You Deserve the Best Care

By | May 9, 2012

Sometimes getting good medical care seems like an elaborate maze.

Today we will start a new series of blogs that explore the question of what constitutes the best care and how to know if you are getting it.  Let’s begin with a story that illustrates several of the main themes we will discuss.  George (not his real name) is a middle-aged male with private insurance who came to see me recently with radicular back pain after being referred by one of his friends.  After speaking with George and examining him, I reviewed the most recent MRIs with him and told him that he had a classic right L5 radiculopathy caused by a moderate sized right lateral disc protrusion at the L5-S1 interspace.  George said that no one had ever reviewed his films with him and explained what the problem was.  I shrugged my shoulders and told him that it was standard procedure at Schlesinger Pain Centers.  I next told him that I thought that he might respond well to a simple interlaminar lumbar epidural steroid injection at that level.  George told me that he had had epidurals before and that they had never given him much relief, but that he was willing to try again.  He asked when I wanted to schedule him in the surgery center and began to ask anesthesia related questions about things like drivers, fasting etc.  I stopped George and said that I never do simple injections like that at a surgery center and that not only was an anesthetic unnecessary, but I was not sure that it was even safe in all cases.  I showed George our procedure room and told him that we had better equipment than any surgery center or hospital that I new of and that I would not hurt him.  Bewildered but game, George said, “Let’s give it a go.”  Ten minutes later when I told George that we were done he asked me why the other guys used anesthesia and told him that I really couldn’t say.  Five minutes after that as we were preparing to discharge George from the recovery room, George pulled me aside and asked why his physician hadn’t sent him here in the first place.  I just smiled and told George not to worry about it and that I would take care of all of his back problems from now on.

To paraphrase George's question,"Why did I have to go through the maze? Why didn't my doctor just send me here first?"


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