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Yesterday I called the Case Management Nurse of my health insurance company.  I have had a professional relationship with this person for several years, and she has assisted me with a number of medical issues during that time. Today’s call was to ask her to help me set up post-surgical in-home physical therapy, in place of the  out-patient therapy I had arranged yesterday. My first appointment with that facility is set for this coming Monday. It is obvious that if I want to make a change to a different facility, it has to be done today, today being Friday. At least it seems  obvious to me. All we need is the doctor’s signature on a form and faxed to the nurse case Manager.

Most of the day went by, and it was nearly 3:00pm, and I had not heard back. I called the nurse, who picked up the phone immediately. She had also been sitting by the phone waiting, in her case for the doctor’s call-back. We discussed the situation briefly. She was as incensed as I about the lack of attention. I called the doctors’ office and found it was closed for the weekend, and I called the nurse back and told her this. I had to make a decision as to whether to wait until Monday rolls around and see if the nurse can make this happen then, or to go with what I had. I chose the latter.

This may sound like a simple solution to an equally simple problem. But it goes deeper than that. For example, this medical office of four doctors and four staff has screwed up in some way each prescription they have written, either in the name of the drug, in how it should be taken, or which pharmacy should be called. This was a one-day procedure, in at six and out before noon. Now it seems that the physical therapy was going to get complicated.

The doctor failed to do the following: (1) write the required prescription for the P.T. and give it to me before I left; (2) ask if I would like to have in-home rehab, or if I had a preferred facility; she gave me a paper with a list of names, and I chose one of them; (3) write a new script for a non-narcotic pain med, which she had just discussed with me. All of these things are routine and should have been taken care of as I walked down the hall to make my next appointment, or if any were forgotten, called me later. Each one was overlooked and caused my daughter and me a great deal of time, inconvenience, and gasoline. To ignore mine and my nurse’s request for service was at the very least unprofessional and rude. It could even be illegal due to the extra accommodation I am asking for and is required in my case.

My surgery was on my right foot, making it impossible for me to drive or to get around by myself for anything. I need in-home therapy and am entitled to it because I am home-bound. This therapy, as far as I know, does not require any equipment I don’t have in my house. If I cannot get in-home rehab, I will have to find transportation to the facility. I am in a no-win situation; whatever decision I make will be the wrong one in someone’s eyes.  And even as I write this, I think I may have made the wrong decision. I should insist that this be given top-priority come Monday morning.

Let me take you back a little. I am 72 years of age and manage roughly six or seven areas of health care for myself. Some of them overlap. Here are my practitioners:

Primary Care Physician
gyn oncologist
I am adding physical therapy to the list, and I’ll also mention here that I get a yearly mammogram, and have gone for MRIs, colonoscopies, and radiation.
During the last 15 months I have had three major surgeries. I am familiar with the medical profession, and my early career was spent in this profession.

When I realize how many doctors I have seen in the past year, I am surprised; but managing my medical care is probably no surprise to most women my age. Many of us live alone, and even if we don’t, we take care of these things ourselves and possibly for a spouse as well. We are not dummies nor children, yet we are sometimes patronized or ignored. We know a lot. It involves prescriptions and updating and changing prescriptions; knowledge of drugs and x-rays; appointments and changes to appointments; talking to dozens of medical staff, as well as insurance companies’ reps, Medicare reps, and pharmacists. We read up on the latest developments on our health issues. We do all this in addition to volunteering, baking for social hours, visiting grandchildren, and knitting caps for preemies; and as you can see, some of us blog our experiences and write poetry.

My point is this: no one should discount those of us older Americans who have an illness or a disability or who are getting old. We are entitled to respect and to good service. I’ll acknowledge that sometimes I may not feel well or am tired; but I always try to be respectful to the medical profession. I also deserve respect, and in this case I was not given that. The doctor ignored the urgency of my request. The staff did not have the courtesy to give the nurse a call-back and made us wait all afternoon in vain.

As I read this over, I see that once again I have given over to someone else and not believed in my own rights. So thank you for listening. I will stand up for myself come Monday morning.

One more thing: for the most part, those in the medical profession are very courteous and professional, and they go out of their way to make patients comfortable and to accommodate their needs. It is a demanding industry. I have no complaints of the 99%, but now again, one must stand up and make a statement.
And another thing: In re-reading this, I acknowledge that I have made a classic mistake – thinking from my own nationalistic point of view. So when I spoke of “older Americans,” I say shame on me; I misspoke. I amend that to say “older citizens,” because this issue certainly applies to people everywhere. I am grateful for my readers in many locations around the world and apologize to you for being so thoughtless in this regard.