Here’s a little personal story that shows why medicine is in such a mess.
Last week my elderly mother was startled while sleeping on a couch. She bumped her head on the coffee table leaving a small bruise, a little swelling and some soreness. It was obviously not a serious injury. She lives in an assisted living facility where the staff doctor wanted her to have an x-ray. She and I decided that we’d prefer to consult her own doctor and take the opportunity to ask him some other questions as well.
Mother’s own doctor seemed quite unimpressed by her injury, but in an obviously defensive move suggested an x-ray of her face and jaw. I was not alert enough at the time to ask him what kind of treatment could possibly be rendered even if the x-ray showed some kind of fracture. My suspicion is that nothing could have been done anyway, so the x-ray was a useless exercise to put Mother through.
The doctor’s office had an x-ray facility, but they said they couldn’t do that kind of x-ray. We’d have to go to a radiology lab. Here it got even weirder. Upon arriving at the radiology lab I asked whether they could do the x-ray, since the doctor’s lab said they didn’t have the equipment. The desk clerk couldn’t answer the question and wouldn’t disturb the technical staff, which was apparently at lunch.
I then tried to contact Mother’s doctor to get a clarification as to what “difficult” x-ray technique or equipment was needed and had prevented his office from doing the job. Contacting a physician by telephone, email or smoke signals is impossible these days — misunderstood instructions might result in a law suit, you know.
After an hour’s wait and no clarifying return call from the physician’s office we were escorted into the x-ray lab. The staff seemed confused about what had to be done. They were consulting manuals, discussing the case and buzzing around the equipment. After a while they told Mother to paste her face against the flat surface of the instrument. Some pictures were taken from the back of her head, some discussions ensued over the x-ray viewing screen. Then a couple of side angles were taken, more discussion. Another person was called in and I was excused on the basis that I took up too much room.
Shortly thereafter the x-ray tech came to get me and said that Mother had refused to continue with the procedures. I realized that I should have been a lot more assertive from the beginning and asked why they were taking all of those shots when we’d come in for a simple image of one side of the face. I challenged the man who had come into the room belatedly and now had his back turned to me, asking who he was. He said he was the supervisor. I asked him what the hell they were doing. Why not get the single x-ray we’d come for and be done with it. The supervisor responded that they had a “protocol” that they had to follow.
Well now, I suspect that the “protocol” had a medical procedure number assigned to it and that they’d charge Medicare for a whole series of x-rays that were useless to us. We needed just one.
I’m waiting for a statement or a bill and will vigorously challenge it if Medicare or anyone is charged for more than one x-ray. I doubt that Mother’s doctor will ever see the x-rays they took.
From the very first of this story a little good judgment would have saved a lot of discomfort and expense. The medical system has become so bureaucratized and so legalized that no medical professional can be counted on to exercise good judgment or initiative, or to communicate with the patients. The result is bad treatment and out-of-control expense.
As for Mother, she’s fine. The swelling, bruise and discomfort are gone, but she worries about how much radiation she may have absorbed unnecessarily.