We need to overhaul healthcare

If I wasn't laughing I'd be screaming: Trying to get treated at Kaiser Permanente (Part II)

2008-05-11T18:09:00.000-07:00

If I wasn’t laughing, I’d be Screaming
or
The difficulties in trying to get treated as a patient at
Kaiser Permanente
READ Part I

The following continuation of a story illustrates how difficult it is for a patient to be treated at Kaiser Permanente.

Synopsis:
Patient has a prior hip injury, and 3 years later is re-injured and tries to a) determine the cause of injury and b) seek treatment.

Three years had gone by since I’d torn the acetabular labrum in my hip. Since it had slowly improved over time, the orthopedic surgeon (Dr. #2 from Part I of this saga) had not recommended surgery at the time, but recommended open debridement with possible osteotomy. The only reason I know his recommendations is because I order copies of all my medical records and get copies of tests if possible. You will see why this is a wise thing to do if you keep reading.

I did get PT with an excellent physical therapist (PT #1). I only got two visits though.

Over the course of 3 years, the pain was largely gone but many exercises aggravated my hip and I would go through periods of pain. I noticed that yoga and deep stretches made the problem worse, as well as squats and anything with a large ROM on that side.

It was in April of 2008 that it came to a head. I had been doing deep squats in a fitness class; I told the instructor they hurt my hip but she told me I was probably just doing them wrong (I wasn’t). She told everyone that. I’ll know better next time to listen to my own body and stop despite what someone else is telling you.

I had been taking the class for 2 months. One week, I went for a 5 mile hike in the mountains with some friends. One dance class later and I was in a world of hurt. My non-Kaiser chiropractor who had been previously helping with Active Release Technique, suggested that I might have re-torn the labrum.

I remembered what Dr. #2 had said 3 years ago, to come back if the pain got worse. I called and told Kaiser what he had said and asked for an appointment with him. He was no longer with Kaiser, they said, and they couldn’t tell me where he had gone. I Googled him and called his new medical office to ask for OS recommendations, but he never called back. Amazingly, I was able to request an appointment with an OS I found on ratemds.com over the phone by leaving a message with my Primary Care Physician. This was a new PCP for me by the way; I had to leave the old one because she was making up diagnoses and leaving them on my health record, part of the reason I got denied when I tried to switch out of Kaiser to another provider.

So I was surprised when I was able to get an appointment with a specialist without seeing my PCP in person. It had to have been some sort of miracle.

Kaiser told me to come in locally and get x-rays. This time I had done more research and when the technician told me she was only going to take the AP view requested by his office I asked her to do lateral and frogleg views. She reluctantly did frogleg but not the other views I asked for. I’m pretty sure it was unusual for the patient to ask for a different view. You have to look out for yourself in Kaiser though.

A short week later (another miracle) I was in Dr. #3’s office in Facility #3, armed with pen and a list of questions. He did some orthopedic tests and looked at my 2 x-rays on his computer screen. He promptly told me I had a cam impingement. I asked him to look at my previous labrum tear from 3 years ago and he said he didn’t have access to it. It turns out their computer system only shows them data from the last 3 years and it had been slightly over 3 years. I asked him if he could request it, and he said curtly, “What would be the point?” To compare it to a new one? I actually had the MRA disc at home and asked him if I should bring it in, but he wasn’t interested. He wanted to try PT and a cortisone shot first before any procedures.

He also declined to look at some x-rays I had brought with me, which included multiple views taken the previous week and 5 years previous (all non-Kaiser films). I looked at them with my chiropractor later and he pointed out to me where the cam impingement was 5 years ago, smaller. Many people had missed it, so I was impressed with Dr. #3 for at least finding it, if other aspects of the visit were frustrating. For example, he wouldn’t write a note to drop my fitness class or write me a prescription for pain. (He told me to stop using a crutch and I said I needed something for pain in that case.) I was supposed to see my PCP for these things, apparently, another trip out with my injury, and a $50 copayment.

Meanwhile I couldn’t exercise the leg muscles because of the pain, so I was losing a lot of muscle. I figured if I had torn the labrum (no MRA so I didn’t know for sure) that the inflammation needed to go down and exercising would just exacerbate it.

Obviously I had questions. I emailed Dr. #3 but he didn’t respond thoroughly at all, so the next time I wrote, I capitalized the word QUESTION, and had to send him 3 separate emails because Kaiser had a character limit. He still glossed over them and said we would need to talk in person for so much detail.

One of the questions I had written was whether I should do his recommended PT before or after the cortisone shot because I was atrophying but couldn’t do much without pain. He wrote back that PT would not help the cam impingement (it is a bone growth). Helpful!

So I knew I needed some time with him in person before he did the cortisone shot. I called his office and asked if my visit would include some time to talk to him first. “Of course,” the woman replied. “He’s not just going to come in and start doing procedures on your body.” She said I had 2 appointments scheduled for that day, one with him and one with x-ray, and I should come to his office before going to radiology. I told her I needed at least 20 minutes and asked how long the appointments were . 30. Great! Out of curiosity, I asked her what happens if you go over and she said that’s life, sometimes you go over.

While I was waiting for the visit, I went to see my PCP for the vicodin. It’s a Schedule III drug, so you can’t have someone just get it for you. More painful walking and a $50 co-pay. The first thing he did when he walked in was apologize for the co-pay. I was shocked. I explained what was going on, told him what a cam impingment was (a lot of family doctors don’t know), and asked if he could get me an MRA. No, he could only schedule MRIs. The surgeon would have to do that. He seemed a little out of it but he was really nice.

What’s funny is that several days later, I got a radiology report in the mail. It briefly said everything was normal. Attached was a note from him saying “Bones look ok.” That’s what passes for a radiology report these days at Kaiser? I’d even explained that a cam impingement was a bone growth, obviously not “ok”.

I also saw a new PT at Facility #4 (PT #2 as opposed to the one 3 years ago). Like nearly all PTs at Kaiser, she was excellent. She wanted to know what the surgeon’s plan of action was because she had read our emails (I guess they’re not private after all), and saw that he’d said PT wouldn’t help a cam impingement. She said he was known for hips. She was not surprised I had had a bad experience (mis-diagnosis, rudeness, pain) with Dr. #1. She gave me some exercises to try and asked me to call her when I learned the Plan. It seemed to straightforward and simple. Of course, it wouldn’t be.

I wanted to re-schedule my cortisone shot sooner because it hurt so much but I had already re-scheduled twice and I didn’t want to piss of the OS or his staff. My partner drove me to Facility #3, over an hour away. My choice; I picked the surgeon. The pain was so bad that I grabbed the wheelchair I saw sitting in the hallway. Ortho there was on the 2nd floor at the end of a long hallway. The chair had no leg rests so I had to tighten my leg muscles to keep my feet from dragging, more pain at the hip.

After I had paid my $50 copay for the office visit (yes I did just say that), the woman told us to go directly to radiology. No, I insisted, I had an appointment with the OS first. "I don’t think so, I’ll check.... Go talk to those people over there." After some explanation and low murmuring among themselves, they told me to wait.

I was grouchy; my pain level was an 8 out of 10. After 5 or 10 minutes, we were taken back to an exam room. Dr. #3 entered in a few minutes. I explained the weird visit issue because he said he had several patients. Like everyone else there, he seemed inconvenienced, but curtly asked for my questions. I told him my pain and atrophy was increasing and wanted to discuss surgery with him. (Cam impingements, I had learned, do not go away. They are a bone growth that keeps growing, and destroying cartilage, leading to pain and early osteoarthritis.) He said he wouldn’t even consider surgery until we’d waited 2 weeks to determine if the problem stemmed from inside or outside the hip joint. I explained my concerns about my schedule. I was just accepted into a competitive program that started in several months. I had a summer class and 9 free weeks for surgery recovery. He was unsympathetic. He said I had an unusually high level of pain for this diagnosis. No one else was unable to do these exercises because of pain. I was overly emotional and likely to have a bad surgical outcome because of it. “People are not cars.” Very true. At Kaiser, we’re cattle. Overall I was quite upset but also a little impressed that he didn’t want to rush into surgery. I would have been more impressed if he hadn’t been a Kaiser doc though. Surgeries are expensive.

He was good during the actual cortisone shot procedure; he seemed careful and compassionate, asking if he was hurting me. I was surprised after his curt office visits, but I guess some people are just like that. Oh, and I paid $10 for the test; definitely not that $50 I had paid for an office visit I supposedly didn’t have.

After the shot, I kept a pain log for the OS. The pain took 2 days to start reducing, and I’m not sure if it’s because of the shot or because I’m walking around less than I was the last 2 days. I will keep you posted.

Sicko

2007-07-26T16:08:00.000-07:00

I saw Michael Moore's Sicko recently. I was ecstatic to see a movie which finally shows the truth about insurance companies and the state of healthcare in America. It was also interesting to see how some of them came to be that way. It turns out Kaiser was dissolute from the beginning. In a transcript between Nixon and Ehrlichmann, Ehrlichmann describes the proposed HMO's plan: "...The less care they give them[the patients], the more money they[the HMOs] make."

Another interesting note I read recently: In one part of the film, an 18-month-old girl is driven to the hospital due to a 106.6 degree fever. She is not treated there because the hospital cannot get permission from Kaiser, the girl's insurance. By the time an ambulance takes her to Kaiser to get the antibiotics she needs, she is dead. Kaiser is apparently trying to blow this one off as medical malpractice. When the doctor involved defended himself, he tried to claim that he thought it was asthma, even though phonecalls indicated he was asking to treat the girl with antibiotics for sepsis, a deadly bacterial infection. Kaiser is trying to use the excuse given in court by this doctor (who lost the court case, by the way), and excuse the fact that their corporate greed led to this girl's death.

How to file a complaint with the DMHC against your HMO

2007-01-04T23:18:00.000-08:00

You can download and fill out a form with the DMHC (Department of Managed Healthcare) here:
http://www.hmohelp.ca.gov/dmhc_consumer/pc/pc_forms.asp

They also have an online comments form here:
http://www.dmhc.ca.gov/contact/hmohelp/

Another furious Kaiser member

2006-12-17T23:07:00.000-08:00

Read for yourself...
http://mypeoplepc.com/members/jspr007/patricia/id55.html

Kaiser, where the patients are treated like cattle

2006-11-25T23:46:00.000-08:00

I recently heard someone refer to Kaiser as "treating patients like cattle", which seemed like an apt comparison, given that Kaiser docs see a different patient every 15 minutes. And we all know what happens to cattle... Read on for corporate cost saving resulting in death or injury.
http://www.kaiserpapers.org/californianews.html#corporate

Ever wonder if your (Kaiser) doc has been sued for malpractice?

2006-11-22T17:32:00.000-08:00

Here is how you check their license. Go to: http://www2.dca.ca.gov/pls/wllpub/wllqryna$lcev2.startup?p_qte_code=MDX&p_qte_pgm_code=6301

Kaiser rep misstates Consumer Reports' rating

2006-11-22T16:20:00.000-08:00

A Kaiser sales rep intentionally misstated a CU report, saying that it had rated Kaiser Permanente as the best HMO, when in fact, it hadn't. Kaiser's HMO in the particular location didn't even have one factor which was rated best.
Read more at http://www.hmohardball.com/consumer_rumors_y2k.htm

9 out of 10 trying to buy health insurance failed

2006-11-22T16:06:00.000-08:00

9 out of 10 Americans who tried to buy their own health insurance failed, either because the price was too high or because they were denied converage due to pre-existing conditions. Read about it at http://ca.news.yahoo.com/s/14092006/6/n-usa-corrected-most-forgo-buying-own-u-s-health-insurance.html

Healthcare profitability

2006-11-22T15:59:00.000-08:00

Healthcare companies are making profits. For example, the top 12 in Fortune 500 are all profitable, with HealthNet having a 439% profit increase.

See:
http://money.cnn.com/magazines/fortune/fortune500/industries/Health_Care_Insurance_Managed_Care/1.html

Grievance department at Kaiser? (Charged for services not rendered)

2006-11-22T15:48:00.000-08:00

Has anyone tried to go through the grievance department at Kaiser?

I didn't even know there was one until I one day I looked at a receipt for an office visit and noticed that a test had supposedly been done when it hadn't. I contacted the doctor about it and it went through billing, and it must have been a big deal, because I got a lot of papers about it in the mail. Kaiser refused to refund my office visit payment, despite the fact that they had not provided the service as documented.

Problems with Kaiser (summary to date)

2006-11-22T15:43:00.000-08:00

Problems I have experienced at Kaiser:
--Not getting help for my medical problems
--Getting locked into an expensive plan
--Kaiser docs making up illnesses which go on my medical record and prevent me from getting health insurance or changing said expensive plan
--Kaiser docs failing to do proper paperwork which resulted in false positives, preventing me from changing health insurance
--A horrible phone system which which can take about half an hour just to leave a message for your provider (there's no way to talk to them directly of course)
--False diagnoses
--Refusal to do the tests I need because Kaiser doesn't want to pay for them
--Being charged for things which were not done
--Kaiser doctors taking a long time to respond to messages
--Kaiser taking a long time to schedule tests (or any other procedure including office visits)

Kaiser cannot help patients using the system they have, which requires them to be both the doctor and the insurance company. They are not interested in paying money to help their patients, and so their patients are not helped. Being a patient with them has been a horrible experience, and if I could leave, I would.

Kaiser using Google to focus web searches

2006-05-25T20:18:00.000-07:00

This sounds like a great way for Kaiser to attempt to get better coverage on Google (i.e. fewer posts from patients and more pro-hmo propoganda). What do you think? I invite your comments...

Read about it

A patient's dream of exactly what to do with Kaiser...

2006-05-25T18:40:00.000-07:00

Criminal activity at Kaiser?

2006-05-25T17:04:00.000-07:00

This person claims on their site that Kaiser is conducting criminal activity, presumably to hinder financial investigation. View for yourself.
"Shortly before I was scheduled to look for billing discrepancies at Kaiser HMO, a gunman fired a shotgun in my general direction. I was obstructed in conveying my reports to my clients at Kaiser and subjected to intimidation by other Kaiser employees. A whole array of problems including arson fires began at that time and has continued to the present. I believe that two fires resulted in one fatality each."
http://home.earthlink.net/~jimristrem/

Concealment of malpractice... and patient death

2006-05-25T16:47:00.000-07:00

This is a shocking incidence of concealment, but according to its writer, malpractice is usually concealed, as no one wants to be responsible for a patient's death.
http://kaiserconsumers.org/Concealment.htm

Got lawyers?

2006-05-25T11:29:00.000-07:00

Here's a law office dedicated to helping Kaiser patients.

Kaiser in Wikipedia

2006-05-25T10:45:00.000-07:00

Looks like Kaiser is taking exception to what people are saying on Wikipedia about them. Heh.
It might be this line: "Kaiser among others has paid fines for patient dumping." I say, get it out there. For a non-profit organization, Kaiser sure is concerned about profits and making themselves look good.
http://en.wikipedia.org/wiki/Talk:Kaiser_Permanente

MIB intentionally withholding patient information?

2006-05-25T10:25:00.000-07:00

Earlier I mentioned the MIB, the Medical Information Bureau. Recently, when I contacted them to find out if I had any records with them, they responded with a letter stating that they didn't have any under the following names. Following were several misspellings of my name. Since I had given them my name, birthdate, social security number, address, and other information, I don't see why there should be any ambiguity. They either have my record or they don't. Please tell me they don't file things in their database under name. How many John Smiths are there in the United States?

Another Kaiser member not using Kaiser

2006-05-25T10:18:00.000-07:00

At the pharmacy (not a Kaiser pharmacy) today, I had a conversation with the pharmacist about a clinic. He mentioned that he was using it because his healthplan was bad. "Kaiser?" I guessed. He shared a story with me about his own bad experiences as a patient there. Isn't it ironic that we can't use our healthplan to get healthcare?
I hope he visits my blog.

Adword silliness

2006-05-25T10:17:00.000-07:00

Isn't it ironic that there is an ad for Kaiser at the top of this blog? If anyone were considering them as an HMO, they would probably change their mind after reading more...

I couldn't believe this...

2006-05-03T22:19:00.000-07:00

An example of patient privacy being violated...

"Who Said I Take Prozac?
In Florida, Walgreen Co. mailed free samples of Prozac Weekly to patients who were taking Prozac Daily. Imagine the patients’ shock when they realized that strangers were seeing and using their prescriptions records without their knowledge or consent. Under the new HIPAA regulations, this marketing is now called 'patient education'."

(This story and others like it can be found on http://www.patientprivacyrights.org/site/PageServer?pagename=True_Stories.)

Petition for medical privacy

2006-05-03T22:07:00.000-07:00

By filling out privacy notices at doctor's offices, you are really signing a release form that allows the office to share your health information. Patient Privacy Rights Foundation has a petition you can sign to send Congress the message that we care about patient privacy. Sign it here.

How do you keep your medical information private?

2006-05-03T21:01:00.000-07:00

HIPAA has helped, but in today's tangled web woven by insurance companies, your medical information isn't really all that private. You can bring a written request revoking your consent to release medical information to the insurance company. (I doubt this works with PPOs.) To be more secure, you can pay out of pocket, not using your insurance.
For more information, see the Privacy Rights Clearinghouse.

Who stores your health information?

2006-05-03T20:48:00.000-07:00

In your quest to be an educated patient, you may want to know about the MIB. Not the Men in Black, but the Medical Information Bureau. If you apply for insurance (be it health, life, or disability) and are denied, they may have the reason for denial stored as a code, which can be accessed by its 600 member companies (i.e. insurance agencies that you may wish to apply to in the future).
You are allowed one free look at your file per year. If you haven't been denied healthcare, you may not have a record. To request your record, go here.

fightkaiser.com

2006-05-02T18:13:00.000-07:00

Another Kaiser site, with some advice: "If you are a member of Kaiser Permanente - never trust your physicians. Make sure you receive copies of all your evaluations. Know your rights to obtain proper medical care. Appeal their denial of care and put everything in writing."

Memorable Kaiser Malpractices

2006-04-25T14:43:00.000-07:00

Here are some of the more tragic instances of Kaiser's malpractices.

Having trouble getting your medical records?

2006-04-24T21:28:00.000-07:00

For some reason, it can be difficult for patients to obtain health information about themselves. Here's one method for getting your records.

State action against bloggers violation of constitutional rights

2006-04-24T20:36:00.000-07:00

This individual had Kaiser actually launch a disinformation attack against them.

Here's the whole story
... and a timeline

Patient denied health insurance because of Kaiser Permanente's faulty information

2006-04-24T20:26:00.000-07:00

So more recently, I tried to leave Kaiser. That as well is a long complicated story, but I decided to try switching to a PPO. I was denied coverage because of a list of items, three of which were not even true. Two were both "guesses" on the part of the nurse practitioner who diagnosed me. A third was just a blatant lie. They claimed that I had not had a test done, and it had been done, and with a good outcome.

It was also interesting to me that when I received requests to access my health information from the PPO (they're required to get these because of HIPPA, I presume), the form was designed in such a way that it looked as if it was mandatory for you to reveal information such as psychiatric care and whether or not you have HIV. It is illegal for a health insurer to ask those questions of an applicant, but they were just trying to see if someone would sign it by accident, allowing them to check.

Kaiser chooses not to participate in patient satisfaction survey

2006-04-24T08:52:00.000-07:00

Check it out here

Kaiser Permanente Thrive Exposed

2006-04-24T08:47:00.002-07:00

Do you feel you've been thriving at Kaiser? Read more on this "be pro anti-HMO" site. It's a great site with lots of information about "Kaiser Permaprofit".
http://www.kaiserthrive.org/

Here are some Kaiser horror stories:
http://www.kaiserthrive.org/kaiser-permanente-horror-stories/#warehousing

http://corphq.livejournal.com/51385.html

Avoid using Monistat for recurrent yeast infections

2006-04-03T02:27:00.000-07:00

Overuse of creams to treat vaginal itching.
I took Monistat 7, 3, etc., trying to get rid of my problems and Kaiser (my HMO) wasn't helping. Finally at some point I developed an allergy to it which I think may have been one of the reasons I had chronic yeast infections. I had burning and abdominal pain. A year later I took it because I couldn't afford a prescription medication at that point and had a repeat of the burning and abdominal pain. I suspect a lot of people are developing immunities to these types of medications.

I'm angry that women spend so much on a product to get their symptoms under control when they don't have a good alternative (for many people oral anti-fungals are not effective at some point).

If I wasn't laughing I'd be screaming: Trying to get treated at Kaiser Permanente

2006-04-03T02:20:00.000-07:00

If I wasn’t laughing, I’d be Screaming (Part I)
or
The difficulties in trying to get treated as a patient at
Kaiser Permanente
Part I

READ Part II

The following story illustrates how difficult it is for a patient to be treated at Kaiser Permanente.

Synopsis:
Patient has a hip injury, is released from emergency care, and chaos ensues as patient tries to a) determine the cause of injury is and b) seek treatment.

January 2005. I injured my hip at a dance rehearsal. The director picked me up and carried me to his van, and drove me to the emergency room (I will call it Facility 1) an hour away. We would have gone to the nearest Kaiser, but another dancer advised, “Don’t go there. They’re so slow; one time I was there and bleeding for hours before I got seen.”

After finding an entrance around the construction near the emergency room, I was admitted, and got x-rays taken. While I waited, I was told that they had given the wrong x-rays to the doctor by mistake. I waited some more. When I saw the doctor (I will call him ER Doctor), he did a very cursory examination. The x-rays showed no broken bones or dislocations. He looked briefly at my hip, had me stand up and take a couple of steps. When I didn’t fall down, he must have decided I was fine, because he sent me home. I asked him when I’d be able to dance, and he said, “by next week”.

I was in a hospital wheelchair at the time, and it was extremely painful to put weight on that leg at all. I asked them if I could borrow crutches, and they checked with the doctor. “No, he says you’ll be fine. Just try to stay off of it.” I was driven home, and carried to bed, which I barely left the next couple days. I could barely walk to the bathroom. My Mom came and dropped off some crutches she had at her house. If she hadn’t, I don’t know how I would have eaten.

Two weeks went by. My chiropractor looked at my hip and said I might have strained a muscle, but it was possible I could have a labrum tear or have fractured something, and that I should get an MRI to be sure. I pay for chiropractic and acupuncture out of pocket because Kaiser generally doesn’t cover such things, even though I have sought them as an alternative to the healthcare system which isn’t working for me. “Oh right, like Kaiser would just give me an MRI,” I said. I called and left a message with my Primary Care Physician. She had been helpful in the past, and listened to me and paid more attention to my medical history than most doctors I encountered. I told her what my chiropractor had said and asked if she could get me an MRI. I even left my chiropractor’s phone number. Several phone calls and days later, she said she could get an appointment for me with orthopedics. My chiropractor later related that she had been rude to him on the phone but he mentioned the possibility of avascular necrosis, so she had to agree to order the test or be liable later.

Many phone calls and a week later, I had an orthopedics appointment for Friday February 18 (one and half weeks after requesting an MRI). I went to the nearby Kaiser orthopedics (Facility #2, the one I had been warned about), where I’d be referred to Dr.#2. They told me to come an hour and a half early. I soon found out why. This facility is probably the most inefficient Kaiser branch I have ever been to. Either that, or extremely ill-equipped and understaffed. I could see why the other dancer had recommended avoiding it. I had to walk over to get x-rays done myself, where I stood in line leaning on my crutches for ten minutes.
While in line, I wondered why I had to get more x-rays when I needed an MRI. From the waiting area, I could see into their back hallway, where patients lay in rolling carts or sat half-dressed in chairs lining the hallway, waiting for their x-rays. “How embarrassing,” I thought, feeling sorry for the patients. The woman in radiology was working the desk by herself during lunch break. “I document it,” she said, frustration evident in her voice.

When I was called in to be x-rayed, I was given a robe to change into and pointed toward a closet-like room. I changed and put clothes into my backpack. Good thing I had it with me, since they hadn’t supplied any bags or suggested a place for clothes. I sat on a chair in the hallway, feeling exposed to the waiting room and sharing horror stories with a woman next to me. “They nearly killed my husband,” she said.

In the x-ray room, I asked if they could cover the ovaries somehow since they were taking an x-ray of the pelvic area. The x-ray attendant couldn’t find anything to cover them with (they’re supposed to have that strangely shaped thing they place over your abdomen while they x-ray you). Finally she found one, though she pointed out that they needed x-rays of the other side. “Just try to make sure you’re ovulating on your right side when you get pregnant,” she joked. I understood it wasn’t too much of a concern since I wasn’t pregnant, but would have felt more comfortable if the equipment hadn’t looked very old.

Out in the hallway again, feeling half-naked. I was handed my x-rays and hobbled back to orthopedics. There I waited for more time until eventually I was called in to see Dr. #1. He asked me if I had any medical conditions. I asked him to define a medical condition. He listed heart disease, diabetes, etc. I told him I’d been having a lot of pain in my wrists. He said, “I’m not talking about minor aches and pains, I’m talking about medical conditions. I’ll put down no.” I wondered if tendonitis counted as a medical condition. Or how about a history of chronic yeast infections and overactive bladder? It was strange that he didn’t have access to my medical records.

He examined me for a while, and asked questions. Finally he said he thought I’d be fine from the incident. But he did want to tell me about some hip dysplasia he thought he’d found. He said the upper part of my acetabulum was not as curved as it should be, which prevented the femur from going in all the way, and could cause arthritis in “fifteen, twenty, thirty years”. He wanted to talk to an orthopedic surgeon about it. I asked if I could talk to him about my wrists because I’d been having a lot of pain in them recently. I’d had wrist pain for a year, which I had tried to seek help from Kaiser about, and had only ended up with a record of “tendonitis”, although the nurse practitioner admitted she wasn’t sure what it was. I had given up and was seeing an acupuncturist. Who knows what else is in my records that Kaiser never really was sure about. I suspect if I told them I had a deadly peanut allergy they would simply record it without testing, thereby worsening my health record, which prevents patients from receiving healthcare. (Patients who have “prior conditions” have great difficulty receiving individual coverage.)

Dr. #1 refused to look at my wrists, saying he didn’t have time. There were a lot of patients in the waiting room; I could attest to that. I also knew that if I tried to get an orthopedics appointment myself I would have to see my nurse practitioner first ($50 copay visit), then wait at least a week, then see him or another orthopedist (another $50 copay). I told him it was interfering with my work, and I told him it would cost me $100 to see him and that it was very difficult to get an appointment with a specialist at Kaiser. “No it’s not,” he said. “You got one today right after you called.” Actually it took me a week and a half, probably ten phone calls, and $50 to see an orthopedist. And the only reason I hadn’t had to see a nurse practitioner first is that she agreed to talk to my chiropractor and schedule an appointment without coming in.

The next morning, I got a call from Dr. #1. “Is this about my wrists?” I asked. No, but he had talked to the orthopedic surgeon, who agreed about the hip displaysia and thought I might have a labrum tear in my hip. “That’s what my chiropractor said,” I agreed. He wanted me to come in and get an MRI done, which is what I wanted in the first place. He asked me what time I could come in, and I suggested 2pm. He said he would see me any time that day, and would have someone call to set up a time. After I hung up, I realized that there would be fewer people in the morning, and decided to go in earlier. I called and left a message saying so. Then I got another call from Dr. #1. “Can you come in the morning?” I told him I was on my way.

I drove back to Kaiser Facility #2, my hip hurting intensely from walking around so much at Kaiser the previous day. I had to park again in the upper lot, very far from the entrance, since those spots are reserved for those with handicapped plates on their cars. By the time I got there, I was in a lot of pain. I asked the woman at orthopedics for a wheelchair. She called and said she couldn’t reach the appropriate department or they didn’t have one available, I don’t recall which. She was having trouble getting the credit card reader to take my card. Later I was told that Dr. #1 wouldn’t be charging for the visit since I’d been seen the previous day. I sat down next to a man with an artificial leg, caused by diabetes. He was very nice. “No use getting depressed about it,” he said.

I was shown into the exam room, and propped into the chair. After a long time, Dr. #1 came in and apologized. He told me the orthopedic surgeon was very busy, moved my leg around a little bit to test something, and left again. I think I was waiting at least half an hour. Finally Dr. #2 came in. He was very nice, and seemed to have more experience working with patients and more knowledge about orthopedics in general. He explained that I needed an MRI, but that they couldn’t do it there. I needed an arthrographic MRI (or MRA), which involved injecting dye into the area first. I wondered why I had been sent to an orthopedics department with the wrong type of MRI for my injury type.

He didn’t mention the hip dysplasia, but said he thought I might have a torn labrum. I said, “That’s what my chiropractor said.” Dr. #1 wondered if we should wait to get the MRI done “in case it gets better.” (Looking back at this from a later vantage point, I can’t believe he suggested that.) I was very relieved when Dr. #2 said no, that we wanted to get it done as soon as possible so we knew what was going on. Dr. #2 showed Dr. #1 a way of testing for this by pulling my leg far out to the side. When Dr.#1 tried it, he was almost yanking at my leg. Dr. #2 noticed and said, “You’re hurting her,” and I was glad that he was so in tune with how I was feeling.

Note: Three years after writing this, Dr. #2 has left Kaiser (big surprise, he was probably frustrated) and Dr. #1 has gotten reviews from other patients of being misdiagnosed and not being board certified in orthopedics. I’m not sure if that has changed.

Dr. #1 told me that I would get a call from orthopedics, and that we shouldn’t schedule physical therapy until after I’d had the MRI. I went to leave the hospital, and realized that after walking all that time and having my leg pulled this way and that, I was in a lot of pain. I didn’t think I’d be able to make it all the way out into the parking lot to my car.

I walked out into the hallway and went to the information desk to ask for a wheelchair. There was no one there. I think they were gone that day. I asked a passing man who looked like an attendant. He couldn’t help me. He indicated a security guard. I asked the security guard. He said he couldn’t help me get out to my car, that it wasn’t part of their job. I asked him if he could radio someone for a wheelchair. Finally I got him to radio his boss, and he couldn’t help me. He suggested I walk down the hallway to somewhere else. I walked further down and finally asked an attendant wheeling another woman if someone could wheel me out to my car. She suggested sitting down and said she would find someone.
I sat down and started crying, I was just in so much pain and so frustrated. People walked by and ignored me. I wondered how long a patient who was in pain could be ignored in a hospital if something were more serious. A couple minutes later she came back herself with a chair. It turned out she was a volunteer! She was really nice, and wheeled me out to my car, where I was able to drive home. As far as I could tell, there were no wheelchairs at Facility #2 hospital available for patient use, and since I didn’t have someone with me to wheel me around, no attendants were readily available to help with that.

A week went by, and no call from orthopedics. I decided to call them myself on Thursday, February 24. I documented the call, to illustrate the typical process in trying to accomplish something through the Kaiser phone system.

February 24
8:49am. It took 2 minutes to get through the initial part of the call, where an automated voice told me about allergies, flu, and other things which were not emergency-related. I could not press any buttons to bypass this message.

8:53am. I talked to a phone attendant (probably not a nurse). She said the system had me down as waiting for Facility #2 orthopedics. I wanted Facility #1. Facility #2 orthopedics had already told me they did not do arthrographic MRIs. I wondered what would have happened if I had not called.
She put me on hold to find out what was going on, and we got disconnected. I waited for her to call me back, but she did not.

9:05. After a couple minutes (yes I really did only accomplish that much in 12 minutes) I called again.
9:08. Still waiting, listening to Davis Kaiser’s depressing waiting phone music.
9:12. I got to talk to a call attendant.
I explained what had happened to her, and she said they weren’t allowed to call people back. She gave me the phone number for Facility #1 radiology and said she would transfer me.
9:14 I was on hold again.
9:17 The original person came back on the line and said she had gotten through to radiology and that they would pick up soon.
9:21 Radiology. The person I was talking to had been told nothing. I explained briefly what I wanted (an arthrographic MRI at Facility #1). She said she’d check if they did that type of MRI.
9:24 On hold again.
9:26 “The person you need to talk to is—“
“On vacation?”
She laughed, “No.”
“Sick?”
She laughed again. “No, they’ll be in the office in 5 minutes.”
I said, if it was only five minutes I’d like to wait. I’d already been on the phone for half an hour. What was another five minutes? She pointed out that there were people behind me in the phone queue. She transferred me, I left a message, and waited.

9:52am. I got a call back. While we waited for her slow computer, I explained what I wanted (an arthrographic MRI). She finally asked if I could come in the following Monday. I said, “Yes, and I’m available today.”
“How about 2:20?” I was excited. Finally the MRI appointment I’d dreamed about. “Great!” I hung up and called my partner to tell him the news. I’d gotten the appointment I wanted. Shortly through the call I had call waiting. I switched back to find the same person on the line. She told me that we couldn’t do the MRI. The person who did arthrographic MRIs was out of the office today. She would have to wait until Monday to schedule it, and these things often took two weeks. “Two weeks? That’s crazy. I’ve been waiting for two weeks already.” She apologized and said she would call me on Monday.

To be continued…

Unfortunately, this story and ones like it are not at all uncommon. This is just one of many incidences experienced by this patient in trying to get healthcare.
My goal by sharing this story is not to bash Kaiser doctors. I’ve had good doctors and bad doctors there, just like Dr. #1 (who misdiagnosed me, hurt me, and was rude) and Dr. #2 (who was caring and tried to get the necessary tests, and accurately diagnosed me). But the system which both doctors and patients must deal with does not work. And it’s time that patients’ experiences were recognized.

READ Part II