Re: Posted for Carole M. (the elder), A New Type of Problem

[Guest guest]

C - I also had an obnoxious person to deal with during my hospitalization. As I

have said before, I think writing a letter and cc'ing everyone concerned is

quite helpful. From a legal standpoint, I think you should emphasize the loud

voice broadcasting your problems, as privacy and confidentiality concerns have

become increasinly important lately (to the med ppl; they've always been impt to

us!) as a result of the passage of HIPAA. Those 2 buzzwords should bring

attention to your concerns.

Also, I'd mention that she did not seem to have read the chart - not reading or

misreading the chart leads to medical errors.

Finally, I would include the fact that you need someone (besides you) to be in

charge of your medical care, particularly with followup. Failure to followup is

not good practice, regardless of whether you have paid extra $ or not.

You will best know who to copy on the letter but I would think that at a minimum

it would be your doc and whoever is the hospitalist's boss.

That's just one way I would handle it - everyone is different,a nd if I have

misunderstood your concerns forgive me!!!

>

> From: " Blackledge " <scottb2@...>

> Date: 2004/08/24 Tue PM 10:29:47 EDT

>

> Subject: Posted for Carole M. (the elder), A New Type of

Problem

>

>

>

> I am not really sure where to go with my current problem, but I am

> pretty sure that someone in one of my favorite groups might have run

> into the situation that has me really " worked up " .

>

> While in the hospital recovering from pneumonia, I was introduced to

> a new kind of " Administrative Position " called a " Hospitalist " . In

> my case this person was very opinionated, young and lovely lady

> doctor. We did not " hit it off " and I find myself obsessing over the

> various things that happened which involved her. She was extremely

> abrasive and spoke rather loudly when she gave an opinion. And, she

> gave many.

>

> First, she looked down and saw the tube that went from my urostomy to

> a Foley bag. Her response to that was, " Well, that's coming out

> right away! Who in the world put that in? It is to come right

> out! " Of course, I told her that it was staying and explained about

> the loss of my bladder and my consequent urostomy.

>

> Then, in her booming voice, she announced that I was " on entirely too

> much pain medication, and MUST go to rehab to get weaned off " ! I

> explained that I had been through Pain Clinic(s) and that it had

> taken a long time to get me on a program that worked and that,

> frankly, put me on my feet.

>

> My oxygen saturation was quite low. Wouldn't it be with pneumonia?

> She next zeroed in on that. My own doctor had said that perhaps I

> should spend a few days in Rehab to learn to deal with such low

> oxygen SATs. SHE said that I would be walking the halls with a

> Physical Therapist who would be monitoring my SATs, and that I

> was " not to pull any tricks " ! We (the therapist and I) walked and

> talked and, although said SATs didn't come up as high as he would

> have liked, we did agree that I would be able to manage at home. He

> left.

>

> She came barreling into the room and announced to me that I should

> get dressed and prepare to leave for Rehab, where both problems would

> be addressed -- breathing and pain treatment. I explained that the

> P. T. and I had already agreed that I would be going home. She ran

> out of the room and returned shortly saying, " I guess I misread the

> record " . Get ready to go home. She said that someone would be

> coming to my house to check my levels. She further said that, at the

> hospital, I would be given an instrument to help with my deep

> breathing - a spiro something, which I have used before. Also, I was

> told that I would be using some oxygen at home. (I had part of the

> setup in my BI-PAP machine, but that only.)

>

> I went home. No one visited. Nothing happened. Finally, I called

> my doctor. We got me through the weekend and I called again saying I

> was confused about what was supposed to be happening. He had me come

> to the office. My SATs were definitely down. He also informed me

> that instead of Percocet for breakthrough pain I was to take a med

> whose name I cannot think of! It is Ultram with Tylenol.

>

> Here's where I felt crushed. I actually asked him if

> the " Hospitalist " had gotten to him. He, after all, had always been

> working with me and the Pain Clinic to find the combination of things

> that would keep me going. He responded that he was concerned about

> constipation! I am aware that that is a side effect of pain meds,

> and I handle it pretty well. He also tried to tell me what a good

> person that woman was, etc. I told him that I was very upset. I

> asked if she was the reason he didn't see me in the hospital, and was

> he intimidated by her. Of course, he said absolutely not. Anyway,

> he was to give me a spiro thing, some prescriptions, and arrange for

> a home visit by the VNA. When I got into the car I realized I had

> none of those things. Went back, and was given some med samples. He

> insisted that I stay in touch by either/or email and phone, and that

> he would definitely be available to me.

>

> I've been so angry that I haven't contacted him at all. I've chatted

> at length with my nurse practitioner daughter who is far away. We

> both are very upset with my " Concierge Medical Plan " and are REALLY

> wondering at this point what it bought me. Our payments of

> $1500/year/person to VIP/MD were going to put my husband and me in

> a special group. It was going to allow our primary care physician to

> condense his caseload. I would stay with someone who understood my

> awfully confusing medical problems.

>

> Any ideas out there? I'm sure I need a new appointment with him. I

> am perfectly willing to work on my pain care, but I do not think the

> whole world needed to know about it or " my problem " . I'm almost 70

> years old; my scoliosis is very severe; I doubt I'll live to be 100,

> and what life I have left I would like to be as painfree as possible.

>

> You guys are so great. I'm sure you'll have some wise advice for

> me. If you only read this and tell me I'm wrong, that's OK too!

> Also, if I am at the wrong place, tell me that, too! Just re-read

> that " wrong place " thing; it is a bit fuzzy. Maybe wrong group?

> Maybe wrong doctor?

>

> My best to everyone, and especially to those in pain of any kind.

>

> Sincerely,

>

> Carole M. (the elder)

>

>

>

>

> Support for scoliosis-surgery veterans with Harrington Rod Malalignment

Syndrome. Not medical advice. Group does not control ads or endorse any

advertised products.

>

[Guest guest]

At 02:29 AM 08/25/2004 +0000, you wrote:

>I am not really sure where to go with my current problem, but I am

>pretty sure that someone in one of my favorite groups might have run

>into the situation that has me really " worked up " .

>

>While in the hospital recovering from pneumonia, I was introduced to

>a new kind of " Administrative Position " called a " Hospitalist " . In

>my case this person was very opinionated, young and lovely lady

>doctor.

There was a " hospitalist " at Kaiser, but they never visited me, they did

come to see another patient in my room. He was actually helpful, gave me

the number of the new Ombudsmen. (My doctor had not come to see me for 5

days, just sent patient assistants to see me, so I was mad about that.)

But now that I think about it, he was there to talk to the patient about

getting her out of the hospital (seeing if she had someone to take care of

her, her meds, etc.) I think this is a new title for an old job. They had

such a job when my mom was in the hospital at UCSF, it was the Discharge

Nurse. Hers was like yours. We kept telling the woman we had nobody to

care for my mom, and she forgot to take meds, etc., and the nurse would

yell at us that she was being discharged anyway. They wouldn't transport

her home even though she had Parkinson's--I had to drive in to SF, pick her

up, and take her home. She forgot her meds, fell on the floor, the fire

dept. had to come and break in, and took her back to UCSF!

I complained to my mom's regular doctor, but basically I don't think

anything happened to the woman.

But now, in your case, I'd find out if the hospital has an ombudsmen, and

complain to him or her.

Good luck!

in Oakland

[Guest guest]

Carole,

It seems to me you have two different problems to consider. One is

what happened in the hospital with the hospitalist, and one is what

is happening now with your regular doctor (what kind of doc is he -

a family/general practititioner, internist or what?) It's hard to

tell how closely the two problems are related, and I would think the

latter is the more critical at this point.

So he gave you samples of the new medicine. Are you willing to try

them? If yes and they work, maybe that will be a non-issue. If yes

and they don't work (or if you are not willing to try them at all)

then you need to press your doc for a better explanation about why

you can't stay on the percosets. (Just for the heck of it, I'd pick

the brain of your pharmacist for cost info. on both percosets and the

new meds, and if they are different classes of drugs and if he can

think of any reason, medical or non-medical, why a doc would want a

patient to switch.) Also, is the pain management doc totally out of

the picture now, or can you still work with him?

Next, did you ever get your spirometer and did the visiting nurse

visit ever get set up? If not, I definitely think a call back to

your doctor would be needed to see if these things are necessary and

if he says no, ask why you were initially told that they were!

I'm not sure I fully understand your concerns about your medical

plan. Is this a new plan that is working differently than your old

plan? Were you put in the " special group " because of your medical

problems or was it an option you chose? Is " Concierge Medical Plan "

really what it's called or are you being facetious? What's VIP?

Surely it can't stand for " very important person " because, although

you ARE one, it doesn't sound like you are being treated that way!

Medical plans are so confusing, but it's always a good idea to

completely understand them to best utilize them. Have you read your

insurance plan contract to see if it would shed any light on the

recent events? I'd probably also re-read all that written info. the

hospital gives you when you become an inpatient to see if it gives

any hints on what to do in a situation like this.

I was under the impression that the hospitalist only directed care

while a person was an inpatient in the hospital. I don't know how

much influence, if any, they would have after you've left the

hospital. I'm sure it would make you feel better to bring your

concerns about the way she acted to the hospital's attention, and it

might help some other person avoid that kind of upsetting,

potentially dangerous, treatment.

Re: your doc not coming to the hospital - Sometimes the hospitalist

is REQUIRED to provide care in lieu of your doctor coming to the

hospital, so that may have been why he didn't come.

You deserve answers, Carole, so trust your gut, and make sure they

give you the care you deserve. Hope you'll continue to let us know

how you're feeling and how things go.... Good luck!!

loriann

>

>

> I am not really sure where to go with my current problem, but I am

> pretty sure that someone in one of my favorite groups might have

run

> into the situation that has me really " worked up " .

>

> While in the hospital recovering from pneumonia, I was introduced

to

> a new kind of " Administrative Position " called a " Hospitalist " . In

> my case this person was very opinionated, young and lovely lady

> doctor. We did not " hit it off " and I find myself obsessing over

the

> various things that happened which involved her. She was extremely

> abrasive and spoke rather loudly when she gave an opinion. And,

she

> gave many.

>

> First, she looked down and saw the tube that went from my urostomy

to

> a Foley bag. Her response to that was, " Well, that's coming out

> right away! Who in the world put that in? It is to come right

> out! " Of course, I told her that it was staying and explained

about

> the loss of my bladder and my consequent urostomy.

>

> Then, in her booming voice, she announced that I was " on entirely

too

> much pain medication, and MUST go to rehab to get weaned off " ! I

> explained that I had been through Pain Clinic(s) and that it had

> taken a long time to get me on a program that worked and that,

> frankly, put me on my feet.

>

> My oxygen saturation was quite low. Wouldn't it be with

pneumonia?

> She next zeroed in on that. My own doctor had said that perhaps I

> should spend a few days in Rehab to learn to deal with such low

> oxygen SATs. SHE said that I would be walking the halls with a

> Physical Therapist who would be monitoring my SATs, and that I

> was " not to pull any tricks " ! We (the therapist and I) walked and

> talked and, although said SATs didn't come up as high as he would

> have liked, we did agree that I would be able to manage at home.

He

> left.

>

> She came barreling into the room and announced to me that I should

> get dressed and prepare to leave for Rehab, where both problems

would

> be addressed -- breathing and pain treatment. I explained that the

> P. T. and I had already agreed that I would be going home. She ran

> out of the room and returned shortly saying, " I guess I misread the

> record " . Get ready to go home. She said that someone would be

> coming to my house to check my levels. She further said that, at

the

> hospital, I would be given an instrument to help with my deep

> breathing - a spiro something, which I have used before. Also, I

was

> told that I would be using some oxygen at home. (I had part of the

> setup in my BI-PAP machine, but that only.)

>

> I went home. No one visited. Nothing happened. Finally, I called

> my doctor. We got me through the weekend and I called again saying

I

> was confused about what was supposed to be happening. He had me

come

> to the office. My SATs were definitely down. He also informed me

> that instead of Percocet for breakthrough pain I was to take a med

> whose name I cannot think of! It is Ultram with Tylenol.

>

> Here's where I felt crushed. I actually asked him if

> the " Hospitalist " had gotten to him. He, after all, had always

been

> working with me and the Pain Clinic to find the combination of

things

> that would keep me going. He responded that he was concerned about

> constipation! I am aware that that is a side effect of pain meds,

> and I handle it pretty well. He also tried to tell me what a good

> person that woman was, etc. I told him that I was very upset. I

> asked if she was the reason he didn't see me in the hospital, and

was

> he intimidated by her. Of course, he said absolutely not. Anyway,

> he was to give me a spiro thing, some prescriptions, and arrange

for

> a home visit by the VNA. When I got into the car I realized I had

> none of those things. Went back, and was given some med samples.

He

> insisted that I stay in touch by either/or email and phone, and

that

> he would definitely be available to me.

>

> I've been so angry that I haven't contacted him at all. I've

chatted

> at length with my nurse practitioner daughter who is far away. We

> both are very upset with my " Concierge Medical Plan " and are REALLY

> wondering at this point what it bought me. Our payments of

> $1500/year/person to VIP/MD were going to put my husband and me

in

> a special group. It was going to allow our primary care physician

to

> condense his caseload. I would stay with someone who understood my

> awfully confusing medical problems.

>

> Any ideas out there? I'm sure I need a new appointment with him.

I

> am perfectly willing to work on my pain care, but I do not think

the

> whole world needed to know about it or " my problem " . I'm almost 70

> years old; my scoliosis is very severe; I doubt I'll live to be

100,

> and what life I have left I would like to be as painfree as

possible.

>

> You guys are so great. I'm sure you'll have some wise advice for

> me. If you only read this and tell me I'm wrong, that's OK too!

> Also, if I am at the wrong place, tell me that, too! Just re-read

> that " wrong place " thing; it is a bit fuzzy. Maybe wrong group?

> Maybe wrong doctor?

>

> My best to everyone, and especially to those in pain of any kind.

>

> Sincerely,

>

> Carole M. (the elder)

[Guest guest]

Carole,

Oh man! I'm so sorry this all happened. I would definitely see your doc againa

nd insist he resort back to the pain meds which worked for you.

In my experience, Ultram didn't work at all.

Sounds like your doc WAS intimidated by this gal.

You're in my prayers and thoughts.

xoxo's