The Human Element of Medical Care
It's a shame that many physicians and insurance companies don't consider the health of senior citizens to be as important as the health of other patients. Too many medical practitioners wave off medical problems of the elderly as an expected consequence of aging at a time when research points toward solutions for the aging process. Even doctors who take their senior patients' problems seriously are often unable to provide the necessary care when insurance companies refuse to pay for conditions not considered emergencies.
My mother fell 6 years ago, injuring her spine and ribs. Her condition deteriorated until the pain and weakness from a damaged disk and pinched nerves caused her to begin falling with no warning, leaving her on the ground with no way to get up. The doctor ran several tests over the years, including MRIs, x-rays, and ultrasounds. He decided to send her to physical therapy twice a week for several weeks. Her condition did not improve. She was referred to a neurosurgeon who recommended extensive surgery that involved replacing much of her spine with a steel rod. The invasive surgery required a long hospital stay and an even lengthier recovery that involved more physical therapy.
After the doctor retired, Mom asked the new primary physician if she could be referred to a neurosurgeon in a different area. He agreed and she made an appointment with a skilled neurosurgeon who was highly recommended by many people. For the first time in years, my mother had hope.
The surgeon was very optimistic. He sat down with my mother and showed her the test results, explaining what the problem was and what he could do to improve her condition in language that she understood. When he told her she could think about it for awhile, she told him she had already decided to have the surgery as soon as she could. The hospital set up the date and time for the operation, and she had all of her blood work and pretesting done.
A few days before the surgery, Mom received a call from the primary physician's office. "We just received paperwork for surgery to be done at an out-of-network hospital," they told her. "We didn't give you a referral for that. We only gave you a referral for a second opinion." My mother immediately called her neurosurgeon's office to explain the situation. "Don't worry," his office told her, "we'll get in touch with them and make sure they submit the necessary paperwork."
Mom was so excited the day of her surgery. She was looking forward to being active and strong again. The nurses at the hospital were so nice and helpful, and she was soon hooked up to her IV waiting to be taken to the operating room. Then the hosptal's financial administrator came in. It was her job to explain that the paperwork was filled out improperly at the primary physician's office, and after the correct paperwork was submitted it would take the insurance company at least 14 days to approve or deny the surgery. Although they were optimistic that it would be approved, if they went ahead with the operation that day, my parents would have to pay for it.
Mom's neurosurgeon came into the room. "I know it's hard. You're all ready to have it done today. But it's just a couple weeks." Near tears, Mom told him she didn't want to wait. My father wondered what would happen if she injured herself badly during a fall before she was able to have the surgery. "Why," I asked, "does she have to wait if they are going to approve it anyway?"
Another gentleman in a suit entered the room and pulled the financial administrator aside as the doctor told me, "That's a good question." He told us the gentleman was the hospital CEO and that they were going to do everything they could to get Mom her operation that day. "We can't make any promises," he said, "but don't give up yet."
The neurosurgeon, CEO, financial administrator, insurance company and the two doctor's offices conferred on a conference call. I wondered what my mother's blood pressure was as we waited, worried and wondered. Mom lit up like a Christmas tree when the doctor strode back into the room and said, "The insurance company verbally approved the procedure. We can do the surgery today."
The next few hours were long for us, but they flew by for her. She was in the hands of a doctor she liked and trusted having an operation she understood that gave her hope. As the doctor performed the minimally invasive surgery to replace the damaged disk causing the bone on bone grinding and straighten the spine that was pinching off nerves we had complete faith that she was in the only hands that could restore her health--the hand of God and the hands of the wonderful surgeon God sent her. I don't believe any other doctor would have gone to bat for her with the insurance company, and I know no other neurosurgeon could have inspired the trust that made Mom choose to have surgery.
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