A Visit to the Clinician

[Juvenal]

Could not find any other "Subject" title that quite covered this.

My point is: Last time you had a scheduled appointment with a physician about a past problem, did you get better news than you thought was coming?

Today, at the urologist, in the examination room, on a tray at the examination bench side, I saw all the preps for a cystoscopy.  Mmm.  There had been some action in that area a couple of months back and I thought he just needed a "look-see."

Well, no, he just said, "Keep an eye on your PSA come six months.  See you then."  I wished (silently) the best to whomever that prepping was for.

[clean]

I was very sick several years ago.  I was being seen by my primary doctor and a specialist.  It was soon clear that I THOUGHT that they were communicating with each other, that I was mistaken. They were each striking out on their independent directions, sometimes ordering the same or similar tests.

Example 1. 
Specialist:  I need to send you for a blood panel for ...
me:  Was that not covered by the blood results that I talked to Primary Doctor 2 days ago?  Do you need that updated?
Specialist:  Oh, I guess we should get those results.

Primary doctor:  Your liver is upset with you, Im going to send you for a CT of your abdomen
within a  week,
Specialist:
There is a problem on your chest xray so I need to send you for a CT of your chest.

IF they had coordinated, I could have had ONE CT that covered both areas! 


REMEMBER:
ALWAYS:  IF you are not looking out for you, then no one is!
ALSO: You are YOUR health care MANAGER!  YOU must coordinate your doctors. They will not coordinate FOR you!


Tangent! 
IN the olden days you may remember Octoprof.  Her Mr Wonderful was visiting MD Anderson for Cancer and even though all the doctors are in one huge building, they are not well connected, so she would keep ALL of the records and BRING them to EVERY visit!  Everything was saved to a CD 

I have passed that advice to others, and been thanked over and again because that advice saved valuable, valuable time! 


(Though I have gone to the effort to get  CT and MRI scans saved to CD roms to take them to my Primary doc, to be told that there is no machine in his building that has a CD rom drive!  ... Im at a loss to know these days what technology you need beyond PAPER records that doctors will bother to review).

MORE RECENT
I now have a pulmonary MD 'on my team'.  I have PERSONALLY delivered paper documents to his office to be scanned into my records. I have WATCHED them scan the records, only to ask about those results at a subsequent appointment and be told, "We dont have any record of that!" 
So BRING THE PAPER COPY  WITH YOU

And IF your doctor is TOO busy to read the notes (S)/HE SHOULD HAVE, find another one!  Remember, whether you live or die is not likely to change THEIR lives too much, but it SURE will impact YOURS!!


Good luck!

[cathwen]

That sounds horrendous.  I've had similar experiences in the past. 

Our family doctor recently joined one of the big health conglomerates in this part of the state.  I was skeptical at first (corporate medicine, grumble grumble), but no longer!  When my husband had an alarming symptom, our doctor referred him to a urologist in the system, who then (after some tests) referred us to an oncologist.  (In fact, the urologist walked us down the hall to introduce us to the oncologist--it was the end of the day--and to help us set up an appointment.).  The oncologist in turn works closely with the surgeon.  Any tests ordered or notes taken by any of the doctors show up on the computer screen of the other doctors, since they're all in the same system.  Also, they talk to each other!  I am beyond pleased with the care he's getting for this very scary condition. 

[mamselle]

I miss Octoprof.  And I'm still sad about Mr. Wonderful's demise.

And you're right about the files.

Also, be aware that a hospital to which your MD(s) has/ve admitting privileges may/may not have all the files your MD(s) have because MDs in private practice keep their own files, and sometimes only share a page or two with the hospital, or may summarize something in their admission notes that might be better spelled out.

Also, if a fast transfer happens for some reason, your notes may not all make it with you from office to office or from office to hospital or whatever.

They can come scudding along through an interoffice mailing system that goes into the mail room and back out again instead of traveling with you or the MD/RNNP/PA who goes with you into admissions (if they do).

And just casually, off-hand mentioning stuff as if "Oh, yes, I know you probably know this, but just in case..." is always wise.

We had this come up with my mom: she had an odd congenital kidney condition (her kidneys drained from the top, not the middle) that caused many issues, most commonly kidney inflammation when they'd get backed up and not drain properly if she didn't drink a lot of water every day).

She knew this, but sometimes she'd get lax about her water regimen, and wouldn't think to mention it to an MD or an admitting RN or whatever. I'd have to "say something" at the outset because it was usually buried somewhere in her chart, but MDs usually just leaf through a chart quickly if they're backed up, and if it weren't well-flagged, they wouldn't see it.

Having worked on both sides of the desk, I tried to pre-think what could go wrong, and say something before it became a problem.

As to the radiology/CT scan thing, they might still have made you do two scans.

They need an RX/order for each scan, and they don't often double up.

That would be too efficient....

M.