Thursday, October 22, 2009

What We Have Here

...is a failure to communicate. Today's follow-up appointment continued the Kafka-esque trend of our discharge experience. We arrived at the hospital half an hour early for James's pediatric gastrointestinology appointment, because he was supposed to have some blood work done immediately before the appointment. We show up at the lab, and they won't do the labs because the lab request is on the wrong form (a prescription form rather than whatever they need). So they send us over to the check-out desk. At the check-out desk, they tell us to go to to the waiting room and a doctor will come out with the correct form. Meanwhile, at the check-in desk, they told us to let them know when we're done with the lab work. Well, the doctor never appears to give us the forms, so we can't get to the lab. After time passes, I let the check-in desk know that we're still there, and finally we get called back into an exam room.

When the doctor arrives, we find out that 1) they don't really know why we're there, 2) they have only the most minimal information about James rather than his complete discharge summary or medical records (despite this being in the exact same place as his Monday appointment where they did have access to this info), and 3) they didn't know about any lab work that was supposed to be done. We thought someone from the NICU had been in touch with them. After all, we had not requested this appointment; the NICU doctors had set it up (our impression was to follow his bilirubin levels and make sure his liver function was continuing to return to normal).

The doctor did increase James's dose of reflux medicine (and we liked his straightforward approach -- he was clearly a very knowledgable person), but it really didn't seem like a necessary visit. He gave us the right form for the lab, and we were able to get the bloodwork done after the appointment.

The upshot is that we spent all afternoon and a $60 copay for lab tests that probably could have been done through our pediatrician instead. The doctor that coordinated our discharge is a nice person and (as far as I know) a competent physician, but she owes me about six hours of my life back.

And the process of getting the diagnosis mix-up removed from James's records is apparently making its way through multiple departments, including Risk Management, Medical Records, and possibly the Legal department (why Legal? we have no idea).

But on the bright side, both of the boys were smiling and happy this morning. Matthew seems to have learned how to bat at the toys on his activity gym, and finds it very entertaining, while James enjoyed "Barnyard Dance." Top photo is Matthew and the bottom one is James. At the home health visit, James's blood pressure was good and his weight was 10 lbs, 8 oz, so all is well on that front, too.

2 comments:

Ann said...

Yep! I can relate to all of that! That is why now I lug a suitcase around (well at least it feels like it) with every report since I became ill.

My favorite was when I was just about getting ready for my chemo treatment and the finance lady comes running in and says how are you going to pay for this $18,000 chemo treatment ([pretty cheap for chemo but it was only 4 ML) and I had already being doing this CLINICAL TRIAL for a year and a half! I said this is a clinical trial the chemo is included!!! She looked baffled! I could not stop laughing and said I can be done today, no problem! In surgery, I had them mark YES and NO on what they were removing!

It is so frustrating to deal with what you are going through then you have to deal with the incompentence of probably ONE PERSON who gets the whole ball rolling! The ball rolls faster down hill distributing the wrong information then uphill in getting it corrected! Forewarning, this will all dwindle down to the insurance company too!

However, the babies look beautiful and happy!

Love Auntie Ann

Ann said...

But on a uplift note, once you get down to one primary doctor and you are only seeing the specialists every six months or yearly, it will get better too! Everyone will eventually get on the same program, I am sure you will make sure of that!