Experiences with U.S. Health Care - Pt I: Treatment

In My Humble Opinion
1

I just had my first run-in with the patient side of the health care system in almost 20 years. I kind of expected it to be a terrible experience - my vacation was cut short by a visit to the doctor’s office which transitioned quickly to surgery and an overnight stay at a hospital almost a thousand miles from home.

I’m interested in finding out if many people have had experiences similar to mine or very different from mine, as far as the treatment side of the health care system is concerned.
As it turned out, everything went about as well as could possibly be expected:

  • I had a really short wait (about 3 hours from first being seen by a doctor to surgery.)
  • I got, as far as I can inexpertly tell, excellent care - in the week since the surgery and getting home I’ve been seen by other doctors and medical people and they all have said that the wound has clean edges and apparently got everything that it was supposed to get out.
  • Even the bedside manner of everyone involved - from the GP who first saw me to the surgeon, anesthesiologist, and nurses, was great. They were all extremely professional, helpful and willing to answer questions.
  • I was well-warned about the side effects of the medications I was prescribed. The medications I was prescribed seem completely appropriate to the job they’re doing.
    I would rate my experience with the health-care system excellent on the treatment end.

What have your experiences with medical treatment in the U.S. been like?

P.S. this is IMHO, so let’s avoid any debate on health care reform. I favor health care reform, but I think there’s probably a bunch of threads in GD we could use if someone really wants to debate that.

2

We’ve been fortunate to escape the “emergency surgery” route… and the only times we’ve had medical emergencies far from home have been handled relatively easily (one asthma flareup, one broken elbow). In the case of the broken elbow, the ER visit was accomplished at midnight or so, and the worst part was it took me nearly an hour to get a taxi back to the hotel (oh, and the ER staff missed the break on X-ray… fortunately the treatment was the same whether it was broken or not and that particular break can be hard to see).

The handful of broken-bone emergencies closer to home were also mostly OK; the worst of that was the wait for an OR when my son broke his elbow. It was something like 4+ hours in the ER until an OR freed up. I suspect they’d have reshuffled some things if it had not triaged out as a step below “do it now or his arm falls off” (a possibility, if the break had impaired the blood flow). Similarly when my daughter broke her back, we were waiting around for 5ish hours before they booted us, as again she triaged as non-emergent (it was a compression fx of one vertebra, no spinal impairment).

What was the nature of your emergency? It sounds like they did a pretty good job of figuring out what needed to be done, and jumping right onto it.

I’d say emergency care is generally pretty darned good in general.

Where things fall down is routine care for the uninsured, I expect. We’ve been fortunate to not fall into that category. Even then - when the person is able to find a doctor, and pay for the needed medication, I’d guess the care is decent assuming the doctor in question is competent.

3

I would rate my experience as variable. It really depends upon the facility you visit and their staff. For example, when I had my firstborn, I didn’t have a great experience - I wanted to do natural childbirth; the nurses didn’t like natural childbirth and were very smug when, after having been in labor after 28 hours, I chose to have an epidural at my doctor’s recommendation (one of them actually said, “See, I told you you’d break down.”). I then had eclampsia, but no one told my husband what the hell was going on or why they were doing what they were doing or how I was even after I was stabiilized. After I was stabilized, the nurses and doctors didn’t coordinate, so for four days, I was awakened every 20 minutes, despite the fact that it was suspected that sleep deprivation contributed to the progression of my condition into a seizure (I’ve already got a seizure disorder and hadn’t had any meds or sleep in 48 hours by the time it happened). And the nurses were extremely rude, one of them saying rather nastily, “Oh, so you want your baby to cry?” when we refused to allow him to have sugar water during his circumcision.

On the other hand, I had to take my son into an ER this weekend and went to a different facility (just across the street from the above hospital) that had a special pediatric care unit. We were in and out in 30 minutes, paperwork included. The doctor was really friendly and put my son at ease; the nurse was understanding and efficient. Everything was explained to us thoroughly and we left feeling reassured.

So it really depends on what’s being done, who’s doing it and their attitude and yours. For what it’s worth, I’ve never had any problems with the medical knowledge of anyone who’s treated me; it’s usually a matter of their attitude or getting them to take the time to listen to me.

4

I am overall pretty happy with my treatment experience, but I lived for several years near one of the best medical care complexes in the country (University of Michigan.) My biggest complaint with that is the extraordinarily long wait times. I very often would call in to see a doctor and actually be feeling better by the time I got in to see anyone. The average wait to see a GP was about a week, whereas I waited about five months to get into the gyno (I would actually shortcut that by going to Planned Parenthood, but I could never really get over the guilt of using this service that was intended for people that didn’t have means.)

Since moving to New Jersey I am even more impressed with the treatment here. Wait times are much shorter, and the clinics are usually private practice, which gives the whole thing a homey, community feel.

You get some good ones and you get some bad ones, but overall I feel like I’ve gotten superior medical treatment over the course of my life. Certainly with all my various surgeries, procedures and hospital visits I would say that I would rate the caring and competence of the staff to be very high.

5

I can’t be sure, but I think my gall bladder would have been diagnosed more quickly if I’d had insurance. My doctor (a PA) knew I was paying out-of-pocket. She made a point of telling me that I could get a cash discount (30%) for same-day payment. That was helpful – three clinic visits, labs, and x-rays came to about $600.

But I think she would have scheduled the CT scan sooner if I had insurance. Instead, she ordered x-rays, which aren’t diagnostic for an inflamed gall bladder. The CT wasn’t scheduled until a couple weeks passed and I wasn’t any better.

However, even though the hospital and the surgeon knew I had no insurance, they moved quickly and treated me just like any other patient.

The only discussion of payment was when the billing office gave me papers to fill out to apply for a hardship discount (which I didn’t qualify for). I thought they’d ask me to sign a promissory note or something, but they didn’t. They gave me a 20% discount for paying the bill all at once, but I had to ask – they didn’t offer it.

So I can attest that you can get treatment without insurance, especially at hospitals. But I don’t know what the private clinic would have done if I didn’t pay – someone asked for money every time I went in.

6

Any time I have checked into a hospital with a specific problem to be solved, I’ve been very satisfied with the experience. I don’t think I’ve ever spent the night in a hospital though.

All my medical nightmare stories stem from routine checkups, unnecessary testing of innocuous symptoms, and insurance woes.

7

My own recent experience as a patient was satisfactory, if unpleasant. On a recent vacation to visit relatives I got a little backed up to the point where it was getting very uncomfortable. I went to an urgent care, got my abdomen x-rayed, and told I better get things moving in the next 18 hours or I would have to go to the ER for disimpaction. I wasn’t sure what that involved, but didn’t want to find out and fortunately didn’t.

My MIL’s experience on the other hand has been a string of fuck ups. I started to write a long screed about her expereinces but I will just give the take home bullet points:
[ul]
[li]her GI specialist didn’t seem to take her lack of eating and drinking very seriously and as a result she was severely dehydrated by the time she finally had the tumor blocking her colon removed[/li][li]because of the dehydration and a stupid anesthesiologist she suffered renal failure[/li][li]her doctors and nurses blew off my wife’s concerns over symptoms that were indicative of her impending renal failure[/li][li]the dialysis center people were very nice and seemed genuinely happy for my MIL when her kidneys recovered[/li][li]her oncologist has left out salient parts of the written CT and PET scan reports - ALWAYS REQUEST AND READ THE ORIGINAL REPORTS[/li][li]she was in surgery again to have her lung biopsied, and whether it was from being overworked, disorganized, or lazy, the nurses and technicians rarely got anything done within the timeframe that it was supposed to during her recovery.[/li][/ul]

8

I had a sudden and very, very serious (almost fatal) health problem a few months ago late at night and had to be taken by ambulance to the emergency room. I was admitted within minutes and they paged all relevant doctors on call who also arrived within minutes. The results of the lab tests were complete within 45 minutes and I spent two weeks in the Intensive Care Unit and Critical Care. The nurses (who really run the show there were excellent). I got set up with all kinds of in-home follow-up care after I was discharged. I ended up with the best possible outcome for the problems and picked the best three doctors I met to do the follow up care. I still have a whole lot of doctor’s appointments with them and they always know my case before even looking at the chart down to the specific numbers from lab tests.

I have had to go back to the emergency room twice as a precaution for symptoms they warned me to have checked out and I jumped to the front of the front of the line both times and was in a private room within 10 minutes of arriving. Most impressive, doctors and nurses that didn’t have to to see me just dropped by to say hi and knew my name (this was at a medium sized hospital).

My care is an A++ although I have had to “fire” (ask not to see) a few doctors over time until I ended up with the really good ones.

9

I have only ever had positive (as positive as going to the ER) experiences with my emergency health care here in Philadelphia.

First time was an asthma attack. Happened at 3 am on a Sunday night. They took me back before my husband had a chance to park the car. Got me a breathing treatment and a chest x-ray just to be sure it was only asthma and got me on my way by 5 am. Quick and dirty, no problems at all.

Second time was a cat bite. Now normally, I would just call my GP friend and ask her to prescribe me some antibiotics if I get bitten and I am concerned about infection. This one was different. Long story short, he bit me on the wrist and hit the median nerve. My hand immediately went numb and I couldn’t use it. I knew that my GP friend would tell me to go to the ER, so I did. Once at the ER, they determined I needed to stay overnight for abx and to possibly have surgery if the numbness and or pain continued. My nurses were great, the hand surgeon and his residents were great. I was not happy to be there and have the whole thing happen, but they got me a room pretty quickly and I didn’t have any issues with the way I was treated at all.

For both of those I used the hospital at the large, urban university I work for. My third experience was at a smaller suburban hospital. I slammed my thumb in the car door on a Friday night. I was too chicken shit to attempt to drain the blood underneath the nail by myself (not to mention that it hurt like hell), so I went to the ER to have them do it. If it wasn’t a Saturday, I probably would have called the Dr’s office to see if I could come by and have someone there fit me in to do it. Again, no wait, had an x-ray to confirm I hadn’t broken it and the Dr. pulled out an electrocautery device and burned a couple of holes in my fingernail to let the blood out. I felt much better afterwards.

My other ER experiences both involved my husband being sick. Once for a bad allergic reaction, the other for a concussion. Neither time did he want to go to the hospital, but I made him go both times. I actually called 911 for the allergic reaction, he had passed out on the bathroom floor, right after telling me how “fine” he was. They took immediate care of him at the ER and he was released later that day. For the concussion, he was mountain biking, took a header and cracked his helmet on a rock. He felt a little dizzy after, but got back on his bike and finished the ride. He drove home and related the cracked helmet thing and told me all he wanted to do was take a shower and then take a nap. I let him take the shower, but then made him go to the ER. I told him that if they think I am over-reacting to a broken helmet, then they can chastise me for clogging up the ER on a whim. He was fine and the doctor did not chastise me for bringing him in. We were seen pretty quickly, and everyone was very efficient with getting us in and out. (I brought the helmet as evidence, just in case.)

10

I have never had a problem with health care treatement, when I was insured. When you lack insurance, or enough insurance, that is when you have issues.

I’ve had jobs in two ERs (doing phone and clerical) and they are excellent places.

On the flip side when I was in my mid-20s I had a kidney stone and was between jobs. I went from ER to ER and not one of them would help me. I was in so much pain, they all said “Sorry you’re in pain, not lifethreatening, we won’t treat you.”

I liked it when I asked for a any guidance, as to where I could get help. “Sorry we’re not a social service organization”

It’s funny looking back, bascially it was, “We provide great service, but if you don’t have insurance, we can’t be bothered even to talk to you.”

There’s not a lot wrong with out health care system, provided you have insurance.

11

I’ve haven’t been to the hospital since I was 16 (elective eye surgery), but the few times I’ve been with family members have been positive:

  1. My daughters birth. We checked in at 6:30, my wife was induced by 7:00am, they waited 6-odd hours until she was dialated enough, and then at 1:36pm (7 hours after check-in), out comes Sophie. Sure beat the horror stories that were incessently told about:

“I had a 46 hour labor with my first!”
“Oh, YEAH? With my first I was in labor for 9 days and it wasn’t until they split me open like a watermelon would that baby come out!”
“Well, YEAH? My doctor took notes on my labor for his best-selling novel Don’t give birth the way THIS woman did!”

  1. My daughter’s broken arm. This one didn’t go as well as the birth as instead of merely putting the thing in a cast at the emergency room (as what happened when I was a kid), they set her arm in a sling then sent her to an orthopedic specialist so he could apply the cast. :confused: It’s a 6 year-old with a minor fracture - they don’t treat those things anymore at the hospital?
12

This is actually common these days - they don’t usually do a firm cast right away because of the concern that it might swell over the next few days. Usually they splint, and do the cast as much as a week later. This is what they did with my son’s arm.

And mentioning childbirth, my experience with my son was 100% horrible. Doctor gave me conflicting instructions before I even went (water broke) including lying to me. Nurse yelled at me to relax. Took 3.5 hours to get pain relief for induced labor. Asshole anesthesiologist botched the epidural - causing severe pain in a spot where I still feel discomfort 15 years later - after telling me he wouldn’t stop when I had a contraction because “if i stopped every time a woman had a contraction, I’d never get done”; from my experience with my second child, you’re NOT supposed to feel such pain from the epidural that you jump and scream in agony - oh, and it didn’t work and they didn’t believe me, which was rather frightening when they started talking C-section… the doctor (whom I’d hated from first visit, but my doc was out of town) kept jamming her fingers into my stomach… one of my many regrets is that I only hit her once… All of this at the biggest hospital / birthing center in the area and the second biggest on the East Coast. Other people I know have similar horror stories from this hospital including one who nearly lost her baby because of fuckups, and another who nearly died herself…

13

My problem was (I guess) relatively simple as surgeries go - infection and an abcess (which I had mistaken for something else, allowing it to get too large.) it only took about 40 min in the OR, and although they had to put me under general anesthesia. I was just surprised by how smoothly it all went and how nice everyone was.
When I was getting certified as an EMT a few years ago I had an opportunity to see ERs from the other side, doing a couple learning shifts at University Hospital in Fresno. It really didn’t seem like any sort of place I would want to be, although the care people received was good, crowding and waiting was bad, and the general atmosphere was not a gentle one that might be considered conducive to rest and healing.
It sounds like a lot of people have had very good experiences with emergency medical care (except for JohnT and Markxxx.) I’m really glad to hear that my recent experience doesn’t seem all that unusual.

14

My experience wasn’t bad, per se, it just didn’t meet my expectations based upon what happened to me 35 years ago.

15

I had an unpleasant experience with an OB when I lost my second pregnancy. The ultrasounds showed that there was no heartbeat, and the embryo wasn’t growing anymore, but I wasn’t miscarrying on my own (by the time they’d checked enough times to be absolutely sure the pregnancy had failed, the embryo had been dead for for about 4 weeks without any indication of miscarriage).

The day before my last ultrasound, I’d had some light spotting. My OB said that was a miscarriage, and I was fine and didn’t need to do anything else. I pointed out that the spotting was the day before an ultrasound showing an intact embryo. “Nope”, he said, “you’re fine.” I’ve since been told that he should have done another ultrasound to check before announcing me “fine” or at least had me pee in a cup to check my hormone levels. He didn’t do or check anything. Just told me I was fine and sent me home.

Several days later, I started having heavy bleeding and cramping. We went to the emergency room, and the bleeding stopped shortly after we got there. The emergency staff checked me out, and said it was only a partial miscarriage and that I needed to contact my OB to schedule a D&C.

When I called the OB office and told the receptionist that I needed a D&C, she said “We don’t do those here.” I told her I was told to contact my OB to schedule one, so she got my doctor on the phone. He said he had paperwork from the hospital that I had a miscarriage last night. Why would I think I need a D&C when I’ve already miscarried? I told him the emergency room staff told me it was only partial. He said that they “don’t always know what they’re doing”, and that I was fine. Again, no appointment for an ultrasound or to check my hormone levels or anything.

A week later I was back in the emergency room with more bleeding. This time, they told me, it was a complete miscarriage, so I wouldn’t need a D&C or anything. I called my OB the next day and told him, and he said “Well at least that’s all over with.” No apology or even acknowledgement of the fact that he was wrong about me miscarrying twice.

I’ve since been told that I was very lucky that I eventually managed to miscarry on my own. Apparently things could have gone very bad for me otherwise.

On a happier note, I’m currently in my 32nd week of a very normal/healthy pregnancy, and my new OB has been awesome through the whole thing. :slight_smile: