Wednesday, December 28, 2011

Am I gonna have to hurt some fools?

"The angel of mercy doesn't work here"
Bob, who has a full body rash going on seven days now,  is on meds. They are not helping. In fact, I think his discomfort, and the appearance of his skin, is increasingly alarming. Today at work, I found myself "off task" -- checking side effects of industrial chemicals, of meds,  looking for dermatologists, calling Bob for updates. I'm writing off a half day vacation so my workplace "health research" is guilt-free, but dealing with the medical community is it's own peculiar purgatory.

Name that malady: Finding a specialist
Dermatologists in the Lehigh Valley must be very, very scarce. I probably called every practice, and not one of them could fit us in before April, and most were talking June/July.  Even when I explained the scary nature of Bob's condition. Even when I implored them as the Worried Wife.  The most-recommended practice had the rudest receptionist of all, cutting me off at the third syllable of my plea.  "Doesn't matter. June is the earliest we can get you in."  I ended up talking to a social worker at the hospital ER. Surely if an ER doctor recommended this practice and doctor, they might put in a good word for us?

Lori the social worker was sympathetic. She called the practice  on my behalf, and ten minutes after I spoke with her she called back excitedly. "Wow, were they rude! But I got you an appointment on January 27th. Call NOW to keep that appointment." I practically hung up on her and dialed the practice. I was  put on hold for five minutes. When the receptionist came back to me, she offered me February 10.
Me: "But I had January 27th , the social worker said January 27th, 7:30am was available."
Receptionist: "It's not available now."
Me: "Are you sure?  I called back within moments of her talking to you!"
Receptionist: "It was longer than that. We have many other patients, we don't hold dates for new patients. We have February 10th available."
Me: "My husband is in pain from a severe rash, it's getting worse, and we don't know what's causing it. I'm getting frantic. Isn't there something you can do to get an acute case seen more quickly?"
 Receptionist: No, not for new patients. Do you want February 10 or not?
Me [exasperated, maybe a little pissy]: I want January 27th--and you would too if you had a family member in this kind of discomfort.
Receptionist [sharply]: " Look you don't know my family situation.  My son has cancer, and we don't get special treatment. Do you want February 10 or not?"
I took it. But I was pissed enough that I didn't acknowledge her cancer remark, let alone apologize. I confess in the back of my mind I was snottily thinking "I've known LOTS of people with cancer, including my own family--and they can see their doctor when they need them."

I'm not at all charitable when I'm angry.

The happy ending, and the reason I don't have to "hurt some fools," is that Bob scored an appointment with that venerable institution, the UPenn Hospital, on January 9--and he might even get in on the 3rd. UPenn also had a long lead time for new patients, but they offered to see what they could do. They were polite, responsive, concerned, and most importantly they listened, and they made an exception for us! From New Bolton's talented equine care pros to the Dermatological Center folks in  Philly,  they're the coolest health care system ever.


  1. When I hear stories like this, it literally brings chills down my spine. Is this what our health care has come too? At this point you're not even sure what is wrong, that in itself is scary, then to say you have to wait months just to get looked at? Something is terribly wrong here. I really hope UPenn, continues to provide the care you should expect. I sure hope your insurance situation isn't partly to blame for this, that would really be awful. I also wonder if Bob's employer should be more involved due to the nature of his profession. Exasperating!

  2. Sadly this is not unusual. While my dermatologist's office is not rude, it IS difficult to get an appointment in a timely fashion. I have had that rude conversation with an orthopedist's office manager which led to me making quite the scene in the waiting room. It's my kid. I'll take the heat, but you damn well better give me her files even though your file specialist is out for the day.

    We have to be advocates for those in need. Give the name of the office and tell everyone in your area. They won't be premier forever.

    You go girl.

  3. The wait times in Canada, at least Ontario, are worse. I am lucky if I only have to wait three months to see my GP, at least four for a physical. I can't imagine being covered in a rash and knowing I would have to wait for a really long time to see someone. Hope they figure out what is going on fast!

  4. if the rash is getting worse and is actually painful couldnt he go back to ER and be evaluated? if they consult derm while he is there/and or admit him they would have to see him

  5. UPENN is down by me, and from what I have heard, you will be in very good hands, among the best in the country.

    Best Wishes

  6. I have had very similar experiences. I HATE, HATE, HATE our health care system. I do not want to put the blame on any one entity--though I would darn sure like to single out insurance companies--but the net result is just what you (and I) have experienced. I am extremely "proactive" these days- I say and do whatever thing I feel is most likely to leverage the result I want-sometimes it helps me, sometimes not. But the system is absolutely broken. I hope the hospital is good to you--in our area people who interacted with the big teaching hospital at Stanford were very happy with it.

  7. Mention that he is having a hard time swallowing and they'll freak out about the possibility of dying from anaphylactic shock. That might get them moving.

  8. The national healthcare debate is often framed in terms of making sure nameless, faceless government workers don't "take away our right to choose" or sit on "death panels." Truth is, this is already happening all over the country. If you are unlucky enough to live in an area that doesn't have a ton of doctors or if you're poor or if your insurance sucks, you are literally at the mercy of your doctor's receptionist/the insurance company/your thin paycheck.

    When my husband and I lived in upstate New York/northeastern PA, we had the worst healthcare possible. It was dismal, dismal, dismal. But we were expected to curtsey and act grateful when we DID get to see our shoddy doctors because they were the "best" the area offered. (And believe me, I made sure we found the best doctors possible.)

    I'm amazed less that the receptionist was a snotty, rude B. and more that the emergency room staff didn't pick up the damn phone themselves to help grease a wheel or two or three. THEY should have been helping you get in to see the best doctor in the area, not leaving it up to YOU to handle. Really shoddy business all around...

    I hope your sweetie feels better soon. (And not to be too scary, but they have tested him for bacterial infections, right?)

  9. This is what our health care system is. Our trauma care is extraordinary. Everything else is ...... not. An extremely painful rash.... have you looked up shingles?

  10. Dermatologists might be among the worst mostly because--from what I see posted in mine's office--so many of their procedures are elective, rather than truly medical.

    If Madam MoMo wants to come in for her absurdly expensive botox injections on Thursday, she needs the appointment, not some miserable human with a hard to diagnose rash.

    The concept of "emergency" might well escape the average receptionist's brain....

    UPenn has a good reputation. They are well respected for their skill at diagnosis and treatment. Here's hoping.....*S*

  11. Agreed that the quality of health care in this country is going downhill and it's only going to get worse. Thank God the national health care plan kicks in gradually. (Congress passed it, and we're just now finding out what's in it--with a lot of it SO bad, favored companies and groups are getting waivers). I think the plan needs serious scrutiny and that many parts of it need to be repealed.

    People from countries with "national health care" come HERE to be treated because the bean counter (or the snotty receptionist) in charge won't let you get by them to talk to someone who could help.

    The Dragon at the Gate can be an unattractive fat woman in scrubs and wearing really ugly shoes.

    I had thought shingles, too, Barbara, but they are generally not over the entire body. The blisters follow the path of the nerve in which the virus has been hiding since it was chicken pox.

    Good for you for being the ombudsman for your dear hubby. And BLESS UPenn.

  12. Apple Cider Vinegar (organic is better) might help with his allergy.

    Have a big glass 1/4 ACV and 3/4 water.

    Then have 1/8 ACV and 7/8 water daily.

    Hope it helps

  13. That is... just... atrocious. ATROCIOUS! Dermatologists seem to be among the very worst with unwillingness to see new patients, acute condition or not. The problem is exactly what Jean said: they have tons of paying customers in there for elective and expensive cosmetic procedures. It's a total ripoff branch of medicine and extremely lucrative. What a rotten system for people to have to deal with when they are truly in need. Not to mention, I have had a dermatologist MISS, oh, a little thing like the SKIN CANCER ON MY FACE. "Oh, we'll just take that off if it's bothering you looks-wise." One week later: "Um, that was basal cell carcinoma and we need to go back in to remove more.." Great. Also had one misdiagnose a rash on my belly; a coworker who was an RN looked at, and took two seconds to diagnosis and tell me the simple way to fix it (30 seconds in a tanning booth, no joke). So I do not have much respect for them in general!

    I sincerely hope the hospital is able to help Bob. I applaud your going to bat for him. We all MUST have someone to help us navigate this total CRAP system we have now.

  14. I can't believe that treatment! It would only make sense that a practice would keep a block of at least two or three apts a week open for emergency cases, that's terrible! I don't understand what is happening with doctors. My step mom has been in pain for two years after a car accident, so much that I feared she would take her own life. She went to 41 doctors for help! None could figure it out, numerous accused her of just wanting pain killers, she couldn't even walk more than a few feet or look down and they accused her of making this up! She saw a commercial for a medication and went to a doctor to ask about it, thankfully it is working and she's slowly getting her life back.

    I hope your husband gets some help soon.

  15. Here comes the (long-winded) voice of experience... Ready? This is, unfortunately, the way it usually works. My cancer was nothing compared to the autoimmune ordeal that followed. Physician referrals are the fastest way to "get in", but often they still come with a wait (mine was 3 months). Consider it a blessing that we don't have healthcare like England and Canada (where your wait would be more like a year or two - I have friends there). Yes it's often frustrating, but we still offer the best health care in the world.
    By the time my muscle disease was diagnosed it was almost a year later (it was Dermatomyositis), I could no longer walk more than ten steps before collapsing; breathing like a freight train the whole time. Because muscle tissue does not regenerate, it has forever changed my riding abilities (toast). I am back on the medical merry-go-round for a second mystery disease (autoimmune); lots of symptoms that have escalated over the past 3 years, but still no answers (other than the Mayo Clinic's affirmation - after three trips - that it was "something autoimmune"). *sigh*
    Hopefully, Bob's condition is not autoimmune and you'll both get some answers at your appointment.
    I would suggest (if you haven't already) starting a notebook. Write down and maintain lists of symptoms with dates, questions you have and also ask for copies of all testing and medical records to keep in there and take with you should you need to visit another physician (saves lots of time :o)
    I wonder if he could bathe with Aveeno? Works on chicken pox and shingles; maybe it couldn't hurt? Dunno. Keep us posted!

  16. IMHO the dragon at the gate needs to go. She is giving the doctor a bad reputation that has nothing to do with the quality of care. It sounds like really poor offfice management.

  17. I agree with Heidi. I am a receptionist myself, and while I don't schedule appointments, I know for a fact I would be FYE-RRED in a HURRY if I treated callers like that. Some doctors (and vets) seem to prefer that type manning the phone, though, because I've certainly run into them before. :-(

  18. So I'm a medical student, worked many summers as a receptionist at my father's office and need to go to the doctor myself so I guess I've been on all sides of this equation.
    I do have to say that unfortunately this is a pretty classic story. Even when I get referred as a medical student from the same institution the physician graduated from/practices at I rarely get to jump the line. I've currently been waiting 3 months for a cardiologist.
    The one advice I do have is if you have any sort of thing that may become a bigger problem in the future go make an appointment with the specialist now. Even if the first time you go you have nothing wrong with you in that moment keep the appointment and describe what happened because that first visit will establish you as a patient and from then on you will be seen way more promptly. I waited 4 months for my first gyn annual visit, but once I was a patient they were great and I could get an appointment within a week and the doctor would call me back the same day with answers to my questions.
    Unfortunately this country is a bit short on doctors and it means wait times are long and receptionists get stuck being the gatekeeper and the easiest way to draw the line is to say people we don't already know are not our problem until it's a more convenient moment. I know this woman was awful, but if she squeezed you in should may have been in a huge amount of trouble with her boss. Not saying that justified her attitude.
    Now on to the actual rash. I think the fact that it seems to be worsening and has not been responsive to the meds given warrants another trip to the ER if it's really painful and you hadn't been able to get the spot at Penn.
    As far as etiology it is unusual for an allergic reaction to have no response to antihistamines like benadryl, unless you were continuously challenging yourself with more allergens and overwhelming the medication. The prednisone story is also a bit strange. It makes me a little more worried about autoimmune skin diseases or something contagious like a fungus or viral reaction. Hopefully the mystery gets figured out soon and you'll update us.
    I agree with a previous poster that shingles sounds unlikely given the distribution. Shingles rarely crosses from one side of the body to the other unless you're really immunocompromised and tends to show up in lines/stripes following a nerve course.

  19. Ah the health care debate rears it's head again. I say if you hate this country's health care system, do live somewhere else for at least 5 years and get sick there. I have, and I'm telling you, you have no idea what's coming ... so please, please remember socialized medicine and even plans skirting around it like our new one, is no respecter of early diagnosis ... or prompt treatment.

    There is no perfect system and NOTHING is truly free. When we got this new health care bill, we threw the baby out with the bathwater I'm afraid. It's only gonna get worse.

    Anyhow, I am truly sorry about your husband's health. I have an auto-immune disorder and it is no picnic whatsoever. I pray it is just an idiopathic glitch, but an easily treatable one. :)

  20. Sounds frightening! Perhaps the lack of urgency from doctors is a good sign?

    To the anon who mentioned waiting 3 months to see their GP - I have been living all over Ontario for my whole life and have never experienced this for general practice. My doctor requests booking annual physicals on an annual basis - so a year in advance - but there is room for changes closer to the date. Yes, it's weeks, not days. That's reality. My husband did have to wait almost 4 weeks for a dermatologist about 5 years ago. We took pictures knowing it would probably be gone by the time the appt rolled around!

    But our newer systems (eg. tele-health) really do work if you go with it. I was the biggest sceptic at first but am hugely impressed with my experiences.

    I guess I'm saying over-generalizaiton is misrepresentative no matter the situation, country etc.

    We ALL need more doctors.


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