Thursday, March 26, 2009

The mammogram chronicles – part 3: Learning the rules

I’ve had unexplained soreness in my shoulder the past couple days along with a sore breast so I’m getting a little anxious about scheduling this mammogram. After having waited two months already, I figured I would not be getting an appointment before the end of the three-month scheduling period (the magic date is April 28), so I called the breast clinic today (the callback was scheduled for 1 pm. They called at 1:25) to find out the procedure for scheduling a mammogram in another health care district so I would know what to do come April 28.

Apparently there are two care options: Free Choice and Guaranteed Care. The Free Choice option means if I find a clinic that will take me before April 28, my district will pay for the mammogram but not transportation. The Guaranteed Care option, which kicks in after April 28, requires my district to schedule a mammogram for me somewhere in Sweden (I don’t know if it covers Europe), presumably within 3 months after April 28. They also pay for transportation. So it looks like I should get a mammogram somewhere in Sweden no later than July 28.

I was a little confused. I thought I couldn’t arrange a mammogram on my own before April 28 unless I paid for it. The nurse said because there was a “stopp” in the queue and since I had already waited so long I could use the Free Choice option. (In Swedish, “stopp” can mean anything from a blockage, to a bottleneck, to, in this case, closing the queue completely. She didn’t explain what she meant and I didn’t ask.) Why hadn’t some one told me this two months ago? They are so eager to keep health care money within their district they will jeopardize patient health to do it!

She then offered me an appointment with a doctor next Tuesday and explained that the doctor visit usually followed the mammogram, but since I had been waiting so long, I could see a doctor next week. I asked what the doctor could do for me and she explained if there was anything suspicious the doctor could look into it (a biopsy, I suppose). But isn’t a mammogram usually the next step if the doctor detects anything suspicious? Yes, she conceded. So this visit is actually backwards? Yes, she said.

Well, I know my breasts are sore and lumpy and that my shoulder hurts. So not a lot to be gained from a doctor visit, which would also cost $37. I declined.

I said I would try and call the neighboring city to see if I could schedule a mammogram there. She mentioned that that city also has a queue, but I decided to try my luck anyway. I called the central health care referral number and asked for the locations and phone numbers of mammography clinics in the city. The receptionist referred me to the central hospital and gave me the number to the x-ray department. Of course, it was the wrong – mammography is its own unit – but the person in x-ray was kind enough to give me the correct number. When I dialed, I got a message: telephone hours are Monday –Thursday 8-10, and Monday and Tuesday afternoons 1-3.

Guess what I’ll be doing Monday morning at 8:00 am!

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