Are We Caring For The Patient Or The Health Care System?
I was visited by an old nemesis this week. One I knew well but had not battled with in five years. Cellulitis of the breast due to a lumpectomy in 2003 came roaring into my body and within a matter of two hours had created a 102 fever, chills that left me shaking uncontrollably, muscles painfully contracting, and the left side of my torso hot, heavy and hard. I was in trouble with a familiar foe that left me stunned at the sudden and quick attack. For those unfamiliar with cellulitis, it is a bacterial infection that left untreated can quickly escalate to sepsis (a potentially life-threatening, whole-body response to infection). As instructed, I keep a stock bottle of antibiotic in the house or with me during my travels and immediately started a dose. But the night was long and I knew that I had to get in touch with my Infectious Disease Physician to get on an IV infusion of antibiotics as soon as possible.
And that’s when the trouble started.
At 9 am the following morning, I called the office and explained my plight. I was told that since I had not been to the office in almost five years I would need to see my general practitioner first. Thinking the receptionist was speaking about health insurance coverage; I told her my insurance did not require a referral. Nevertheless, the doctor would not see me until I was referred. Folks, for future reference, this means that they have put your medical record in storage (Am I dead yet?) and someone needs to go get it. Being too weak to argue, I phoned my GP and was given a 2 pm appointment. I show up at the GP’s office and with one look at my hot, heavy and painful breast was told “You need antibiotics and possible admission!” Haven’t I been saying that? I explained that this had happened before (the GP had never seen me for this) and that what I needed was an IV antibiotic which could be administered as an outpatient. Would she call my Infectious Disease Physician? A deal was worked out that if the ID physician could see me and administer the IV I would be spared a hospital admission, but if not….
At 4 pm the ID physician did indeed see me and ordered the IV antibiotic to be administered immediately.
But not before I shared my opinion.
We are no longer practicing medicine but we are being managed as cattle through a system we call healthcare. It’s more about the care of the health care system with its standards of practice, procedures and protocols than it is about patient care. We have given up caring for the patient in lieu of caring for a system.
I explained to the ID physician that I could have been here a whole lot sooner but had been put off by the office. Now at almost 5 pm after being charged for two office visits, I am finally receiving the care needed. In addition, the cost of treatment has now been increase because of paying overtime to an IV nurse who doesn’t need to take more time away from her family. All because the receptionist didn’t ask the physician for guidance, but empirically decided that I was to be treated as a new patient. One size does not fit all, folks!
The ID physician’s response was that they would speak with the front desk but that I could have gone to the emergency room for treatment. Wow! Now that’s quality of care. And of course, had I not known what was happening or what needed to be done, not had the oral antibiotics, or how to do it without costing me or the insurance company thousands of dollars, I would have. But let’s assume, we all just went to the emergency room for whatever our needs were because we are no longer able to have access to our physicians. We would no longer need the private practice physician – would we? It seems as though health care is leading in that direction.
In defense of physicians, practicing in today’s healthcare system is like walking a tight rope without the use of arms for balance. Difficult at best. The healthcare protocols, and practices in our medical system were created without much physician input and the system is not oriented to good patient care. It has been transformed from doing what is best for the patient to dollars and cents and cost effectiveness. The physician is caught in a system where they don’t have the freedom to practice medicine and to adhere to their Hippocratic Oath. We must remind all healthcare providers that there is “an art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon’s knife or the chemist’s drug.” We desperately need to pray for our health care providers: doctors, nurses, emergency medical staff, et al as well as for change in our health care system.
Add yourselves on the prayer list as well. Pray for one another as people and patients. Pray that we have the wisdom to empower and educate ourselves with the knowledge of health care practices today, be in partnership with our healthcare providers, and view ourselves as consumers shopping for good quality care. Your life could depend on it.