Service of Harried Healthcare Staffers: Impact on Patient Patience & Security

July 27th, 2016

Categories: Database, Facts, Identity Theft, Medical Administration, Medical Care, Medical Records

Nurse at desk

A friend wrote this post and the timing was perfect. It took two days for my husband to receive a prescription last week when it formerly took hours. One misplaced prescription spawned countless phone calls because the pharmacist never got the first digital request. Before the “new and improved” system—I wrote in April about NY State’s electronic prescription law–often meds were waiting for him on his return from his appointment. Thank goodness it wasn’t a life-saving medication.

She wrote:

Have you noticed that the support staff in many doctors’ offices seems overworked?  Because they are, you may have been on the receiving end of deep sighs, harrumphs, blank stares, disconnected calls or worse. And because these things happen so frequently, I guess we have to learn to live with them. But when, within a 24-hour period, three harried-health-care-worker incidents occurred that not only inconvenienced me but also potentially put my identity, my health and my mother’s health at risk, I got angry.

Bloody Irritating

receptionist in dr officeThe first incident involved a blood draw at a hospital that consistently earns a top ranking on the U.S. News & World Report list of top hospitals in the country. The patient who had registered with the receptionist just before me gave her a hard time about something. I wasn’t really listening but I was aware that the patient had raised her voice before storming out. I was next in line, and as I approached the check-in desk I instantly decided to be extra-nice to the receptionist, who clearly was frustrated.  I made some upbeat small talk as I handed her my prescription, which was written in typical physician hieroglyphs. She narrowed her eyes and asked no one in particular, “Why can’t doctors write more clearly?!” Since she was having difficulty deciphering his handwriting, she summoned a colleague for assistance. I watched as the second set of eyes narrowed, and then a what-do-you-think-this-prescription-says guessing-game commenced.  I quickly offered to call the doctor to get the definitive word about the prescription—which, of course, is what the receptionist should have done–but I was ignored. So, because I was facing a time crunch, I proceeded to the lab, had blood drawn, and then headed home. By the time I reached my house, there was a message on my answering machine from the lab manager informing me that they had not drawn enough blood because they had misinterpreted the physician’s instructions. As a result, I needed to return to the hospital. Not only was that inconvenient, it also left me wondering whether their final interpretation of the doctor’s handwriting was correct or not.

Facts? What Facts?

Patient recordsLater that day, I brought my elderly mother to an appointment with a pulmonologist. Although this was the first time she was seeing this doctor, he is affiliated with the aforementioned hospital, where she’d had several admissions. This facility keeps a centralized database of patient records, which is accessible to all doctors affiliated with the hospital. Because the doctor’s staff neglected to send us paperwork in advance, I spent 20 minutes entering mom’s current health data. She takes lots of prescriptions, and the dosages and names change frequently. As a result, she always carries an up-to-date list in her handbag.  At the conclusion of the appointment the staff gave us a report with test results and other info. My mother glanced at it and noticed that some, but not all, of her current meds were listed, and the report included several mistakes in dosages. I knew I had not entered incorrect info on my mother’s paperwork, so I asked the receptionist how all these errors had happened. Did the old records override the new ones? Did someone choose not to enter the new info because they were too busy? I’ll never know because I didn’t receive a coherent explanation. What’s the point of providing a list of a patient’s current meds if the info isn’t entered into the patient’s records? More importantly, how can a doctor make sound recommendations to a patient if the doctor doesn’t have up-to-date facts?

Vanishing Act

medicare cardThe third incident occurred the next morning at a surgeon’s office. I had been there at least five times over the past four months for treatment of a complication following a procedure. At my April appointment I provided updated insurance information and watched as the receptionist photocopied my brand-new Medicare and insurance cards. By the time I arrived for my next appointment, in July, that info had vanished. There simply was no record of it. When I told the receptionist which of her colleagues had photocopied my cards, I was met with blank stares. I ask you: Where does this stuff go??? The incident was disturbing because those cards included everything needed to steal my identity. Although the receptionist reacted with a shrug of her shoulders and a “yeah, this happens every day” attitude, their carelessness was a big deal to me because it has the potential to cause significant consequences.

I get angry and concerned when mistakes are made by health care employees because there simply is no room for error in their industry.  Am I unrealistic, or do I have a right to feel this way? More importantly, what can patients do to ensure that no one involved in their health care cuts corners?

 

blank stare

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9 Responses to “Service of Harried Healthcare Staffers: Impact on Patient Patience & Security”

  1. Jeanne Byington Said:

    Guest Blogger,

    In short, you should be angry. Imagine if on top of everything else you didn’t feel well enough to parry these issues or your mother didn’t have you to bat for her. And you are still left with questions that nobody can–or bothers–to answer.

    In addition to all the potentially hazardous repercussions these workers might cause, I shudder at the waste of time–yours and theirs–in addition to the anxiety the slapdash, ho-hum, unprofessional attitudes and results you suffered over two days.

    While not the solution for everyone, we registered my husband with a doctor using a tablet. This isn’t a perfect solution either: Patients can make mistakes by clicking the wrong response because they don’t understand the questions and the program seemed to be sponsored by big pharma and once the key health questions were over, a whole bunch of what appeared to be info for marketing purposes cropped up. And of course, not everyone is up to using a tablet.

    I fear that the answer might be to pay for healthcare and forget trying to work within the system to acquire insurance. What a horrible kettle of fish that would be. If I win the lotto–and it would have to be a big one–that’s the road I’d consider. Meanwhile, like everyone else, I keep my fingers crossed.

  2. Nancy Farrell Said:

    I was once a patient at a general practitioner’s office that refused to fit me in for a same-day appointment on more than one occasion. In fact,the staff referred me to a walk in clinic. This happened more than once and when I followed up with my doctor the second time, he wanted to know why I hadn’t called his office in the first place. I told him that his staff said they couldn’t fit me in even though I’d called first-thing in the morning. I could tell he was angry about this because his face turned red. I never had another problem with that again after that.

    Another doctor’s office kept asking me for my insurance card every time I brought my daughter in. They claimed they didn’t have it. The third time it happened I asked what date of birth they had on the file they were holding. Sure enough, wrong month, wrong day, wrong year–wrong patient. Their explanation was that they have 3 patients with the same name. Maybe so, I asked them, but how many have the same date of birth and how many of these patients live with me? When I mentioned it to the doctor he wondered aloud why it kept happening. I told him they needed to check the address or some other information but he stared blankly at me. I have since changed doctors and even though the drive is much, much longer, it is worth every minute to have confidence that my daughter is getting decent care by people who are looking at her very own medical history.

    Try to resolve the problems and if you can’t then take your business elsewhere.

  3. Lucrezia Said:

    Perhaps some of us might be better off taking our chances and avoiding doctors altogether. The oath, “do no harm” does not appear to be heeded, so why pay to be maimed, or even killed?

    On a less flippant level, something is very wrong with the current system. While citizens of some countries can live free of medical worries, which includes not losing everything because of huge bills, the ordinary US citizen must live under the constant stress aggravated by incompetence and soaring insurance costs. The sooner this issue is removed from the political scene and made into a societal problem, the better.

  4. Jeanne Byington Said:

    Nancy,

    I could be blind “thanks” to the power of a front office person. This was a nurse practitioner. I experienced a scary eye sensation so I called the doctor–it was a Wednesday–and asked to come in right way. She said not until Monday! I gave her my parent’s eye history and said I’d like to come in sooner. She “squeezed” me in that Friday. She was in the examining room when the doctor looked at my eyes. He said from my description it could have been a detached retina, in which case he’d have to operate immediately. In fact, it was something related to migraine headaches. I was intimidated by her being in the room and unnerved by the potential eye troubles and didn’t say anything–but someone must have as she was gone the next time I went.

    Data entry is an essential job but I wonder how many bosses tell staff how crucial it is in any field, especially medical. Wearing my luddite hat, when there were paper files, mistakes happened but not like this–nor this often –and not to me or my friends and relatives. It was rare.

  5. Jeanne Byington Said:

    Lucrezia,

    One of my favorite doctors has the two week “rule.” It’s really a suggestion– for a cold or a twisted back–clearly NOT if you have chest pains or signs of a stroke, 105 fever or other serious malady. He wants to know if the cold or other non-life-threatening situation bothers you after two weeks.

    The system sure doesn’t seem to be working. To add insult to injury [pun!] throwing money at it hasn’t helped: everything costs more–the insurance, medicine, the co-pay–and many deductibles are huge. One friend carries a $6,000 one. If you live paycheck to paycheck, you either don’t go to the doctor or your credit card bill can sink you with $4,000-$5,500 worth of bills.

    Once acknowledged as a societal problem, who, but politicians, will address and fix it? Such a mess.

  6. CG Said:

    The solution in Nancy Farrell’s comment–to bring the unacceptable situation or shabby treatment to the attention of the doctor–is a good one. Doctors need to know when their staff is under-performing or screwing up. I did this once with a pain-management specialist. Much to my surprise, he actually defended his staff, saying they were overworked. I couldn’t believe it! I wanted to tell him to hire more help and stop chasing profits! Instead I left his practice. As Nancy pointed out, that’s really all a patient can do.

    Not all of my experiences with support staff in doctors’ offices have been negative. In fact, one doctor’s staff has consistently been superlative. The four or five women who work in his office sit in a space the size of a small walk-in closet, elbow to elbow, with the backs of their chairs almost touching one another. I’ve never seen them checking their cell phones or chatting with their colleagues about last night’s date or a People magazine cover story. They WORK full-tilt, and they get things right every time. I’m sure performance expectations are made very clear by the doctor, who has a very direct manner and no-nonsense personality. That can be off-putting to some patients but the guy is brilliant. He’s been in the Castle Connolly guide and on the New York magazine list of the “Best Doctors in New York” for as long as I can remember. If anyone reading this needs an extraordinarily-gifted NYC-based cardiologist, I can provide his name to Jeanne, who then can pass it on to you.

    P.S. He doesn’t accept insurance because he doesn’t have to. Patients still flock to him.

  7. Jeanne Byington Said:

    CG,

    The great cardiologist cuts out so much paperwork and nonsense and can focus on curing people by not accepting insurance.

    I mentioned this post to a colleague who said that his doctor admits spending more time with paperwork and less with patients than in the past. I can’t believe that this is the outcome the new and improved health care system was supposed to deliver.

    As for telling the doctor, I should have in my eye situation. I still feel guilty about it. Had your former doctor defended his nurse by explaining that she was under pressure because her [child, husband, parent] was in the hospital you’d have accepted that. But his explanation was ridiculous. He deserved to lose you and he should consider research: A slide doesn’t care.

  8. hb Said:

    It is the Ying and Yang of it. Just as the Industrial revolution brought a higher standard of living to many of its beneficiaries, it also brought the misery of world wars and the atom bomb. In simpler terms, while the automobile freed us from the constraints of mass transit, it also brought us drunken driving, road rage and worse.

    While I’ve had my share of problems, several never satisfactorily resolved, with the mechanics of modern medicine, I’ve also had my inflamed appendix removed by a surgeon using the latest robotic surgery. I was home four hours later, back at work the next day and I don’t even have a scar to show for it. When my mother had hers out, she was hospitalized for a week.

    Sadly perhaps, but inevitably for sure, medicine must abandon the Hippocratic oath and adopt a two tier delivery system under which the elite receive better care than the masses. It is already happening. If you are not constrained by its cost or your insurance policy, you can buy the care you need.

    Recently, with generous agreement of my wife, when all else had failed, I was successfully treated for a chronic condition by a doctor whom I paid each time I saw him. He refused to accept insurance because, as he put it, “No insurance is going to pay the cost of the time I need to take to treat you.” His first session with me, most of which was time spent with him, took four hours, not 20 minutes. As doctors go, he was not expensive, but then he did not have pay for staff to deal with insurance paperwork. I still feel a little guilty about this. As I walk around “in remission,” others are suffering miserably, or are dead because they cannot afford proper care.

    I’m for universal health care, and, if you want better, you pay for it. At least we’d be rid of the insurance industry which like some giant, ever more persistent leach, sucks more and more money out of medicine and causes most of the aggravation you so vividly describe.

  9. Jeanne Byington Said:

    hb,

    When people hire an expert, many expect a complicated solution. Seems to me that a small tax on all citizens who make enough to pay taxes–and a bigger chunk from the one percent and those with yearly incomes over $1million–could have covered the cost of healthcare insurance for those without any. Leave the previous system alone. But it sounds too simple.

    Think of all the people employed to make sense of the new tangle and eventually, all those people physicians will need to handle their ends of the bureaucratic rigmarole, none of which cures a single patient. I suppose it’s a way to combat the dismal real employment situation. A friend told me anecdotally that he heard that there will be 10,000 jobs created by the World Trade Center shops and services. Whether most will be at work for four hours a week at minimum wage with no benefits was left unsaid. I suppose a job is a job.

    I resent and fear one industry that forces people who know what they are doing to consistently opt for the cheaper alternative whether it’s appropriate or not. From first I heard of it, it made no sense for an insurance “expert,” staring at a chart, to tell a physician with 40 years experience whether a patient should be in the hospital, at home or in rehab; taking physical therapy or acupuncture and for how long. In the years since it continues NOT to make sense.

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