Sunday, January 28, 2007

Mistaken Identity - a parable of heath care in America

I sought a dermatological screening from my health care provider, Kaiser Permanente, in early December because I was concerned about a suspicious mole on my face. The lead- time to see a specialist was about eight weeks. Last Thursday, the appointed day arrived and I made a special effort to be on time. In recent visits, Kaiser had been quite prompt about appointments. I registered with an unsmiling, waiting room attendant, a woman of few words, skilled in avoiding eye contact – or any human connection - with her clients. She collected a fifteen dollar co-payment, tapped an entry on her computer, and instructed me to wait.

I waited,… and waited… and waited….. Fortunately, I came equipped with cell phone and laptop so the time was put to some use. I was grateful that the television, now ubiquitous in all waiting areas was turned off. There was a status board in the waiting room listing doctors’ names, but the doctor with whom I had an appointment was not one of them. After fifty minutes had elapsed. I got the attention of the desk attendant and asked how far behind schedule Dr. _____ was? “He’s not behind schedule,” was the reply. “I’ve been waiting nearly an hour,” was my response. “What’s your name” …”John Richardson.” She looked at her computer and seemed puzzled. She disappeared through a door behind her desk, returning after a few minutes. “What’s your name?” she asked. “John Richardson,” I replied. She disappeared again, and then reappeared, looking at me with a puzzled expression.

Soon afterwards, a physicians' assistant came through another door looked at me and called a name that I did not recognize. When no one responded, she disappeared. She then appeared behind the desk and caucused with the desk attendant, looked at me, then disappeared. She soon afterwards, she reappeared. Looking at me from the other side of the waiting room she queried, “Are you (a name I didn’t recognize).” “No.” I said. “What is your name?” She queried, “John Richardson,” I responded. “Follow me,” she said and led me to an examining room, where she explained what happened.

She reported that she had called my name an hour earlier. I was on my cell phone, she said and another patient had responded to the name ‘John Richardson.” She had given him a preparatory examination and entered the information on my chart. The young man was about forty years my junior, but this did not, apparently, attract her attention or, subsequently, the doctor’s. The doctor then came in and gave my impersonator a complete screening, entering the results on my chart. Serendipitously, I was wearing my American University name tag (I manage a customer service organization at AU and require my staff to wear name tags, so I do as well.). Looking at the tag, the physician’s assistant said, “Well, I guess you really are John Richardson.” After giving me a prep examination and entering the information in her computer she looked at the screen. “Poor Dr, _______”, she said. “He spent so much time entering the results of the other examination on your chart, and now he is going to have to erase it and do the whole thing over again.”

There was good news from the most pleasant doctor when I finally did get to see him. The suspicious mole was benign.

All is well that ends well, however I’m glad that my impersonator and I were not scheduled for an amputation, kidney transplant or open-heart surgery.


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