My patient experience wasn’t an outlier

On a warm and sunny August Sunday, I was rollerblading with my kids on the Shining Sea Bikeway. On mile nine on the trip, I hit a tree root, went flying, and landed on my shoulder.  I could tell immediately that something was wrong — I couldn’t move my arm and was in the worst pain of my life. Feeling for my left shoulder, it was obvious that I had dislocated it. What happened next was that I received some of the best care of my life — unfortunately it was not from our healthcare system.

As I was lying on the bike path, nearly everyone stopped and asked how they could help. A pediatric nephrologist offered to pop my shoulder back into place. I declined. This wonderful couple on a two-person reclining bike stopped and insisted on pedaling me to the hospital. We were far from the road and knew that calling an ambulance was not straightforward. So I sat with my left arm dangling, in excruciating pain, while David rode the bike to Falmouth Hospital. It was a 20 minute ride finishing with a very steep hill. David apologized after each bump on the road as he heard me swear and wince.

The emergency room

We finally made it to the ER, and, ironically, it was then that my care stopped being so wonderful.

It started off well enough — a triage nurse saw me walking in holding my arm, in distress.  She got me a wheelchair and brought me into triage. I explained what happened, gave my name, date of birth and described the pain as the worst of my life.  I was then shuttled to registration, where I was asked to repeat all the same information.  It felt surreal. I had moved all of 10 feet and yet somehow my information hadn’t followed me. The registration person asked me question after question.

Initially, the same ones: name, address, phone #, etc.  Then, my social security number (presumably so they could go after me if I didn’t pay my bill), my primary care physician’s name, his address, his phone #, my insurance status, my insurance #, my insurance card, my emergency contact, their address and phone #, etc.

I told her I was in excruciating pain and needed help.  A few more questions, she said.  She needed the complete registration.

I was wheeled to radiology and sat in a hallway for what felt like forever, groaning in pain. I couldn’t find a comfortable position. Six or seven people walked by — and as they heard me groan, they would look down and walk faster.  The x-ray technologist avoided eye contact.  It was hard — I was right outside her room.

Finally, I asked a passerby if she could help.  Caught by surprise (I must have sounded human), she stopped.  She looked at me.  She then went into the x-ray suite.  A few minutes later, a second technologist came out, saw my arm, and was the first to acknowledge that my arm looked painful.  He told me the ER was pretty quiet and he would get me in right away.

One of the ways we measure quality of emergency department care is to examine the proportion of patients with a fracture who receive pain medications within 60 minutes. While I don’t know who came up with 60 minutes, it wasn’t anyone with first-hand experience sitting in a waiting room in excruciating pain.  Even though I did not have a fracture, my injury was comparable — and I was getting pretty close to 60 minutes when I was wheeled from the x-ray suite back out to the waiting room. I hadn’t been assigned a room, I was told.  Still no pain medicine.  How much longer before I could be seen, I asked? No one seemed to know.  When I was eventually wheeled back to the treatment area, I was told I had to wait for a physician before I could get pain medication. How soon, I asked? No one knew.

The ER doc actually came pretty quickly — he ordered some morphine and things became better.  He was very good at what he did — he manipulated my shoulder and while it was insanely painful, I knew it had to be done. My shoulder popped back in quickly with amazing relief.

The lessons learned

The rest of the time in the ER was uneventful. As I sat on my gurney awaiting the results of the repeat x-ray, I sent out a Tweet. I described the experience as wonderful people, awful system.

1. People who work in hospitals can be wonderful.  One could ask if the people there really had been so wonderful.  Why didn’t the triage nurse take me back right away and skip parts of registration (or at least express sympathy for my pain)? Why couldn’t the registration person wait for the minute details? Why did all those people look away when they heard me groan? I can’t imagine walking by somebody groaning in pain and ignoring them.  Except I probably have.  In the hospital.  And why do we do that? Why do we leave our humanity at the door when we arrive to work?  I assume we just get desensitized to suffering.

What was remarkable was that there were people who were able to break out of that trap.  When I was able to engage someone as a person, they responded.  The woman who stopped when I asked for help.  The second x-ray technologist who expressed sympathy for my pain.  The ER physician who took care of my shoulder quickly when he realized the severity of my pain.  It is the job of healthcare leaders to create a culture where we retain our humanity despite the constant exposure to patients who are suffering.  It’s clearly possible and several people showed it at Falmouth.  And yet, too few healthcare organizations appear to have those kinds of leaders.

2. We have a lousy system.  There were so many reminders in my short visit to the ER.  Asking someone in excruciating pain to repeat demographic information and wait for their insurance information to come up on the computer?  Even when I pleaded with her, she blew it off, reassuring me insurance information was important.  Because that’s how we do business in healthcare.  Making sure I was insured was much more important than making sure I was treated quickly.

When telling this story to colleagues, one person even defended it.  Asking people to wait in pain is fine, she said, because registration information is valuable.  Really? That’s the tradeoff? We can’t design a system where some of the information is obtained when the pain is better? There was no way to take my credit card as collateral and let me go on my way?  Can we really not design a better flow so that patients with severe pain get relief without waiting needlessly? There were so many little opportunities to make my process faster, but it was clear that there was no reason for the hospital to invest in those changes.  No one holds them accountable.  In most industries, the payer holds the provider of poor services accountable.  Not in healthcare.

Not an extraordinary story

The biggest lesson for me was that this was not an extraordinary story at all.  When I told my story to colleagues the next day, no one was surprised. We accept that when we walk into a hospital, we give up being people and become patients.  We stop receiving care, the way I did on the bike path.  Instead, we receive services. And when you are in pain, the difference between care and services is stark.

People in healthcare get upset when they are compared to other industries, but on this one, it’s tempting.  So many companies have figured out how to do flow better.  How to keep their employees engaged and sensitized and not burnt out.  But in healthcare, we underinvest in that.  Companies spend vast amount of time studying flow and thinking about how to ensure that customers get the services they need quickly.  In healthcare, it’s considered a luxury and most organizations do very little.

Part of the reason our acceptance of mediocrity is particularly frustrating is that this is what care looks like in the most expensive system in the world.  If we, as a society, chronically under-funded healthcare services, one could understand the lousy service we often provide our patients.  I could live with being parked in the x-ray waiting area, ignored — if I knew that we were instead spending precious societal resources on education and research and building roads and bridges.  But that’s not our story. We spend an enormous amount of money, and accept mediocre service in return.

Now that we are measuring patient experience and ER wait times as quality measures, I wondered how Falmouth Hospital did.  Out of curiosity, I looked up its ratings. They are fine.  Average. This is not an outlier hospital. My experience was not an outlier experience.

And that is the biggest disappointment of all.

Ashish Jha is an associate professor of health policy and management, Harvard School of Public Health.  He blogs at An Ounce of Evidence and can be found on Twitter @ashishkjha.

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  • FugaziedUp

    I am reminded of a young girl, carried for miles down a mountain by her parents over days, due to lack of EMS, after suffering a GSW to the belly, to our operating table in a tent. After her ex-lap, i had never experienced a family so appreciative of the care she received. But back to how bad our healthcare system is because patients have to give registration info and wait 60min for analgesia for a nonemergent (albeit painful) condition

    • Judgeforyourself37

      Not only did my husband have to give information to one nurse who brought in a computer on a cart, but he had to do this six different times. Give the same information to six different people bringing in computers on carts who would ask the same questions regarding name, age, insurance, previous surgeries, medical conditions, such as hypertension, high cholesterol, diabetes, etc., and he had to over and over give them a list of his medications. Don’t these computers :talk to each other?” Why does a sick patient or his worried wife have to repeat this information over and over? Oh, they had his insurance information, and other information from a recent, unrelated trip to the ER. Thank goodness we have not had to darken their door for a while, now and maybe just maybe they have managed to get their information from one interview, now. However, I would not count on it.
      Why does this happen? Because medical care in the US is a “bottom line” commodity.
      In a previous post someone, a doctor, complained because someone asked for his insurance information before even addressing his severe pain. Had that person NOT obtained that information, she/he would have lost their job. If he was in pain, the hospital did not care, get the money or put in for the money, then worry about a patient’s pain or impending death, if this was the case.

  • guest

    I am honestly a little mystified, although sympathetic to the fact that having a dislocated shoulder is quite painful.

    How is it that a professor of health policy and management, at Harvard no less, does not know why it would be that a community hospital could not afford to maintain ED staffing at levels that would allow for instantaneous attention (and exceptions to administrative routines having to do with payment) to a non-critical patient? Seriously.

    On a side note, if the standard of care (pain meds within an hour) was met, and you were not satisfied with your care, then your quarrel should be with the standard, not with the system that met it. It seems a little unethical also to use your national platform to call out the specific hospital in question.

    • adh1729

      “Why it would be that a community hospital could not afford to maintain ED staffing at levels that would allow for instantaneous attention … Seriously.” Money is the answer, of course. If it was profitable to run a caring ER, then they would exist. Capitalism cares about pleasing customers. Socialism does not.

      • guest

        There’s profit in healthcare, but it’s chiefly being made by the executives and shareholders of insurance companies and drug companies. To me that seems like capitalism, not socialism.

        • Disqus_37216b4O

          It’s far from capitalism, because the person receiving the service is not the person paying for the service.

          The person providing the service is not “working for” the person receiving the service, and thus has no incentive to provide satisfaction to the person receiving the service. The entity providing the service gets paid regardless of how good or bad they are, from the consumer’s point of view.

          The only “customer” the health system as it stands now is working to keep happy, is the government and its cronies in Big Insurance.

        • adh1729

          Obviously profit is being made, so we don’t have pure socialism (yet!)
          I would say, we currently have the worst of both worlds.

          • GT

            Crony capitalism: it’s neither capitalism or socialism, but is a mélange of the worst aspects of each.

    • Mengles

      The effect of the ivory tower is daunting.

      • guest

        It certainly seems to engender a remarkable degree of entitlement.

        On a possibly related note, I am always mildly bemused that the academics who post pieces here about “the missing humanity of medicine,” or whatever, invariably have faculty directory pages which describe them as “practicing physicians,” and list some clinic appointment that they have. Which leads me to wonder about these clinics and whether they are the usual sort of clinic, in which one is expected to crank through a patient every 7-10 minutes and meet monthly with administrators to be nagged about RVUs and Press-Ganey scores. Or are there special clinics with different expectations in which professors of health policy get to be “practicing physicians?”

        • guest

          Actually, after some further reflection, I have answered my own question. Faculty who are “practicing physicians” are probably working in teaching clinics where all of the tedious clerical work is completed by medical students, residents and fellows. The attending gets to come in and hang out with the patient and spend time with him or her after the initial history and physical have been done and documented, and gets to leave after telling the trainees what administrative scut needs to be done to arrange treatment.

          So I guess that would lead to the conclusion that we should all have administrative and medical assistants in order to provide optimal care to our patients. Brilliant!

  • adh1729

    “In most industries, the payer holds the provider of poor services accountable. Not in healthcare.” That’s because the health care system is no longer truly capitalistic. You work for a too-big-to-care corporation, that pays premium dollars to a too-big-to-care insurance company, that contracts with too-big-to-care hospitals. Result? Nobody gives a hang, nobody can change anything, and everyone is just a little cog in a huge system. Middle men run the show.

    It all started with Medicare and Medicaid: somebody took your tax dollars and mine to buy the votes of elderly and poor individuals. The ultimate goal was takeover of the health care industry, and it has been wildly successful. CMS says jump, and we say, how high?
    Uncontrolled healthcare inflation would never have been possible if the doctor and the hospital had always been paid directly by patients.
    Expect universal VA healthcare in the near future, for all but the rich. The clock will not turn back.

  • http://onhealthtech.blogspot.com Margalit Gur-Arie

    Great article!
    The lesson from this “biggest disappointment of all” should be that compliance with all the new standards and ratings and “quality measures” is meaningless. So perhaps those who are in a position to influence how health care is delivered in this country should just pause for a brief moment and reconsider the mind numbing rhetoric we’re all being drowned in these days.
    Hint: Genuine human caring has very little to do with payers holding providers “accountable”.

    • guest

      Seems like that could be the topic for a very interesting study should someone like a professor of health policy and management care to investigate:

      “Relative amounts of time spent by healthcare providers in performing direct patient care compared to time spent engaging in non-care activities related to documentation, quality assurance, compliance, continuing education and coding.”

      I really do wonder why no one has looked at this…

    • Rob Burnside

      Mind-numbing rhetoric isn’t new, it’s just more numerous and more numbing than it ever was–an unfortunate by-product of our service economy, I believe. Formerly, in a manufacturing economy, if the Widget didn’t work it wasn’t wonderful–in other words, no one bought it. As health care consumers, most of us don’t have that choice today. This perpetuates mediocrity, in a place where it really doesn’t belong and shouldn’t be tolerated for a moment. And, all the “time studies” in the world can’t fix it for long.

      Your hint is right-on, M. But how do we re-infuse caring in our caring industry, an industry that was formerly a service, but has been sliced, diced, and re-issued in “new, improved” Widget packaging? If you want an interesting comparison of industry now vs. industry then (the 1950s), rent or download “The Pajama Game,” a great Broadway musical about the garment industry in NYC. It’s a fine production–many nifty songs–with a theme of industrial efficiency vs. humanity remarkably presaging the subject at hand. And if I’m way off, at least you’ll enjoy a good show!

      • guest

        We really don’t need to “re-infuse caring” in our industry. Caring comes from people, and the people who are benighted enough to go into primary care (and stay there) are clearly doing it because they are caring individuals.

        What we need to do is recognize that the current way in which our industry is being managed leads to insurrmountable barriers to caring people being able to provide that caring. We need to stop giving people tasks that prevent them from doing what they want to do–take care of patients.

        Until we do that, and there is less time spent on documentation and clerical activities, no amount of regulation will “re-infuse caring.” And to the extent that whatever regulation or “re-training” is put in place results in additional paperwork for the provider, it will only exacerbate the problem.

        • Rob Burnside

          You’re absolutely right across the board! Perhaps “re-infuse” was a poor word choice. I was thinking more about the system itself, not health care workers per se. Function follows form in this case. You and I know health care as truly caring in the main, primarily because of the people working in it, but watching as it is re-designed for maximum efficiency, with caring as an afterthought, injected here and there like Botox, upsets us–as it should. I’m 65 and near journey’s end, but I worry about my children and grandchildren. Will our “new norm” remain their reality? In the future, will health care careers draw more technocrats and far fewer altruists? I, for one, hope not! I suspect you might agree.

          • guest

            Absolutely!

          • Rob Burnside

            I see your “Absolutely!” and I’ll raise you a “Positively!” Better yet, I’ll call. Thanks for the mid-course correction!

        • Mengles

          benighted = in a state of pitiful or contemptible intellectual or moral ignorance, typically owing to a lack of opportunity.
          Wow, what a back-handed slap to PCPs.

          • azmd

            If I had not used “benighted” ironically then it would have been a slap.

  • kjindal

    maybe you didn’t get morphine quickly enough. but I bet the electronic medical record the hospital used was able to document whether you were treated for CAD, and if so, if you got an aspirin; and whether you were offered an influenza vaccine. and whether you were treated for presumed pneumonia, and if so, got antibiotics within 30 minutes.

    And in the time someone was documenting all of that for you (one patient), another two patients were seen seeking narcotics, well-known to the ER staff as “frequent fliers”, possibly uninsured that the hospital, ER staff (possibly voluntary rather than employed by the hospital) will never see a dime for.
    You should check out the recent JAMA article sept. 18th “medicare payment for chronic care delivered in a PCMH”- right up your alley of administrative gobbledygook that starts with an agenda (use electronic records, NPs, and produce yet more documentation) and then expects everyone on the ground to jump for joy in anticipation, with MAYBE the prospect of getting a few more pennies from CMS in the process. Just 2 weeks earlier in JAMA is an article exposing the failure of ACOs to reduce costs (“ACO effects on health care spending and quality” aug 28th).

    • Payne Hertz

      He should count himself lucky he wasn’t falsely accused of being one of the 2 out of 3 patients you imagine are guilty of drug seeking. Then he would have discovered just how inhumane and barbaric this system can be when he was denied any pain treatment and left to wait for hours as punishment before they popped his arm back in.

      Then they would have added insult to injury by accusing him of drug-seeking in his medical records.

      He doesn’t mention it, but I imagine the MD after his name led to more expeditious treatment than the norm.

  • Noni

    Great article with a couple of really poignant statements towards the end:

    We accept that when we walk into a hospital, we give up being people and become patients. We stop receiving care, the way I did on the bike path. Instead, we receive services. And when you are in pain, the difference between care and services is stark.

    Part of the reason our acceptance of mediocrity is particularly frustrating is that this is what care looks like in the most expensive system in the world.

    So when practitioners become patients it is horrifying to see how bad our care is. When my son came in to the ER with a head injury I was frustrated though not surprised when first and foremost they needed to see our insurance card. Experiences like these bring humanity back to practitioners so that for a brief time they deliver care again – at least until they become desensitized again.

    • Michael Rack

      Some practitioners don’t experience this because they get VIP treatment, especially if they (or their family) go to a hospital where the practitioner has privileges. The author of this article went to a community ER where he did not have privileges

  • Michael Rack

    agree. He wasn’t suspected of being drug seeking because he came in with an objective, acute injury rather than with 1) a chronic problem, 2) subjective problem, or 3) recurrent painful conditions. (disclaimer: I am NOT saying that people with 1-3 are drug seekers)

  • Mengles

    Can’t help but wonder if this is a way to sow distrust in community hospitals, considering the author’s employer’s hospitals are Brigham and Women’s, Mass General, and Beth Israel Deaconess who monopolize the healthcare market in Massachusetts.

  • Guest

    Yep. I’m an MD, and the MA at my former OB-Gyn’s office told me that for an acute problem I could not get an appointment before 48 hours as they needed to request my chart from medical records, and this took at least 48 hours.

  • Noni

    I’ve been a patient or parent of a patient several times now. I’ve found the experiences satisfactory, sometimes frustrating, never exemplary.

    It just dawned on me (yes, I’m slow) that I may have in fact received VIP treatment, meaning that the typical patient experience is seriously horrible.

  • DeepBreath

    I’ve become convinced, based on my own experiences, that arriving at the ED as a “walk in” is deemed less urgent than arriving via ambulance. I’ve never seen a patient on a gurney being wheeled in by an EMT/paramedic stop at the registration desk or have to produce insurance information.

    • medicontheedge

      Nope. Ambulances are triaged just like walk-ins. You just don’t SEE the exchange of insurance and other info.

    • GT

      Yours is the misconception shared by all those who ring for an ambulance when they really COULD make it in under their own steam, but think that coming in via ambulance with a stuffy nose or a rash or indeterminate chronic pain will let them queue-jump.

      These people are almost inevitably getting “free” ambulance transport and emergency department care, courtesy of the taxpayer, so they care not about the cost.

      • medicontheedge

        Spot on… from your language I imagine you are from the UK? We have the same problem here… I have heard these abusers of welfare and the system state that it’s “free”. *snort*

      • SarahJ89

        That’s interesting. I’ll have to let the ER staff person who told my niece that it was her fault her husband’s head injury wasn’t treated in a timely fashion because she hadn’t called an ambulance. “He would have been treated right away if he’d come in an ambulance.” were the exact words. The fact we live in a rural area and it would have taken an hour to get to the ER in an ambulance due to the delay in having it arrive on the scene of the accident didn’t appear to factor into the thinking at all. The attitude of “It’s your fault” was actually more of a problem.

  • medicontheedge

    Our ED has been doing the “RME” thing for about a year now, and aside from a few glitches in the learning curve, it is working well. Needs are addressed before demographics and insurance info is obtained for people who have never been in our ED. “Quick registration” has been a real boon to decreasing our door – provider times, and patients get treatment quicker. Pain control is at the top of the list, which is always fraught with problems, due to a population of “drug seekers”, but we all know who they are. That being said, even a “drug seeker” will get pain meds if they have objective signs of distress.
    It is too bad this Doc had such a crappy experience.

    • Judgeforyourself37

      Where is your hospital? It sounds as if they are actually caring for patients.

      • medicontheedge

        A medium sized community non-profit in central CT. We are not perfect by any means, but we do alright!

  • FugaziedUp

    Concur…call me crazy, but if go to the ER for a true emergency, the only thing I care about is how timely my emergency is treated, The compassion with which it is delivered is pretty low in my list of needs at that point. In this case it sounds like it was treated in a timely manner. Additionally, although it may be difficult to see when in pain, the “care” and compassion that the author claims was lacking, comes in many forms…a bystander willing to swiftly reduce the dislocation, being whisked to radiology immediately after registration, quick bed placement after a trip to radiology, a quick physician evaluation/reduction…not just an opiate-filled syringe. I couldnt foresee any problems with the administration of immediate analgesia to every patient claiming 10/10 pain on their way through the door.

  • Judgeforyourself37

    It is obvious that you have never had a dislocated shoulder. To get that shoulder back in place is terribly painful and must be done by someone who has experience in doing so. It needs to be done under sedation, and it is not something any “just anyone,” even a doctor can do. An ER/Trauma physician has training and experience in doing this and would never do this without sedating the patient first.

    • flowerdocs

      There are many ways and places to relocate shoulders; I’ve done it myself successfully in an urgent care setting. In the nineteenth century it was done by country doctors, including women physicians, without the benefit of IV sedation, etc. The pain miraculously goes away once the shoulder is relocated. While it is nice to drug up your patient for the procedure it is not always a necessity, especially if the patient has had multiple dislocations in the past. In that instance, the patient can be taught to relocate his/her own shoulder without medical intervention. So a blanket statement that only a trauma physician should touch a patient with a dislocation is simply untrue, as is the need to always sedate the patient.

  • Judgeforyourself37

    Sadly, the scenario that you cite is all too common. I hope that your arm healed well, after your ordeal.

    • SarahJ89

      Thank you, yes. When all was said and done the arm did heal well. I have pain at odd times, but I was a geriatric social worker in my youth. All of my clients had “bunches” or rheumatism or scars that were highly predictable weather indicators. I always knew when a storm was coming–my clients’ pains were far more accurate than the weather folks. Now I have one of my own. I hate having a plate in my arm, but am grateful to have my arm back.

      Actually, I use that arm more than I ever did. I’m highly right-handed and made a point to use that broken left arm once I was cleared. My doctor didn’t refer me for PT because he said “You’ll do it yourself. At this point you can make yourself hurt, but you can’t hurt yourself.” That’s all I needed to hear. He was correct. I live and work on a farm. Gotta pick up that bucket of water? Use the LEFT arm to build it up. It’s now stronger than ever and I continue to make a point to use it more.

      But I’ll continue to avoid the ER.

  • Sillycibin

    Sadly the system is the way it is because people abuse it. Drugs seekers and so many chronic pain patients who are irresponsible and miss their follow ups or screw up their relationships with their pain management folks. Plus the crazies.
    The fact is, we can’t just blindly trust everyone who walks in the ER door. Day after day of being lied too, manipulated, or having to deal with schizo or bipolar patients leads to a jaded routine and nurses and docs don’t want to step out of their routine for fear of being taken advantage of.

    • Suzi Q 38

      There are the crazies and the drug addicts but there are the average patients who are sane and just need medical care.
      Surely you can figure out the difference. That being said, you are trained and paid to treat everyone, regardless of who they are or what their life circumstance is.

      Taken advantage of?? Maybe you are so jaded that it is time to get out of the ER and find a different place to use your physician skills. In the ER you get all sorts of people from all walks of life.

      Maybe you need to work in an different type of setting more to your liking and skills.

      Moving on when you don’t like it or trust the patients is a better idea than the constant fear of being taken advantage of.

      • Sillycibin

        Maybe you need to walk a mile in my shoes before you criticize me. Do you work in the ER? If not, then you don’t know the challenges I and all the other providers face.
        I can usually tell what kind of patient I am dealing with, but I don’t see the patient until they get back to a room.

        Here is something else, the majority of the patients who come to the ER are legit and really are sick and in pain. Some critically so. We see everyone as soon as we can but everyone needs to be seen. And if people have to wait while sick and in pain, it is probably because we are treating someone else who is sick and in pain. We aren’t sitting around on our butts.

        • Suzi Q 38

          “……Here is something else, the majority of the patients who come to the ER are legit and really are sick and in pain. Some critically so. We see everyone as soon as we can…..”

          This reality is not what you described in your other post. The way you described your patients the first time, around, one would think that you thought otherwise.

          You needed to come up with a combination of your two posts to get an accurate description of your patients.

          I knew the majority that walked through your door were not “..drug seekers….chronic pain patients.. crazies…scitzos or bipolars.

          I know because I have been through the door more than once in my lifetime and I am none of the above.

          I can only guess that there are more of us.

          Moving on when you don’t like a job or line of work makes sense.

          You can do so much in medicine that you don’t have to work in the ER at all.

          “…….We aren’t sitting around on our butts.”

          I didn’t say that you were, and I doubt that you are.

  • Suzi Q 38

    I agree, but some just do not care, so it is best for US to move on to a different provider who does care. They exist.

  • Suzi Q 38

    You only waited 3 hours???
    I stupidly went to the ER to get stitches on my thumb…
    My cousin slammed the sliding side door of my mini-van right on my thumb, as hard has she could.
    I realize that I should have gone to the urgent care; but none was in business at the time.

    I ended up waiting 8 hours.
    It was a Saturday night.

    • SarahJ89

      When I described the ER waiting room to my nurse friend she said “Oh, that’s because all these people come in with sore throats.” Wrong. These people were in severe pain. I doubt they were med seeking since no one was watching them as they writhed in obvious pain for the 90 minutes to two hours I was there.

  • SarahJ89

    This totally agrees with my experience. I owe my well being to the skills of a few, but in general medical care in my 65 years has gone from a person-to-person relationship that was private and helpful to an intrusive, marketing-oriented, computerized and adversarial experience I can only hope to survive.

    I trust my individual medical provider as a person but I do not confide in her anymore because my concerns no longer stay in that room. Nope, they are duly noted on the computer in which she has her head buried and are available to a marketing “team” to which I never signed up and which harasses me to buy their screening products. There is no longer anything that resembles a helpful relationship or privacy. Medical care, like so many other professions, now resides squarely in 1984–lots and lots of doublespeak.

  • SarahJ89

    Here’s the problem with relying on patient satisfaction to guide medical care: the facts we need to make such a judgement are mostly withheld. I worked in hospitals and rehab settings for decades, but find it nearly impossible to discover if I’ve actually received good care. I can tell you if people are nice to me, kind, empathetic, etc. But do they have good medical judgement? Were those instruments sterilized correctly? Did I get the correct medication in the correct dose for my rapidly aging self? I cannot tell you that stuff. And that stuff is the important stuff.

  • bjt1970

    The delay in treatment that is caused by making sure the patient is insured can be almost entirely addressed by a single-payor health care system such as Canada’s system. Unfortunately, I was born south of the border right here in the USA.

  • Margaret Fleming

    Thank you so much! I wasn’t in horrible pain, but had memories of some earlier bad experiences to overcome, when, in for an unexpected Xray, I had to repeat all the info I had just given the preceding DAY in the next room of the same hospital’s imaging building! And then more info besides!
    Who’s in charge?

  • http://warmsocks.wordpress.com/ WarmSocks

    I wondered the same thing. Why didn’t he let the doctor on the bike path do the relocation?