I had the unfortunate opportunity to experience our two major local healthcare system competitors in a 48-hour time period this week. I found quite a difference.
On Thursday I started at the doctor's office, where a STAT MRI of the brain was ordered. They called one local hospital, who fit me into an already-booked diagnostic schedule. I arrived there in bad shape and was met with a sweet, sympathetic young lady in registration who spoke softly for my benefit, filled out much of my paperwork for me, and came out from behind her station to walk me to a chair in the waiting area. Once in Radiology, a man helped me onto the table, gave me a cold washrag on my face, a set of headphones, and a panic button. Laying down was excruciating and I was clearly shaky. He chimed in repeatedly during the 20-minute scan to ask if I was doing okay (side note: to anyone facing an MRI, I highly recommend sedation, especially in a STAT situation while in pain). My mind was wandering and scrambling. Amusingly, I'd recently seen that true-story movie 127 Hours starring James Franco, who had to talk himself out of a mental breakdown several times. I decided to have this same conversation with myself throughout the procedure, and also wondered if this was the kind of torture our military underwent when captured. Melodramatic? You betcha. But it made the minutes pass and I was losing it. The extreme loudness of the clicking and beeping was more than a normal person can tolerate with debilitating head, eye and ear pain. I made it through the worst 20 minutes of my life and was removed from the 'tunnel'. The tech sat with me for as long as necessary until I could stand. No rushing, he said, even though I knew the next patient was waiting right outside. I proceeded to the lab for bloodwork and at this point my pain tolerance was crashing. I was pale, dizzy, had blurred vision and was severely nauseated. The young phlebotomist noticed this, and although I was not next on the draw list, she nabbed me from the waiting area and took me back to a reclining chair in the lab room. She asked repeatedly if I needed anything, and gave me a mint from her purse to help my stomach. Now, while normally a diagnostic procedure and report would take a day or two to report out, mine went like this: MRI at 1 p.m., review of images by radiologist at 1:50 p.m., dictated, transcribed and faxed to my primary ordering doc's office by 2:30 p.m. Prescriptions were called to the hospital pharmacy, ready for me in ten minutes. Not one person discounted my situation or herded me through like cattle. While I provided my insurance card, there was never any talk of benefits or co-pays. That was the least of their concern. Those touches alone kept me together. My mommy drove me home and I crashed to sleep with Percocet.
Fast forward two days. Shopping with Mom (heart condition) and daughter Courtney at the mall. Just as we enter the food court, Mom's heart rate takes off for no good reason. She takes a seat in a vestibule area with couches, chairs and a TV. We try a few tricks that can sometimes slow your heart rate. Several shoppers walk by wondering if they should call security as I'm squeezing her neck in a choke hold to try and put pressure on her pulse points. We finally drive to the other system's ER, the large conglomerate in Toledo; this is where she's always attended and they have her records on file. The first thing I notice while we're sitting in the little ER Triage room is the main desk behind us. A young guy is on the phone discussing a patient's condition and ordering a room number for him/her. An obviously-aching woman is standing in front of him waiting to check in while he's on the phone. He does both at the same time. All the while he is scrolling down Facebook on the computer, reading status updates on his Home page. Once in the ER room, my mother is light-headed, short of breath, not able to talk a lot. The first nurse instructs her to remove her sweater and tank top (thanks for the help, she can barely exert an ounce of energy). Another nurse, with butt crack and undies protruding from her scrub pants pulled down ghetto-style, attempts to start the IV and comments how "This is the 3rd stick today I'm not getting, I'll have to back out and stick you again. Oh look at the needle, I guess I had it the first time, should have left it in. Ok, big poke..." It didn't help that the ceiling light above her was out. I jokingly commented that my cell phone has a flashlight feature if it would help her. She ignored me:) A couple people begin hooking up EKG wires, nasal oxygen, and securing the difficult IV. They begin explaining what she'll receive, although she's been through this before and knows the drill. My mother 'introduces me' more than once as each person enters the room as I sit in the chair next to her bed. Not a single nurse/doctor look at me or acknowledge. Droopy-pants nurse stands at the counter now, back facing us, and begins talking to my mom through the back of her head. "Any history of high blood pressure? Diabetes? High cholesterol? Any other history of heart problems?" We didn't see her face during this shouting session. If we would have, she may have noticed the chest scar, a clear indicator of previous heart surgery. Then comes the kicker. A woman enters with a rolling laptop and announces that she is going to take my mom's registration information for billing. She goes line by line, asking first and last name, with spelling, street address, phone number, and asks for the insurance card. It is clear by her ignoring my presence and looking directly at my mom that she expects the information to come from her and not me. I fumble the insurance card out of my mom's purse. Lady then asks expectantly, "What is your husband's social security number, we need it for billing?" At this point I'm amazed at the lack of civility in here, but I keep my mouth shut. Are these demographics really necessary while her heart rate is 168 per minute? By the way, the average heart rate is 80-100; she has been pumping double-time for an hour now. The doc tells us later that the heart can tolerate this strain for about a half hour before bad things can happen. In all the chaos, my mom amazingly (not really though) spouts off the requested digits. Next question, while gown, EKG and oxygen are still being applied, "There is a $25 co-pay due today. How will you be taking care of that? We take cash, check and credit cards." That was about it for me. I'd seen enough. If I were standing near her I'd have whipped that computer right out of the room. I could only stare in awe. I sometimes have a history of running my mouth, so I made a mental effort to bite my lip and again fumble for a credit card in her wallet, although there were too many people between us to deliver it to the lady before she stepped out. At this point I decided to exit the room; I could feel my irritation spiking. Also along for the ride were my boyfriend and his daughters, who'd met us at the mall and followed behind in his car while I drove my mother's. I'm sure they weren't anticipating spending an hour or two of their Saturday in this manner. I was thankful he/they stuck with me. I should have taken them for ice cream after! Half hour later, Mom has been treated with adenosine, which momentarily stops the heart and allows it to reset to a normal rhythm. She hates this with a passion. It is startling. Anyway, as they're wrapping things up and she's regular again, she comments to the nurse about how they seem to closely watch the heart monitor screen when she gets this injection. His response is that they like to watch her flat-line and then re-start because it 'looks cool' on the monitor. Glad we could entertain them! Is that the most thoughtful response he could deliver to his patient? I'm sure it wasn't cool for my mother. Eventually we exited the facility and she was feeling good and looking colorful again. Registration boy still had his Facebook page up. I never did pay that co-pay.
Now, I recognize that the visitation of various departments during my own hospital visit is not an apples-to-apples comparison of my mother's ER trip. I'm sure the emergency environment is different. However, I happen to work for one of these hospital systems and always knew of the quality and warmth at the patient-care level and focus on well-being versus our less-sensitive-yet-sophisticated-and-advanced counterpart. I have lived in Toledo my whole life and now seem to have personally experienced a little of each! Both did the trick in different ways. I left mine happy on Percocet (with a measly diagnosis of sinus impaction:) and Mom left hers with a happy heartbeat.
