The Business of Medicine

It never ceases to amaze me that medical businesses are not run like a business.  Every business cross-trains employees so that if somebody is on vacation or out sick, the critical elements of that person’s job are performed.  Apparently that isn’t true in medicine.

My GI referred me to Virginia Mason for a lithotripsy and ERCP.  I could have the ERCP locally, but I’m told there’s no point since it needs to happen after the lithotripsy anyway.  I have to go to Seattle for this one.

I waited a week, then called the GI back:

Didn’t you say they were going to call me to schedule an appointment?

Yes.  They will call you.

Any idea when?  I had hoped this would be done by now.

Let’s see, I sent that on the… oh, my!  You should have heard back by now.  I’ll call them and make sure they got our fax.

Thank you.  Do you think I could get their phone number, too, and call them myself?

A call to the place I was referred got me the run around, but eventually someone told me that the person who handles referrals was out of the office for a week and a half, so it’s taking a while to get through all the referrals that accumulated while she was gone.  No, they would not schedule an appointment for me until their doctor said so.  The doctor did have my information, and they’d call me in 1-3 days.

Three days came and went.  A week later I called the GI office back and left a message asking if they could light a fire under Virginia Mason.  This isn’t a plea to fit me in sooner.  Just call me and schedule an appointment!

A few days later, GI called me back and said that Virginia Mason says they’re still working on it.  You’ve got to be kidding me!  My nine year old knows how to dial the telephone, talk to the person on the other end of the line, then write something on the calendar.  What is the problem here?

Imagine if your furnace quit working and the repairman said that he couldn’t schedule a repairman, but he’d get back to you in a week or two to arrange a good time for someone to take a look at the problem.  What if it was 20 degrees out, the faucets in your house stopped working, and there was a stream of water running out from beneath the house?  Would you do business with a company who wouldn’t return your phone calls or send someone to investigate the problem, or would you call around until you located somebody who wanted the job?

I asked GI to please find someone who actually wants my business.  Monday I will be on the phone looking myself, even if that means finding a different GI in a different city in order to get a referral to someone who will actually make appointments and see patients instead of sitting on their pile of faxes.  There must be somewhere else that this procedure can be done:  UWMC, OHSU

Did You Hear That?

Mom was getting older, and really needed to do something about her ears. We’d drop subtle hints like, “Hey, Mom! Do you have anything other than a hearing aid on your Christmas wish list?”

It was causing problems.  She’d have a conversation with me, then report it to my brother who would get upset with me over what I’d said.  Likewise, mom would report to me what my brother had said, and I’d be mad at him.  Finally we realized what was happening.  We started phoning one another, “Mom said you told her…”  then we’d roll our eyes, laugh, then give the real scoop.  Belatedly, we realized that any time mom claimed, “Your brother/sister said…” whatever mom thought she heard probably wasn’t exactly accurate.  Although she’d get the basic topic right, it was important to double-check with one another on the details.

Finally, exasperated during one of her visits, I got out the yellow pages and started phoning around to get an estimate.  Most people refused to talk numbers over the phone, but one well-known company was happy to inform me that their hearing aids started at only $3,000 each.  “How much???!!!!” I gasped.  “Never mind.  We’ll keep yelling at her.”

A few months later we discovered that Costco has an audiology department, and we ended up paying $2,000 for a pair of hearing aids.

That was a few years ago.  Her ears are worse.  Now mom keeps missing phone calls because she doesn’t hear her telephone ring.  She’s late to events because she can’t hear her alarm clock go off.

My brother solved the problem – for a lot less money than a new set of hearing aids.  The android app store has a free hearing test.  It can be used quickly and much more easily than arranging another trip to the audiologist.  Bro simply attached a headset and played different tones until our mom said, “I can hear that.”  When she said, “Oh, I hear that one in both ears!” he knew he had a winner.

Noting the frequency/pitch, he transferred that information to Audacity, a freeware program on his desktop computer.  The program includes a tone generator, and he was able to create separate sounds so our mom knows whether an alarm is going off or her phone is ringing.  She no longer misses phone calls and ringing alarms.

Once set up, the entire process of testing, generating distinct tones, and installing them on her phone took less than fifteen minutes.

If you have aging parents (or aging ears), something for you to consider.

Still recuperating – this post written and scheduled in advance.

How Bodies Work

Like many people, I grew up knowing very little about how the human body works.  Not much more than a toddler’s ability to point out basic anatomy is required to get through our school system, so that’s about all I learned.  My RA diagnosis a few years ago gave me a quick crash course, though, and I found myself fascinated with the intricacies of anatomy and physiology.

I mentioned previously that I would be looking for materials so that my children don’t grow up as ignorant about this topic as I did.  The things that we’ve found the most interesting and informative are:

Lyrical Life ScienceVolume three is The Human Body.  Fun songs, set to familiar tunes, make it easy to learn the basics about the different body systems.  If you click the link, you can listen to some samples of the music.  My favorite, ironically enough, is the digestive system; unfortunately that one doesn’t have an online sample.  The first two volumes are good, too, but we started with the third and went back to pick up the others.  This is written at the junior high level, so it’s very understandable.  I highly recommend it.

For a good overview of the basics, I think that’s enough.  One of my daughters wants to become a paramedic, and has taken the initiative to learn more.  She’s studying AP biology – which is anatomy & physiology – and I can’t wait for her to finish the course so I can have the textbook.  She’s also following a couple blogs (here and here) to learn more, but that’s more about EMS than anatomy.

Beyond the basics, and to make things more interesting, I’ve added some visual aids.

Skeleton:  Being a hands-on person, I’d much rather have a three-dimensional object to study than just a drawing to view.  We can read (and sing) about the skeleton, number of bones, and many of the bone names, but it’s different to be able to get a good look at how the individual bones are shaped and where they’re located.  We can take the skeleton off his stand and put him in one of the chairs to sit with the family.  My kids are getting a much better grasp (no pun intended) on the bones of the body than they’d get if we just looked at pictures in a book.  I really wanted a skeleton with muscles attached, but one look at the price on those models put an end to that idea.

Torso:  Another of those hands-on things (since we don’t have the option of cutting bodies open to peek inside) is a torso.  There is a huge variation in types and prices, and I found a decent one that gives us the option of male/female/neutral (because guests are okay with a skeleton in my bathroom, but an anatomically correct gendered-torso in the living room might be a bit much for even the most open-minded of my friends).

 Brain:  We also have a brain model.  It can be taken apart to get a good view of the different sections.  My kids roll their eyes at having to actually learn this stuff, but all their friends are jealous.  It’s pretty funny to have company visit and someone suddenly ask, “Is that a brain?”  then pick it up and start taking it apart to get a good look at everything.

Rotator cuff:  I think any joint would work to illustrate how muscles and tendons all fit together and attach to bones.

We also do a few dissections:  lungs are fun, but we’ve done heart and kidneys, too.  I want my kids to have a good basic understanding of how their bodies work.  This approach seems to be making that happen.

Anything you think would be worthwhile to add?