Our broken medical system.

motown13

OK, this has nothing to do with Obamacare or otherwise, from my perspective. This has been like this for ages... I just want to share a story.

Thirteen days ago, my daughter and I went to the YMCA. She went running while i did my routine. That was a Wednesday evening. The next morning she tried to get out of bed, and she screamed. She said her ankle and leg hurt so much that she couldn't stand on it. So I took her to a pediatrician who said it was likely a sprained ankle, but just for safety she wrote a prescription and referral for X - Rays.

I immediately took her to the hospital where they took 4 X-Rays. The results came back, and the hospital said that 3 of them were just fine, but the fourth looked like "something" might be wrong, but they weren't sure what. So they said we should go see and orthopaedist. So this required getting a prescription and a pre-certifcation number. The pprecription was easy to get, but then it took 10 days or so to get a pre-cert. And we were on the phone EVERY DAY trying to get one. We kept getting bad information. People would say one thing, and the next person would say the opposite thing, with it now being about 10 days of my daughter wearing a boot. The pre-cert was for her to get an MRI.

We finally got a pre-cert, but then it was still 3 or 4 days to get the MRI..... She is at the MRI center right now.... We had the prescription, but whoever wrote the prescription, didn't even indicate which ankle it was. So the MRI center called the ortho, and it was over an hour before they were able to get a new prescription. She is getting an MRI as I type.... but they don't have anybody at the MRI center who will read the MRI today. My wife just called and they said it will be at least a day, and possibly 2 days until we get the results.

At that point, if the MRI indicates it, she will then need to go get an appointment for a soft cast. She - my wife - was told that this might even take another couple of days, and will need a pre-cert and prescription for that.

So at that point, it will be more than two weeks for my daughter to get a final treatment on what they think is a stress fracture, at least that is what they think pre MRI.

I know that this is supposed to save money but I can't possibly see how.. All this back and forth has to cost money. Plus they hire an independent company to decide if she even gets a pre-cret...... So, to get a cast - if needed - look at the path:

1. Pediatrician
2. Hospital
3. Pre-cirt company
4. Ortho
5. Pre-cert
6. MRI center
7. Pre-cert ( maybe.... this is unclear at the moment )
8. Measurements at another place for a cast
9. Go back and get the cast after it is made

Re Freaking Diculous!!!!!

She might actually take 3 weeks to actually get a cast. Definitely more than 2 weeks.

MaraDiaz

In before lock. This is probably going to be seen as a political topic.

I agree, it's ridiculous. It is also what happens when you allow a for-profit healthcare system. Go figure, they want to take your insurance payment every month and not have any expense of actually providing medical services.

n0ob

In before lock. This is probably going to be seen as a political topic.

I agree, it's ridiculous. It is also what happens when you allow a for-profit healthcare system. Go figure, they want to take your insurance payment every month and not have any expense of actually providing medical services.

there's a self fulfilling prophecy if I've ever seen one...

OP, we're dealing with similar problems with my son who has some food allergies. It's bad, but it's not like the specialists he needs grow on trees.

I do feel fortunate to live in an area of the country with some of the best health care in the world though.

motown13

In before lock. This is probably going to be seen as a political topic.

I hope not. I'm not looking at it politically at all.... The idea of referrals and pre-certs pre-date Obama..... This is just a general gripe against HMO's. What's kind of "funny" to me is that my wife works in "big pharma", with a higher level job... think low level executive, and we still have a crappy HMO.

Lisa1971

I'm so sorry! I hope they can give you answers soon! I'd be SO frustrated!

motown13

So, tomorrow is day 15, and she can't get the results of the MRI until Monday, and she can't get an appointment until after that to get fitted for a soft cast...... It looks like it will be THREE WEEKS before she finally gets a cast, if she needs one. ( for a stress fracture )