Opuscula Patient is caught Between doctors’ Offices’ ineptness

MY SPOUSE BROKE HER ANKLE — in two places. She was taken to a local hospital’s Emergency Room (ER) where she was x-rayed, was seen by an ER doctor and by a passing orthopedic surgeon.

The bones were aligned and a splint applied and she had an appointment with the orthopedist for the following week, “when the swelling went down.”

She was released after only 9 hours in the ER.

SO FAR, SO GOOD.

She kept the appointment with the very busy orthopedist who confirmed what we already knew: surgery was necessary to secure the bones.

The surgery was scheduled for the following Thursday, with a pre-op session with the surgeon on Wednesday. She was told she needed clearance from her Primary Care Physician (PCP) before the surgery.

She called the PCP’s office and tried to make an appointment.

“We can’t make an appointment until we have an order from the surgeon.”

The spouse calls the surgeon’s office and requests the order. The surgeon’s office assures the Spouse that this will be done.

Friday before the surgery the Spouse calls the PCP’s office to confirm they received the order.

“Sorry; we never got the order.” One of the PCP’s office staff volunteered to contact the surgeon’s office and ask that the order be faxed — or refaxed — to the PCP’s office.

The Spouse calls the surgeon’s office and the office staff assures her that they will resend the fax.

The Spouse calls the PCP’s office to confirm arrival of the fax.

Ring-No answer.

The PCP’s office is closed from 1 p.m. to 2 p.m. and calls are routed to an answering service.

At 2:10 p.m. the Spouse calls the PCP’s office. The call is answered by the service.

She tries again at 2:20. Same thing.

Finally, sometime between 2:20 and 2:30 someone at the PCP’s office had the good sense to wonder why they were getting no calls and realized that the calls were still directed to the answering service. (The answering service could not or would not contact the PCP’s office via an alternate number to tell the clerks to turn off the answering service.)

When she FINALLY gets someone at the PCP’s office she is told that yes, they received the surgeon’s orders, but that is insufficient; they also need a progress report. This is the first my Spouse heard of the additional document.

She calls the surgeon’s office, is put on “Hold and Forget.” She redials and finally gets to a person who allegedly can — and will — get the latest demand for paperwork over to the PCP’s office. The surgeon’s admin person promises to fax the paper and then call the PCP’s office to assure the PCP’s clerks knew the fax was waiting in the machine.

My Spouse called the surgeon’s office to confirm the second fax was sent and that the clerk who promised to call the PCP’s office to assure the fax was found. The surgeon’s clerk asked my Spouse “Did you want me to call the PCP’s office?” DUMB! Of course; that’s why she gave you the PCP’s number.

My Spouse calls the PCP’s office — it must be the 10th time today — and learns that FINALLY all the paperwork the PCP needs is at the PCP’s office and that she has an appointment scheduled for 1 p.m. — lunch hour for the doctor.

My Spouse is not employed by either doctors’ office. She is the PATIENT yet she apparently is expected to coordinate all the paperwork — paperwork about which she knows nothing. Not her job.

Having worked in Medical Administration in the military and in a civilian hospital, and later worked as a Risk Management consultant, I cannot fathom why the surgeon’s office does not routinely fax a pre-op requirements package to the PCP and why the PCP’s clerk failed to tell my Spouse that she needed BOTH documents when she initially tried to make an appointment.

My Spouse’s PCP is an excellent doctor burdened by an incompetent administrative staff. Still, many of the problems must be laid to the surgeon’s office staff. The surgeon’s clerks should have known what typically was requested of a PCP. There should be a check list.

GOLD STAR The wife’s PCP, Dr. Eduardo Perez-Stable, gave up his lunch break (“I need to diet, anyway”) to see my Spouse to make sure she could have her surgery on time. The Spouse has been his patient for several years, and he is the reason she stays with the practice despite the administrative foul-ups.

While the PCP was reviewing the paperwork from the surgeon’s office the PCP noted one “minor” discrepancy — the surgeon’s admin people had the Spouses operation slated for her left leg . . . the fracture was on her RIGHT leg. Oops. (At least the screw-up was not in the operating room.)

Perhaps incompetency is contagious; it certainly seems epidemic in my neck o’ the woods.

Now, if only the insurance company will authorize the surgery. (It did -- finally -- three hours before the scheduled surgery.)