Raise your hand if you’ve been through the ordeal of waiting for approval from your HMO or other managed care provider, only to have the doctor then say, “Why did you wait so long to come in?”
Okay, you can all put your hands back down.
I’m am half to blame for taking too long to have my right biceps checked by a qualified doctor. When I originally injured it, I had no medical insurance and could not afford to go to a doctor to have it looked at. But once I was covered, it took me six months to finally wend my way through the debacle that is our healthcare system.
Last April I wrote about my panicking within an MRI machine. So, again, I am partially to blame for the length of time it took to see an orthopedist. But once I managed to get the Open MRI, and was securely enveloped within the flow of the system, it still took me five months to get to see the doctor!
Here’s the Rundown
About six to eight months prior to being accepted into our healthcare system, I decided to be a good Samaritan and help two college-age boys lift a couch into the rear of a small truck. The couch was half on and half off the truck. The two were struggling with it and were both up in the rear of the truck. I was crossing the parking lot of the apartment complex where they were parked and I gave them a wave, indicating that I’d lend a quick hand.
I squatted down so as to lift with my legs and not my back. I lifted. I felt a shooting pain in my right biceps that was accompanied by a loud and distinct sound of tearing; as if someone had ripped a piece of Velcro. And the couch hadn’t moved even a centimeter.
The pain was tremendous and, even though I iced it immediately, the discomfort continued for a few days. Eventually the soreness passed but I had lost quite a bit of strength in my right arm and I could clearly observe that the muscle had changed shape; it wasn’t where it used to be.
I enter the healthcare system
I had my first appointment with my new physician in February. She checked for blood pressure and cholesterol; the things for which they can prescribe medications. Then she asked if anything else was bothering me. I showed her my biceps. She said she would request an MRI.
After about three weeks I received a letter saying I’d been approved for an MRI and telling me where to call to have it scheduled. I told the woman I had a feeling I was claustrophobic and thought I’d better try an Open MRI. She assured me that they could do that.
The day arrived and the technician informed me that he was a temporary tech and he wasn’t exactly sure how to scan my arm in the Open MRI but he was pretty sure that it couldn’t be done.
I thought he was trying to kiss off my scan so he didn’t have to do it.
I was sent to another location two cities away and they informed me that I wasn’t on their schedule and, after a while, informed me that I was on the schedule of their office which was another city to the east.
I got there to wait for two-and-a-half hours and then discovered that it was not an open machine and that I was, indeed, claustrophobic.
So I went home. After a day or two, I began to wonder what my next move was. I called my primary care physician and the woman who answered the phone said, “Well, you’re already scheduled for an appointment in two months. Just ask the doctor then what you should do.”
Okay. If that’s what I’m supposed to do, then that’s what I’ll do.
Two months later, after my doctor tells me my cholesterol and blood pressure are looking good, I tell her about not making it through the MRI.
“Didn’t we request an Open MRI?
“Yes,” I said, and then explained about the temporary tech and the rest of my day.
“Okay. We’ll schedule another for you.”
Three weeks later I get another letter from my healthcare plan informing me I’ve been approved for another MRI at a different imaging place. I called and was assured that, if I went to a specific office, I’d have an Open MRI. And I did! And I didn’t panic and it was good!
Two days later the MRI people called back and said I needed a bit more of my arm scanned and they said, “We’ve got an opening tomorrow.”
I was available and spent another half hour getting my shoulder scanned. Cool!
Nice MRI. Where’s your X-rays?
Three weeks later I got a letter from my healthcare plan telling me that I’d been approved to see an Orthopedist. Great! I called them and they said they didn’t have any openings for a month. I took the first opening they had.
“Oh, and bring your X-rays with you.”
“What X-rays? I had an MRI.”
“Our doctors don’t want an MRI. They want X-rays.”
“Then why did I spend the last three months trying to get an MRI?”
“I don’t know, sir. Our doctors want X-rays.”
“How do I get those?”
“Call your primary care physician.”
I did. Luckily there was a cancellation on her schedule the next day.
“What are you here for today?”
“The Orthopedist’s office said I needed to bring an X-ray instead of an MRI.”
“Okay. What do they want X-rayed?”
“How would I know?”
“They didn’t tell you?”
“No. But I’m assuming that they want the X-rays of the same thing we had scanned in the MRI.”
“Well, that’s not always the case. Where did you go? We’ll call them.”
I looked through my phone to see if I entered the name and address of the Orthopedist and gave it to her. I waited an hour. She came back with a lab-order sheet and said, take this over to the hospital and they’ll do your X-ray. Be sure to make an appointment so you have them finished in time for the other doctor.”
“Okay. You know, while I’m here I may as well ask about my shoulders. For about the past nine months to a year they’ve begun hurting when I raise my arms.”
“Yeah, your MRI report shows some Tendonitis in that shoulder. It’s probably the same in both.”
“It’s not Arthritis?”
“No. Tendonitis. Just take an anti-inflammatory if it bothers you too much.”
I went home and called the hospital to make the necessary appointment for my X-ray.
“We don’t take appointments. Just come in early in the morning and we’ll get you taken care of.”
And they did. And I waited for my X-rays and left with three CD’s of them.
A few days later I got a packet from the Orthopedists informing me that I had to have the complete medical questionnaire completed before I arrived. Additionally, it said that I need to bring my X-rays and any other imaging! I called their office and explained that I was told that I didn’t need my MRI results, only X-rays.
“Who told you that?”
“Whoever answered the phone last time I called.”
“Well, bring everything you have.”
I called over to the MRI place and the woman there said, “We will mail it out for you.”
“They said they want the images, not just the report. Should I come and get them?”
“No, sir. That’s what we do. The mail already went out today so they will go out tomorrow. Do you have the address?”
“Yes.” I gave it to her.
“And the name of the doctor?”
I gave it to her.
Finally the week of my MRI arrived. Two days before my scheduled appointment I got a call from the office.
“You have an appointment for 7:10 Monday morning with Dr. Whang.”
“I will be there!”
“Well, Dr. Whang won’t be in the office that day and he’s booked up for six weeks so we’re rescheduling you with Dr. Gesundheit for Friday. That way you only have to wait another four days.”
“Okay. Well my MRI place said they were sending my images to Dr. Whang. How can I make sure that Dr. Gesundheit gets them?”
“Oh, they go into your file, not the doctor’s.”
“Okay, see you Friday.”
Nice X-rays. Where’s your MRI?
On Friday I arrived, with my X-rays in hand. The assistants took me to an exam room and I waited while they entered all of the data into the computer from my pre-filled-out forms. I wondered why they had me take the time to fill them out in advance when they just had me sit there and wait while they entered all of the info into a computer. Why not just ask me the questions while I sat there?!
“Okay,” the young woman said as she finished typing. You have your X-rays?”
“The girl at the front took them from me when I checked in.”
She sighed. “I’ll be right back.” She returned with the discs and said, “And your MRI’s?”
“They said they’d mail them here. When they called to change me over to Dr. Gesundheit, I asked if my scans would be moved over. She said my MRI’s would be in my file. Plus, when I originally called for the appointment, they said they only need X-rays.”
“Who did you talk to?”
“I have no idea.”
“Well, you should always get a name.”
Dr. Gesundheit entered and shook my hand. “Tell me about your injury.”
I explained about trying to lift the couch.
“Let me see your arm. Bend it this way. Bend it that way. Okay. We have X-rays. Did you get an MRI?”
“Yes, but it’s not here. They told me they’d mail it but she said it’s not in my file.”
He put both hands to his face and then dragged them down. “I’ve been here 20 years. They never once have mailed the images. You should have gotten them when you had the scans done.”
“How am I supposed to know that?!”
He turned to the assistant. “See if you can get the report.” He looked at me and said, “We’ll get the report. Sit tight.” He left the room.
“What was the name of the imaging center?” the assistant asked.
“Uh, gee, I don’t remember and I didn’t think I’d have to know the name of the place since I was told you only needed X-rays.”
“Please wait here.”
She left and I sat.
After ten minutes or so she came back.
“The imaging center said you panicked inside the machine and left without a scan.”
“That was the first one. I went and had two more in an open MRI at a different place.”
“Well, this is the name they gave us.”
“Who gave you?”
“Your primary care doctor.”
“But there’s a report in my file at their office from the second place I went to! They didn’t have it?”
“This is the name they gave us.”
She leaned on the door jamb as she talked and left with a shrug as if she’d done all she could do. I got out my phone a Googled “imaging” in the city I’d gone to. I went down the list until I recognized the web page of the center. I went out of the exam room and found her at a nurse’s station.
“It’s called Bob’s Imaging. Here’s their number.”
“Thank you!” she said with a chipper smile.
I went back to the exam room and waited.
Eventually the assistant and the Doc returned. He had a report in his hand.
“Well, your biceps is torn. It detached at the tendon in your elbow. Too much time has passed since the injury and there’s nothing that can be done. Why did you wait so long?”
I wanted to lash out and say that, with the approval process and all the scheduling and crap that I had to go through, it had taken me five months just to get into see him. But it was also due to me not having insurance so that’s what I said to him.
“Okay. Well, sorry. So, does your shoulder hurt?”
“Yeah… I mean when I raise it up above horizontal.”
“Yeah, I can see some deterioration and a little arthritis.”
“Really?! My primary Doc said there was no arthritis. This is surpr—“
“Look. I’m a shoulder guy. That’s what I do. I’m not your primary doctor. I don’t know about your blood pressure or your cholesterol or your heart…”
I made a fist with my right hand and put it to my chest. I began a squeezing motion and said, “Well, it’s a large muscle right about here and it pumps blood through the entire body…”
He kept talking as if I hadn’t said a word.
“So I’m telling you that you have some arthritis in your shoulder plus there’s some deterioration of the hyperbaric neoplasm where the bilabial fricative attaches to the tuberous malfeasance.”
“I don’t know what that means.”
“It means you’re getting old and you’re deteriorating.”
“Okay, sir. I meant no disrespect when I told you what my other Doc said. I’m just expressing surprise and—“
“So I can’t really cure your disease and there’s not much that can be done with surgery right now. If you want I can give you a cortisone shot and send you to physical therapy. How much pain are you in?”
“None, really. Unless I have to raise my elbows above my shoulder or extend out to the side like this. Ouch.”
“What do you do?”
“Sit at a computer and write.”
“Do you want a cortisone shot?”
He stood and offered his hand. “It was nice meeting you. Come back if the pain becomes unbearable.”
As I stood to leave, I turned to the still-typing assistant and said, “Is that it? Can I go?”
“Yeah, I’m just requesting a copy of your MRI.”
“I thought the Doc said they didn’t mail them…”
“Oh, they mail them all the time!”