Thursday, February 11, 2010

Trouble getting medical care

Ever since the complete turnover of staff at the family health center we've been attending for years, and the resultant change to integrative medicine that made me worried we wouldn't fit in, we've had trouble getting follow-up care from our bariatric surgery.

Back when we had it, the people at High Point (in North Carolina) tried to insist -- literally while we were driving to the airport to leave, a week after the surgery -- that we would need to visit once a year for a follow-up. Previously, we had been very clear that we weren't going to do this and they were clear that we didn't need to, provided our primary care physician could order the right blood tests and keep in good communication with them. But the doctor insisted that no one had ever been able to pull that off. We insisted we could -- if anyone's organized enough to get blood tests on a schedule and get them faxed to the right place, it's us -- and we certainly have, despite any number of bouts of selective amnesia on the part of various people.

The fact is, there's nothing that requires us to be physically present in North Carolina, not when blood tests can be sent anywhere and the questions the doctors need to ask are simple ones. The only technical thing here is the blood tests; the physical examination is basic stuff with no real special things to check for, and the questions to be asked are also straightforward. I think 90% of the big fuss here is because of all those patients who can't follow directions and don't pay attention. It's regrettable that there are people who play squash after major surgery, but we're not them.

Last year's annual checkup was entirely satisfactory to the High Point people (though since then they've lost the report and forgotten they got -- both remedied now). However, this year we've hit a roadblock. The complete turnover of staff at our local medical center means all the "integrative medicine" staff don't feel qualified to follow our case. They haven't gone so far as to say we can't be their patients but they're pretty close -- how much care can they provide us if they don't feel qualified to follow the results of this surgery?

Even the local gastroenterologist's office won't do it. Everyone's planning for the worst case patient instead of us, and won't even meet us long enough to learn we're not the worst case.

So we're going to have to try to get a bariatric surgeon at one of the hospitals an hour away from us to do our annual checkup, because the alternative is flying to the most boring city in the world (okay, maybe not the most boring, they do have that Giant Chest of Drawers... so second most boring) once a year. I hope those surgeons won't mind doing followup on a surgery they didn't do that's not precisely the same as the RNY they do (not that the differences are terribly relevant here).

No comments: