Monday, July 20, 2015

And We Call This Health Care

We rarely go to the doctor. We just don't. We never had health insurance when I was growing up, that I'm aware of. Nor did we have it the first 15 years or so we were married. So we never got in the habit of being doctor-goers.

Of course now we are forced to have "affordable" health insurance. Not that we can afford it, but our government assures us it's affordable, so it must be. In spite of that, we still don't go to the doctor much.

Our experience over the weekend really doesn't do much to make us want to change that.

Thursday evening Lyle showed me that his foot was swollen and red across the top. I had him soak it in epsom salts and essential oils. By Saturday it was looking worse and he just wasn't feeling good in general. I figured it was probably infected and needed an antibiotic. I took a picture of his foot and texted it to my sister, who has 30 years of experience as a nurse.

"Yeah, that doesn't look good," she said. 
"I think it's cellulitis. He probably needs Keflex."

On Sunday afternoon I finally convinced him to go to the urgent care clinic. The PA on duty looked at his foot.

"Yeah, that doesn't look good," he said. 
"I think it's cellulitis. I'll prescribe an antibiotic."

Great! That's what we needed. $20 co-pay. Isn't urgent care wonderful?

Oh, wait. Not so fast.

The PA started tapping around on Lyle's chest with his stethoscope with a very concerned look on his face. He asked if Lyle had been experiencing any chest pains? No. Shortness of breath? No. Hmm. Well, there was something not right here. Better do an EKG right away. So the nurse wheeled in the equipment, stuck little tabs to Lyle's skin in various places and hooked all the wires up. The machine spit out a paper. The PA came scurrying back in.

"This is not good," he said. "You need to go to the ER right away. I'll have the nurse put in an IV and the paramedics can take you to the hospital. There's something going on with your heart."

Lyle and I looked at each other, completely baffled. "But I feel fine," Lyle insisted, "do I have to go in the ambulance?"

"Well, I can't make you, of course," said the PA. "But you do need to go right away. I'll call and tell them you're coming. This is much more urgent than your foot. But they can finish up with that there, too."

He handed us a copy of the EKG print-out, and we walked out to the car. "Do you want me to drive?" I asked Lyle. He rolled his eyes, "Of course not! I feel fine!" he insisted. I just hoped he wouldn't have heart attack as he drove. The PA had me worried.

It was about 5 miles or so to the hospital. We checked in with the receptionist in the ER. "Why did they send you over?" she wanted to know. I had to look it up. Premature ventricular contractions. "Oh, PVC?" she said. "Those are very common. Nothing to be concerned about. But have a seat."

In a few minutes Lyle was called into the triage room. The PAs checking him in looked at the EKG printout. Any chest pains? No. Shortness of breath? No. Hmm. PVC is very common. Nothing to be concerned about. "But we'll get you back as soon as a room opens up and have the doctor take a look." About the foot...

"Yeah, that doesn't look good," they said. 
"I think it's cellulitis. You need an antibiotic."

Soon enough we were called back to the exam room. The nurse came in and installed an IV line and drew several vials of blood. PVC is very common. Nothing to be concerned about. But that foot doesn't look good. She departed.

The doctor came in. Any chest pains? No. Shortness of breath? No. Hmm. PVC is very common. Nothing to be concerned about. Should probably run another EKG, though, just in case. The foot, though:

"Yeah, that doesn't look good," she said. 
"I think it's cellulitis. I'll give you an antibiotic."

And she departed. We waited. An orderly came in to check the supply cupboard. 

A student volunteer came in to see if we needed anything. Nope, we're good, thanks. 

The registrar came in to finish filling out Lyle's paperwork and to get the all-important insurance and payment information. 

And we sat. And waited. 45 minutes later the student volunteer was back. We asked if she could see what the hold-up was on having the EKG. Before she left, the doctor came back in. "Has the nurse done the EKG yet?" No, we've just been waiting. So the volunteer and the doctor scurried off to find the nurse.

The nurse wheeled the EKG machine in and hooked Lyle up again, and printed the report. Then she hooked the IV up to a bag of (guess what?) Keflex. "It will take 20 or 30 minutes to drip in," she told us. "Press the call button when it's done."

The doctor came back. The EKG is normal. PVC is very common. Nothing to be concerned about.

"Why?" we asked. "Why did the urgent care PA send us over here, if this is so normal?"

"Oh, they just don't see them as often as we do. Better be safe than sorry. We'd rather it turn out to be nothing, than them not send you, and it actually turn out to be something."

Because, of course, they aren't the one paying the bills.

After 35 minutes the antibiotic finally finished dripping. The nurse unhooked all the wires and tubes and handed Lyle a prescription for (guess what?) Keflex to continue taking orally. He put his shirt back on and we went home.

But not before stopping at the pharmacy to pick up his prescription.

Co-pay at the urgent care clinic. Co-pay at the emergency room. Probably more co-pays on the two EKGs.. and the IV... and who knows what else. Four hours of our day. I'm just glad we declined the ambulance!

Why can't a nurse with 30 years' of experience, who can expertly diagnose a simple condition via a texted picture, just prescribe the antibiotic?

That's really all we wanted.

1 comment:

Heather said...

Perfect example of the ludicrousness that is modern medicine under the majority of circumstances. I am so sorry you got caught in the wheels. 😒