Comparing Health Systems

Wow, do I ever like Texas! Aside from it being hot enough to fry an egg on the sidewalk, it’s great.

As we’re in the process of moving into our new house, I managed to break the toes on my right foot. OUCH!!!! In my old house, the stairs have a 6″ rise, but the new house has standard 8″-rise steps. My legs seem to think that they don’t have to lift those extra two inches.

And I know that there is usually no point in seeing a doctor for broken toes because they don’t do anything other than sell you an expensive boot. But after a couple days, the swelling went down enough that I could see this might be a problem that needed to be addressed. At home, I’d call my doctor’s office. They’d see me and send me across the street to an independent imaging place, then my doctor would look at the x-rays and decide if he could treat it or if he needed to send me to an orthopedist. Straightforward, easy, relatively affordable.

But that doctor is in Washington and I don’t have one yet in Texas. And timing just didn’t work out, so off we went to urgent care, who told us that emergency would be more appropriate for broken bones..

It was incredible to have people tend to the medical issues first, and later worry about money.

In Washington, you walk in and security makes sure you’re okay to be there and enforces the governor’s mask mandate. Then triage takes your identification and insurance card, after which they write down the chief complaint and take vitals; then they get your medical history and meds list. If they send you out to the waiting room, they’ll call you back up to collect the copay. Eventually you’re taken back and put into a room until the doctor can get to you. It takes a while. If you skip the waiting room and go straight back, they will interrupt the doctor to collect your copay. An hour or two after the doctor orders x-rays, they’ll get around to taking them. Who knows how long it will be until they read the images and return to explain the treatment plan. It’s very impersonal and they act like your injury or illness is a huge imposition. A trip to emergency takes 6-12 hours in Washington so you definitely don’t want to go. Even when my mom was admitted, she was in the ED for 12 hours before being taken upstairs.

In Texas it was very different. We walked in and went straight to triage where they put my name and chief complaint into the computer then did a quick check of my toes. Security was available, but off to the side and not in your face pushing masks on everyone who walks through the door. When I was taken back to be seen, the nurse and PA promptly descended on me as a team and the PA did the exam and ordered x-rays while the nurse took vitals (this makes the bp reading highly inaccurate). The nurse came back later for a meds list, and then later for medical history. Not one time did anyone ever harass me about the stupid pain scale. “You think your broken toe has a bone displaced? Let’s get some x-rays and take a look.” Eventually someone came and asked for ID and insurance info; there was a problem verifying insurance, but eventually she said not to worry about it and we could deal with it on Monday when the insurance company is open. They never did collect a copay. We walked in the door at 9:30 and were home before 1:00.

Every part of the experience was better in Texas. Plus everyone was really nice, chatted a bit, and treated us like real people. I’ve been dreading having to find a new medical team, but gotta say that my first experience with the medical system in Texas far exceeded my hopes or expectations.

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Thankfully there’s no displacement needing surgery. I chipped the bone and that little fragment is what I feel, but the breaks will heal fine without intervention.