Kafkaesque

I had to call Bleak House - I mean Västmanland County Hospital - today to schedule a gynecological exam.

The first thing I noticed was telephone time: 7:00 am - 3:00 pm, Monday through Friday. While I realize some women may appreciate an opportunity to make an appointment before running out the door to work, if the trade-off is to call at 7:00 am or 3:00 pm, I opt for the latter. I think I can safely say the first thought of the morning of most women I know is not "I want to call the gynecologist." (Note: abortion services are another number!)

Second, this is the number to make an appointment for an appointment. When you call, you get a recording that asks you to leave your name and number and a promise that someone will call you "around" a designated time. (My callback was 10-15 minutes late.) If you call too late in the morning, all the callback times are booked and you have to start over the next day. This arrangement is a slight improvement over the old system when you were allowed to call only one or possibly two hours a day and you had to sit on the phone in a telephone queue, often for half an hour or more, waiting your turn. But the fundamental question is: When they decided to make the appointment system more "user-friendly," was this really the best scheme they could come up with?

When the clinic does call you back, you can request an appointment. But first you must justify your need. When I explained my problem, I was asked if it was urgent or if it could wait. If it was an urgent problem, I could get an appointment within a few days. If it was a non-urgent problem, I would have to wait about 2½ weeks. Urgent? Non-urgent? Huh?

I don't know about you, but I don't usually plan my medical problems weeks in advance. When I call to schedule an appointment, it means I'm ready to see a doctor now. If I could wait three weeks, I wouldn't be calling this day; I'd be calling three weeks from now! When I call, it means I've done my waiting for the problem or pain to go away. I'm ready to see someone today (or as soon as possible). That's why I'm calling!     

And so it goes

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?

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!)