As strangers sometimes do when they’re traveling, we share our personal stories. One elderly woman complains of an abdominal problem that has defied treatment. Another explains that she’s visiting her father who is a recent transplant patient.
“He’s at the right place,” intones the senior member of our group. “I come here every year, and I have absolute confidence in the medical care I receive.”
I try to absorb all the information that my fellow pilgrims throw my way. I’ve traveled a long and difficult road to arrive at this world-renowned center.
My problems began a year and a half earlier when I fell backward and landed on my outstretched palm. The pain was immediate, and I went to my HMO family-practice doctor a day later.
“Just a sprain,” he assured me after examining my X-ray. I was sent off with an uncomfortable canvas splint, a prescription for anti-inflammatory pills and the admonition “These soft-tissue injuries take a long time to heal.”
Six months later I was back in his office because my hand was not getting better. I waited several weeks for the results of the new X-rays (which showed a torn ligament) and two months for an appointment with a hand surgeon.
The surgeon said, “If you had seen me sooner, I could have…” That remark made my blood pressure rise. Eight months after my injury, the surgeon put my arm in a cast. “This may just work,” he said cheerily.
Eleven weeks later, when the cast is removed, my hand is stiff and the doctor comments, “You sure do freeze up!” In spite of my limited hand motion, the doctor has no plans for occupational therapy. A new X-ray shows significant bone loss and displacement. The doctor suggests a number of options beginning with “Do nothing” (to avoid the risks of surgery) and ending with surgical fusion of the bones in my wrist.
I’m energized by the unsettling visit to the doctor, and I decide to take control of the spiraling nightmare. In the next four months, I do research and see four different surgeons. Two are in my HMO, one is at a California medical center and the last is in private practice. The managed-care doctors all recommend various forms of fusion, the outside doctors are adamant on a surgery that is less debilitating. The outside doctors point out mistakes that were made by my HMO and insist that the organization pay for my surgery. I meet before the HMO grievance committee to request that they cover the procedure, and they take their time pronouncing the inevitable “No.”
My level of frustration goes off the chart. I decide to pay my own way and find the best hand surgeon to do the job. One day in November–16 months after my injury–I pick up the phone and call the Midwestern medical facility. Within minutes I’m talking to a receptionist who suggests I send my records so the hand surgeon can review them. He responds quickly, describing his philosophy and the various surgical possibilities that he’s found to be successful.
Six weeks later I’m in his office and immediately have the comforting sense that I can trust this doctor. My hand is examined and X-rayed from every angle. I’m seen by several physicians, and the best treatment is determined by committee. I like that.
I feel fortunate that I’m able to have my surgery at such an excellent facility. I’m not so thrilled that I have to pay for my care. But better to pay now, with dollars, than pay later, with a useless hand.
Being an R.N., I may have more savvy in navigating the system than the average person. But I don’t think I’m unusual in my frustration with today’s managed-care plans. My surgery was seven months ago, and my rehabilitation is moving along on schedule. Friends are probably getting bored with all my medical talk, but I have an aunt in Colorado who’s been listening. She asked me to take her to the same medical center so she could have her health problems evaluated.
We may have to travel a few miles, but quality medical care is still available in this country. Unfortunately, so is mediocre care. I’ve received both, and I hope I never have to settle for mediocre again.
