The orthopedist was supposed to call me today at 11.55 to talk about the results of an MRI on my knee that was performed two months ago. By 12.25, he still had not called. I emailed the department (it's virtually impossible to reach them by phone) and asked if he was going to call today.
Don't know if they had read the email, but ten minutes later - 40 minutes after the designated time - he called (with no apology). I said I had not had a chance to talk to anyone about the MRI, which had been done two months ago. Didn't I call and leave a message, he asked? Yes, I said, you left a message on my cell phone, which I didn't find until two days later. You asked me to call if I had questions. Well, I do! We talked, and I pried out of him some ideas about what could be wrong with my knee and some thoughts about what to do next.
In Sweden, you do your job. His job was to report my test results, not to assist with or solve my problem. It seems obvious, but I guess it's necessary to articulate that actually assisting a patient is part of a physician's job description.
Job description: physician. Blah, blah, blah. Must also attempt to solve patient's problem by talking to patient live and identifying action steps for treatment. Disdain for people automatic disqualification for this job.
The orthopedist did his job: he reported the test results. But did he attempt to help the patient?
Tuesday, February 9, 2010
Monday, February 8, 2010
Västmanland County Hospital update: Good news and bad news
On Saturday, I relayed the plight of a man waiting for chemotherapy at the Västmanland County Hospital. The newspaper vlt reports today that after it contacted the oncology clinic last week for Saturday's article, the clinic has since contacted the man and scheduled him for chemotherapy starting today.
The paper also contacted a county commissioner for comment on the man's long wait for treatment, but the commissioner referred the paper to the clinic head. The commissioner added that she had tried contacting the clinic head, division head, and county heath care director herself but had still not had contact with anyone. The commissioner also said, "But we're working to shorten the processes for transferring a patient from one clinic to another."
The good news, of course, is that the man is now going to be treated. The bad news is that it took intervention by the newspaper to make it happen. Regarding the commissioner's comment about making the transfer process more efficient, I say: don't hold your breath. They've been making promises like this for years.
(As Marti points out, you have to be healthy to be sick. Getting care requires a lot of persistence and energy!)
The paper also contacted a county commissioner for comment on the man's long wait for treatment, but the commissioner referred the paper to the clinic head. The commissioner added that she had tried contacting the clinic head, division head, and county heath care director herself but had still not had contact with anyone. The commissioner also said, "But we're working to shorten the processes for transferring a patient from one clinic to another."
The good news, of course, is that the man is now going to be treated. The bad news is that it took intervention by the newspaper to make it happen. Regarding the commissioner's comment about making the transfer process more efficient, I say: don't hold your breath. They've been making promises like this for years.
(As Marti points out, you have to be healthy to be sick. Getting care requires a lot of persistence and energy!)
Saturday, February 6, 2010
Bleak House redux: Don’t get cancer in Västmanland!
I am sad today to relay the situation of a man awaiting treatment for colon cancer at the Västmanland County Hospital. The article appeared in today’s edition (February 6, 2010) of vlt, the regional newspaper for Västmanland.
In October 2009, the man visited his primary physician. It was determined he had blood in his stool. The doctor referred him to the Västmanland County Hospital for a colonoscopy. (Note: until recently, you could only get a colonoscopy in Sweden if you had symptoms of illness. It is used as a diagnostic not preventive test.). He was informed by mail there is a 4-6 month wait for a rectal exam. Because he was in so much pain, he contacted his primary doctor again to intervene on his behalf. Six weeks later he got a colonoscopy. He received a diagnosis of cancer on December 17.
He was then referred for chest and abdominal x-rays. On January 5, he received a stratum(?)/layer(?) x-ray. Six days later, he met a surgeon who confirmed he had a malignant tumor in his colon and that the cancer had metastasized into his liver. That same day he received chemotherapy through a vein in his neck and the surgeon hand-delivered a referral to the oncology clinic. “Everyone knew it was urgent,” the man says.
Since then, he has heard nothing from the hospital. What he does know about his cancer he has researched on the internet. Although he’s in great pain, he has received nothing for it. He takes only aspirin, which doesn’t help. When he calls the oncology unit, he is told there is a long wait for treatment and he has to just wait his turn.
The head of the oncology clinic was also interviewed in the article. She says the man will receive treatment as soon as he is admitted to the clinic. She says the waiting time, which is currently many weeks, is unusually long right now because the clinic is reorganizing its journal system. It has even had to offer night and weekend patient hours. The clinic prioritizes patients who have acute pain, she says.
“But cancer is never an active (sic) disease," she continues. "Medically speaking, it is not acute. It actually doesn’t matter if patients have to wait a few weeks or a month.” She also notes that the surgical unit, which performed the colonoscopy, should have helped the man with pain management when he was diagnosed with cancer. Only when he officially becomes a patient of the oncology clinic does the oncology clinic take care of him.
I've often worried what would happen if I got seriously ill and had to get treatment at the Västmanland County Hospital. Unfortunately, now I know.
In October 2009, the man visited his primary physician. It was determined he had blood in his stool. The doctor referred him to the Västmanland County Hospital for a colonoscopy. (Note: until recently, you could only get a colonoscopy in Sweden if you had symptoms of illness. It is used as a diagnostic not preventive test.). He was informed by mail there is a 4-6 month wait for a rectal exam. Because he was in so much pain, he contacted his primary doctor again to intervene on his behalf. Six weeks later he got a colonoscopy. He received a diagnosis of cancer on December 17.
He was then referred for chest and abdominal x-rays. On January 5, he received a stratum(?)/layer(?) x-ray. Six days later, he met a surgeon who confirmed he had a malignant tumor in his colon and that the cancer had metastasized into his liver. That same day he received chemotherapy through a vein in his neck and the surgeon hand-delivered a referral to the oncology clinic. “Everyone knew it was urgent,” the man says.
Since then, he has heard nothing from the hospital. What he does know about his cancer he has researched on the internet. Although he’s in great pain, he has received nothing for it. He takes only aspirin, which doesn’t help. When he calls the oncology unit, he is told there is a long wait for treatment and he has to just wait his turn.
The head of the oncology clinic was also interviewed in the article. She says the man will receive treatment as soon as he is admitted to the clinic. She says the waiting time, which is currently many weeks, is unusually long right now because the clinic is reorganizing its journal system. It has even had to offer night and weekend patient hours. The clinic prioritizes patients who have acute pain, she says.
“But cancer is never an active (sic) disease," she continues. "Medically speaking, it is not acute. It actually doesn’t matter if patients have to wait a few weeks or a month.” She also notes that the surgical unit, which performed the colonoscopy, should have helped the man with pain management when he was diagnosed with cancer. Only when he officially becomes a patient of the oncology clinic does the oncology clinic take care of him.
I've often worried what would happen if I got seriously ill and had to get treatment at the Västmanland County Hospital. Unfortunately, now I know.
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