USA Health Care: The Good, The Bad, The Ugly

Health care in the USA can be fantastic. My wife Jane just had her knee replaced. This followed having previously replaced both her hips and her other knee. Things went very well. She has the marvel of whole new knee all meshed into her existing anatomy. In six months she will be able to walk anywhere. The doctor was skillful. The drugs worked. The staff was helpful. It was GOOD!

And it was Bad. When we met with the Orthopedic Surgeon Fellow who was to assist with the surgery he explained that he was unable to find any record of Jane’s previous knee surgery (even though it was at his hospital by his partner!). When checking drugs to which Jane is allergic we found that the list we had provided over and over was incomplete. When we tried to contact the anesthesiologist we were told that who that would be would not be known until an hour or so before the surgery. After surgery we again (for the tenth time) gave the list of drugs to which she has violent reactions. The prohibited drugs were still on the list. But we finally got that right and she was sent to Skilled Nursing away from the hospital.

Guess what: Those killer drugs that gave extreme nausea were exactly the ones prescribed for heavy use. When we told the doctor that we had learned exactly what drugs worked, (including exact dosage) that too got messed up. Then the doctor was unavailable (via phone, text, email or tweet, etc. etc.) for 4 days to correct it. Jane’s nausea returned. Then when she was ready to come home the pharmacist was unable to provide the 25 mg. dosage (which had been 2 pills of 10 mg. each plus 1 pill of 5 mg. and would not prescribe 5 pills of 5mg each. And so the story goes on. It was BAD!

Finally it got a little UGLY. I asked the pharmacist how I could ensure that there would be no time lapse when her current prescription is used up and a refill kicks in. The message was clear “You handle this. Just remember that it takes us 5 days to get that filled if your order comes in on a weekend! And we will refill the order only if it comes in on more than 3 days before the current prescription runs out.

All of this is more than anyone wants to read about. But here is a message all need to know. “If you or a loved one is sick the critical factor for good care: Be an advocate. Speak up. Keep records. Be assertive. Insist on talking to the proper doctors. Pity those poor people who have no advocates or who are unable to speak up for themselves.

 If that can all the handled then indeed medical care in the USA will end up moving through the bad and the ugly and can actually be VERY GOOD!