Monday, October 12, 2015


Left hand
Right hand


I'm scheduled for relatively minor surgery on Wednesday.

Standard Operating Procedure (SOP) is for the hospital to tell the patient - me - what I must do/have done before admitting the patient.

Several weeks ago, the hospital sent a "secure" electronic message with a questionnaire attachment. I filled out the hospitals 20-plus questions, updating one or two answers from previous stays at this hospital.

Late Friday afternoon - just "before they shut down the computers" the caller explained - I had to play 20-questions over the phone; same questions, same answers.

ONE DIFFERENT QUESTION was "Do you have clearance from your primary care physician (PCP)?"

Oops. No one told me I had to get my PCP's approval. I see him every quarter and I have kept him up-to-date with reports from my vascular surgeon. Unfortunately for me, my PCP uses Macintosh computers; the hospital's physician information exchange software apparently is not "Mac friendly." I assume my surgeon is sending his updates to the PCP, but because the surgeon is a strong supporter of the hospital's physician information exchange software I am beginning to have my doubts.

ANYWAY, at 4:40 p.m. Friday I call my PCP's office and find out its closed for the long Columbus Day weekend. (And why is it that the Italians get a bank holiday and the Irish don't? Doesn't seem fair.)

No way I can get my PCP's clearance until Tuesday - the day before surgery.

Meanwhile, I am to present myself Tuesday morning - Columbus Day was booked solid - for a series of tests that could have been more conveniently performed in my PCP's office.

One test that hospitals usually insist on doing in-house is a blood type and cross match, a T&C. I have been a Type O Positive since birth; I was a Type O Positive at both my surgeries at this hospital. Even "Dr. Oz" writes that, without outside influences, e.g., marrow transplants, blood types don't change, not alphabetically or positive/negative.

The hospital has a fat electronic file on me that lists my blood type and includes the answers to the questions asked a few weeks ago . . . and then again last Friday.

I can understand the EKG requirement; my PCP gives me an annual EKG close to the start of the calendar year . . . 10 months ago. Likewise an x-ray to assure my lungs are clear.

In addition to the tests, I am to meet with an anesthesiologist. Before I "consented" to Wednesday's surgery, I insisted that the anesthesiologist be the lady who put me under for a major surgery at this hospital. I know and trust her and she knows me and my "big mouth." I had the chutzpah to tell the surgeon, with whom I have a history, that if "my" anesthesiologist is not at the head of the (operating) table, no surgery. Fortunately, we three share similar senses of humor - or lack thereof.

IT IS DISCONCERTING that the hospital administration seems to be a bed of confusion,with the right hand not knowing what the left hand is doing - or has done. If I thought the surgical side of the house was that inept I'd look for a different hospital.

The fact that my Mac-loving PCP cannot (perhaps will not?) connect to the hospital's physician information exchange software likewise is cause for concern. Concern, not panic, since when the hospital posts results of tests ordered by the surgeon, I save the results as a PDF and forward it to the PCP in hopes that his office staff will include them in my folder at the PCP's office.

Specialists are supposed to coordiinate with the PCP - my Medicare Advantage plan demands it - but given that I didn't know I needed a PCP clearance, I have my doubts this is being done.

I have confidence in the surgeon and the anesthesiologist. I've got a pretty high level of confidence in the crews working the cardiac/vascular floor.

But the front office? Not so much.

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