Monday, August 1, 2011

A failure to communicate - and why does the patient suffer?

This story was told to me about a friend of a friend. This woman was suffering from back pain so she went to her doctor. The doctor said we can help you by putting rods in your back. Her surgery was scheduled and she showed up on the appointed day. The anesthesiologist asked about her medications and found she was using Fentanyl patches for pain. He said he couldn't sedate her until she was off the patches for two weeks. Her surgery was cancelled and rescheduled for two weeks later.

She showed up Fentanyl patch free for the second surgery, was on the gurney being prepped and someone asked about her EKG. She hadn't had an EKG in two years so they postponed the surgery again so she could have one. At her EKG they found an irregularity which required treatment and was compared to her two year old EKG which also showed the irregularity that required treatment that she was never told about.

Now this poor woman is busy with all sorts of cardiac fun and games and her back still hurts. At how many points do we have a failure to communicate? A lot. I feel the biggest gaps were in the doctor's offices. The doctor who ordered the EKG should have made sure the results were given to her with recommendations to follow up with a cardiologist. The doctor who ordered the back surgery should have had his office go through all the pre-surgical requirements with the woman so should would have known not to use the Fentanyl patches and to order an pre-surgical EKG.

A little blame goes to the patient in this case as well. If she had an EKG two years ago, she should have asked her doctor for the results if she never got them. She is not to blame for not getting pre-surgical information from the other doctors' offices.

Talking and communicating are big parts of medical care. You need to talk to your doctors - pretend they don't talk to each other like temper mental teenagers and that they don't look at any other doctor's notes in your file. When they send you for a procedure (a/k/a medical adventure) you should ask is there any preparation for it and what about the results.

"What we have here is a failure to communicate." A great movie quote but also unfortunately all too common.

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