What is wrong with the US health car system in a single SNAFU: Lack of communication


I was overdue to have a screening procedure (colonoscopy) done that involves anesthesia and use of a specialist. I dutifully sought out a primary care physician referral, made an appointment with the specialist, and then scheduled the procedure with  full month’s lead time.

This procedure involves multiple days of dietary prep, to include fasting on the day beforehand and consuming laxatives the night before it occurs. Late in the afternoon before I was scheduled to show up I got a frantic call from the specialist’s office. It seems that the whole thing was in doubt due to not having the primary care referral on file. Indeed, the procedure was ultimately cancelled when it became clear the referral wouldn’t be in place in time.

I then had to spend most of a day getting it rescheduled for two weeks later. I couldn’t get anybody to call me back at the specialist’s office and finally went there in person and camped out in their lobby.

I had arranged time off from work, my wife had moved another medical appointment (she was my ride to and back) and I had not eaten in nearly 24 hours by the time I was told to forget about it. Fortunately I had not started chugging laxatives yet, but was within a few minutes of when that stage of the prep was scheduled to start.

Needless to say, I was not a happy camper. Somehow the office staffs of two physicians couldn’t get it together to get a simple referral filed with a month’s notice. The specialist’s office called me the afternoon before the procedure asking for the name of the primary care doctor and her number. Please note this is information contained in all those forms I had filled out for them. The primary care insisted they had faxed over a form, but it turned out to be a patient progress report.

Worse, now I am getting erroneously overbilled by the specialist because my insurer is showing them as not having the proper referral in place.

This is a comedy of errors that highlights a medical system where fragmentation and lack of communication is the norm. In my case the only issue was inconvenience and lost time. For others, it can lead to worsened outcomes.

UPDATE: I got the procedure reschedule. Then, the day before the procedure I got a call asking if I could move it to later the same morning. OK, I agreed. Then their phone-based appointment reminder system called me near close-of-business asking me to confirm a completely different appointment time. Had I followed what it told me, I would have missed the procedure time. C’mon folks, this is Marx Brothers stuff. No other industry would tolerate this much pure sloppiness when dealing with customers.

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