments with him when he first told me he needed surgery. Mrs. Pessimist and I have made a pact that neither of us will go to medical visits alone. No matter how knowledgeable you may be, an extra pair of ears is always helpful. Steve is 78 or 79 years old, lives alone, and doesn’t want to be a burden on anyone.

    Pride goes before the fall, or something like that.

    • #12
  13. kedavis Coolidge
    kedavis
    @kedavis

    Southern Pessimist (View Comment):

    I had volunteered to go to his doctor appointments with him when he first told me he needed surgery. Mrs. Pessimist and I have made a pact that neither of us will go to medical visits alone. No matter how knowledgeable you may be, an extra pair of ears is always helpful. Steve is 78 or 79 years old, lives alone, and doesn’t want to be a burden on anyone.

    Pride goes before the fall, or something like that.

    Doesn’t sound like pride, more like meek-ness.

    • #13
  14. Zafar Member
    Zafar
    @Zafar

    Was worry about cost one of the reasons he didn’t just go straight to ER?

    • #14
  15. kedavis Coolidge
    kedavis
    @kedavis

    Zafar (View Comment):

    Was worry about cost one of the reasons he didn’t just go straight to ER?

    Insurance that covers the hip replacement would cover the ER too, especially if it’s a result of the hip replacement.

    • #15
  16. Zafar Member
    Zafar
    @Zafar

    kedavis (View Comment):

    Zafar (View Comment):

    Was worry about cost one of the reasons he didn’t just go straight to ER?

    Insurance that covers the hip replacement would cover the ER too, especially if it’s a result of the hip replacement.

    So long as he was sure that it was.

    Also – there’s a natural tendency to minimise – “I’ll just sleep through it” – so I was wondering about motivation.

    • #16
  17. kedavis Coolidge
    kedavis
    @kedavis

    Zafar (View Comment):

    kedavis (View Comment):

    Zafar (View Comment):

    Was worry about cost one of the reasons he didn’t just go straight to ER?

    Insurance that covers the hip replacement would cover the ER too, especially if it’s a result of the hip replacement.

    So long as he was sure that it was.

    Also – there’s a natural tendency to minimise – “I’ll just sleep through it” – so I was wondering about motivation.

    Nobody should think of “sleeping through” a leaking surgical incision.

    • #17
  18. MarciN Member
    MarciN
    @MarciN

    Ekosj (View Comment):

    MarciN (View Comment):

    It must be infuriating to a doctor hearing this.

    Is it? They’re the ones who hired the peons who “block access to healthcare”. Don’t they know what happens in their own offices? Don’t Doctors get sick too. Don’t they know what it’s like on the other side of the desk? Or is there the VIP members-only line for other Docs?

    I wasn’t clear. :) I agree with you. 

    It’s up to the surgeon to train the people answering the phone to ask the right questions. 

    Surgery is something the patient does only once or twice in a lifetime. The patient won’t know what to say, especially if he or she is a little confused and scared. 

    I’m surprised that this happened. Most surgeons I’ve known want only one thing in this life: to succeed. They would not do that much work just to have the recovery room staff, home health aides, or their own office staff undo their great work. 

    That’s why I felt sorry for the surgeon. 

    • #18
  19. kedavis Coolidge
    kedavis
    @kedavis

    MarciN (View Comment):

    Ekosj (View Comment):

    MarciN (View Comment):

    It must be infuriating to a doctor hearing this.

    Is it? They’re the ones who hired the peons who “block access to healthcare”. Don’t they know what happens in their own offices? Don’t Doctors get sick too. Don’t they know what it’s like on the other side of the desk? Or is there the VIP members-only line for other Docs?

    I wasn’t clear. :) I agree with you.

    It’s up to the surgeon to train the people answering the phone to ask the right questions.

    Surgery is something the patient does only once or twice in a lifetime. The patient won’t know what to say, especially if he or she is a little confused and scared.

    I’m surprised that this happened. Most surgeons I’ve known want only one thing in this life: to succeed. They would not do that much work just to have the recovery room staff, home health aides, or their own office staff undo their great work.

    That’s why I felt sorry for the surgeon.

    Seems like, as soon as the office people knew that it was a recent-surgical patient, their behavior should have changed.

    • #19
  20. Zafar Member
    Zafar
    @Zafar

    kedavis (View Comment):

    Zafar (View Comment):

    Was worry about cost one of the reasons he didn’t just go straight to ER?

    Insurance that covers the hip replacement would cover the ER too, especially if it’s a result of the hip replacement.

    Would the deductible be significant enough to be a factor?

    • #20
  21. MarciN Member
    MarciN
    @MarciN

    kedavis (View Comment):

    MarciN (View Comment):

    Ekosj (View Comment):

    MarciN (View Comment):

    It must be infuriating to a doctor hearing this.

    Is it? They’re the ones who hired the peons who “block access to healthcare”. Don’t they know what happens in their own offices? Don’t Doctors get sick too. Don’t they know what it’s like on the other side of the desk? Or is there the VIP members-only line for other Docs?

    I wasn’t clear. :) I agree with you.

    It’s up to the surgeon to train the people answering the phone to ask the right questions.

    Surgery is something the patient does only once or twice in a lifetime. The patient won’t know what to say, especially if he or she is a little confused and scared.

    I’m surprised that this happened. Most surgeons I’ve known want only one thing in this life: to succeed. They would not do that much work just to have the recovery room staff, home health aides, or their own office staff undo their great work.

    That’s why I felt sorry for the surgeon.

    Seems like, as soon as the office people knew that it was a recent-surgical patient, their behavior should have changed.

    Exactly.

    The surgeons I’ve known are the archetypes for controlling personalities. That’s just how they are wired.

    It’s inconceivable to me that the surgeon himself didn’t call the patient back upon learning that his patient had called the office.

    • #21
  22. kedavis Coolidge
    kedavis
    @kedavis

    MarciN (View Comment):

    kedavis (View Comment):

    MarciN (View Comment):

    Ekosj (View Comment):

    MarciN (View Comment):

    It must be infuriating to a doctor hearing this.

    Is it? They’re the ones who hired the peons who “block access to healthcare”. Don’t they know what happens in their own offices? Don’t Doctors get sick too. Don’t they know what it’s like on the other side of the desk? Or is there the VIP members-only line for other Docs?

    I wasn’t clear. :) I agree with you.

    It’s up to the surgeon to train the people answering the phone to ask the right questions.

    Surgery is something the patient does only once or twice in a lifetime. The patient won’t know what to say, especially if he or she is a little confused and scared.

    I’m surprised that this happened. Most surgeons I’ve known want only one thing in this life: to succeed. They would not do that much work just to have the recovery room staff, home health aides, or their own office staff undo their great work.

    That’s why I felt sorry for the surgeon.

    Seems like, as soon as the office people knew that it was a recent-surgical patient, their behavior should have changed.

    Exactly.

    The surgeons I’ve known are the archetypes for controlling personalities. That’s just how they are wired.

    It’s inconceivable to me that the surgeon himself didn’t call the patient back upon learning that his patient had called the office.

    That’s assuming the office people let him know.  Which they certainly should have, but what if they didn’t?

    • #22
  23. MarciN Member
    MarciN
    @MarciN

    kedavis (View Comment):

    MarciN (View Comment):

    kedavis (View Comment):

    MarciN (View Comment):

    Ekosj (View Comment):

    MarciN (View Comment):

    It must be infuriating to a doctor hearing this.

    Is it? They’re the ones who hired the peons who “block access to healthcare”. Don’t they know what happens in their own offices? Don’t Doctors get sick too. Don’t they know what it’s like on the other side of the desk? Or is there the VIP members-only line for other Docs?

    I wasn’t clear. :) I agree with you.

    It’s up to the surgeon to train the people answering the phone to ask the right questions.

    Surgery is something the patient does only once or twice in a lifetime. The patient won’t know what to say, especially if he or she is a little confused and scared.

    I’m surprised that this happened. Most surgeons I’ve known want only one thing in this life: to succeed. They would not do that much work just to have the recovery room staff, home health aides, or their own office staff undo their great work.

    That’s why I felt sorry for the surgeon.

    Seems like, as soon as the office people knew that it was a recent-surgical patient, their behavior should have changed.

    Exactly.

    The surgeons I’ve known are the archetypes for controlling personalities. That’s just how they are wired.

    It’s inconceivable to me that the surgeon himself didn’t call the patient back upon learning that his patient had called the office.

    That’s assuming the office people let him know. Which they certainly should have, but what if they didn’t?

    That’s a failure in his office system if they didn’t tell him. 

    • #23
  24. CACrabtree Coolidge
    CACrabtree
    @CACrabtree

    OldPhil (View Comment):

    I had my hip replacement almost 6 months ago and the surgeon was explicit about reporting ANY pain or discomfort with the incision or the hip. He told me to call for an antibiotic prescription before any dental work (“the mouth is the dirtiest part of the body” was interesting).

    So far, so good, knock on wood.

    Yup, my surgeon told me that I’ll have to premedicate before any dental procedure for the rest of my life.  It’s been six years since my hip replacement and no problems.

    As for the above “surgeon”, either he or his front office staff are complete idiots.  In my pre-surgery class we were told that, while after-surgery infections were rare, any sign of infection should be reported at once and even on weekends and holidays.

    • #24
  25. JustmeinAZ Member
    JustmeinAZ
    @JustmeinAZ

    Zafar (View Comment):

    kedavis (View Comment):

    Zafar (View Comment):

    Was worry about cost one of the reasons he didn’t just go straight to ER?

    Insurance that covers the hip replacement would cover the ER too, especially if it’s a result of the hip replacement.

    Would the deductible be significant enough to be a factor?

    Not with Medicare. This guy is well beyond Medicare age. Most likely the whole procedure was covered 100%.

    • #25
  26. Annefy Member
    Annefy
    @Annefy

    Zafar (View Comment):

    kedavis (View Comment):

    6 days? I can’t imagine someone not going to a hospital ER in a situation like that.

    Exactly. What’s a surgeon’s office going to do without an operating theatre out back that’s prepped and ready to go?

    And any front-office person who stood in the way needs a swift kick in the butt some re-training.

    “Sir, go to the emergency room right away”??

    Anyone been to an ER lately? Last place in the world I’d want to be.

    • #26
  27. Annefy Member
    Annefy
    @Annefy

    Southern Pessimist (View Comment):

    Zafar (View Comment):

    kedavis (View Comment):

    6 days? I can’t imagine someone not going to a hospital ER in a situation like that.

    Exactly. What’s a surgeon’s office going to do without an operating theatre out back that’s prepped and ready to go?

    And any front-office person who stood in the way needs a swift kick in the butt some re-training.

    “Sir, go to the emergency room right away”??

    I may be too far removed from medical care to be sure this is still true, but I think if you insist that a physician or his assistant call you back as soon as possible, you should hear from someone within a few hours and in most circumstances that is soon enough. Every physician has a voice activated phone system that states that if this is an emergency, hang up and call someone who cares. Or something like that.

    HI friggen HI larious. I called my doc in Oct of 2020 and STILL haven’t received a call back. 

    Oh wait. One needs to “insist” on a call back. Wait. What? I need to be an a**hole to receive the minimum of what I’m paying for?

    Piss off.

    • #27
  28. Southern Pessimist Member
    Southern Pessimist
    @SouthernPessimist

    Annefy (View Comment):

    Southern Pessimist (View Comment):

    Zafar (View Comment):

    kedavis (View Comment):

    6 days? I can’t imagine someone not going to a hospital ER in a situation like that.

    Exactly. What’s a surgeon’s office going to do without an operating theatre out back that’s prepped and ready to go?

    And any front-office person who stood in the way needs a swift kick in the butt some re-training.

    “Sir, go to the emergency room right away”??

    I may be too far removed from medical care to be sure this is still true, but I think if you insist that a physician or his assistant call you back as soon as possible, you should hear from someone within a few hours and in most circumstances that is soon enough. Every physician has a voice activated phone system that states that if this is an emergency, hang up and call someone who cares. Or something like that.

    HI friggen HI larious. I called my doc in Oct of 2020 and STILL haven’t received a call back.

    Oh wait. One needs to “insist” on a call back. Wait. What? I need to be an a**hole to receive the minimum of what I’m paying for?

    Piss off.

    Unfortunately you do need to be an a…hole to survive in our  current system. Having a police detective with inquisition skills to help you navigate the system is a bonus.

    • #28
  29. CarolJoy, Not So Easy To Kill Coolidge
    CarolJoy, Not So Easy To Kill
    @CarolJoy

    The story you relate, SP, is yet another tragic story to offer up to the public about how the most expensive “health model” in the world is causing so many of us pain and suffering that is unnecessary, and even death as the situation is allowed to go on unchecked.

    In Scandinavian countries, there is the equivalent of a med social worker who does oversight of every health situation.

    There is also a much more intelligent scenario relating to bill paying, which is crucial to a decent outcome.

    So if someone is scheduled for heart surgery, that will be paid for. Then just as importantly,  the patient’s family does  not find out post operative scenario, that the husband and father  cannot get expensive infection-fighting meds due to those not  being pre-approved by the insurer.

    A new dog park acquaintance just related his tale of woe, post op.

    Steve is one of those open-hearted people that few can help liking.

    He had fused vertebrae, and some syndrome perhaps related to that problem that was forcing him to be unable to carry his head normally.

    He was walking around with his head and neck almost collapsed on his breast bone.

    And he was walking over almost bent to the waist.

    Doctors got a hold of him, and Boy oh Boy everything was going to be straightened out by this totally expensive surgery.

    His inability to walk around normally would be restored.

    Not being familiar with the procedure he was to undergo, he figured that since his surgeon was experienced, he’d come out of the surgery with his life given back to him. (Prior to it, he had spent two years mostly in bed, as how does one maneuver with such an unforgiving posture?)

    So the operation was a success.

    He then was handed a bombshell of info: Part Two of this procedure was a need for him to have a specific physical therapy. However no one involved in having scheduled the surgery checked to ensure that this PT would be available.

    The catch in all this was that unless he started this PT regimen within days or a week of the surgery, his condition would not be resolved. Instead, his entire situation would again devolve to the point that his head and neck would be collapsed on his chest, and he would be hunched over and most likel be  back to being bed ridden.

    Even worse than finding this out post-op was finding out that that the physical therapy he needed was not available to him for six to eight weeks.

    On the day I met him, it was clear to see his whole condition was already devolving.

    But who cares, outside Steve and his family? The surgeon, surgical nurses and anesthesiologist all got to perform the operation, and made their salaries.

    This would never happen in a hundred years in Scandinavia.

    • #29
  30. Zafar Member
    Zafar
    @Zafar

    I’d hope not

    • #30
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