PHARMACIST STEVE

I have always heard stories about females tend to get poorer quality of care out of doctors whose ethnicity is from foreign countries. We have seemed to have experienced this personally…

Barb was having some shortness of breath and I suspected either a pulmonary embolism (PE) or pneumonia.. so she called to get an appt with her cardiologist.  The cardiologist that she normally sees was not in the office on Monday but his partner – who I have seen before  –  after the office visit – he suggested that she get admitted to the local hospital for some test, which she reluctantly agreed to.   This doctor’s ethnicity – IMO – appears to be from the middle east – in general.

She arrived at the hospital… and it took them over ONE HOUR to get a room clean… when her admission was called in from the doc’s office before we left. Our local hospital was acquired by a larger hospital system “across the Ohio river” in Louisville,KY and the entire system just upgraded to a EPIC electronic medical records.  This system is so large that all of the practitioners that we see are now EMPLOYEES of this large healthcare corporation and each office practice is connect to this EPIC system.

Part of this change is that our PCP no longer sees his pts when they are in the hospital… all pts are cared for by a HOSPITALIST – another employee of the larger healthcare system.

Of course, there are APRN’s involved in direct pt care and this stay was no exception… one of these two is telling her she has pneumonia and the other is saying that she has a PE. The hospitalist was being “stingy” on authorizing her regular pain meds and other controlled meds… and they said something that they had to check the state PMP (INSPECT) to make sure that she was taking her meds…

Apparently, since they don’t know us… they apparently saw a large gap in her getting her oral pain meds… BECAUSE we had been in at our Florida condo in Aug, Sept and first two weeks of Oct and our PCP had sent them Rxs for them to the pharmacy that we use in Florida and the Florida PMP is not linked to Indiana’s ….  I don’t know if they did a toxicology on her… because she should have had her pain meds filled abt 6 weeks ago – she gets 90 days supply at a time – but her toxicology would show that she is taking her pain meds BUT no records that they could see of her having them filled.

Via Barb’s nurse, I requested that this hospitalist come talk to me… he told me that her shortness of breath was because of her opiates… respiratory suppression … but I tried to explain to him that respiration in chronic pain pts taking long term opiates … disappears and not a issue – of course he denied… he mentioned that people were ODing … which I replied that people were committing suicide because of meds being pulled… which he denied… he then told me that HE treated all pts with objective facts/tests – which my reply was you can’t treat subjective disease with objective measurements.   It was obvious that he was going to quote “DEA’s medical opinions” and recommendations from Beer’s report   which generally SUGGESTS that any pts over 50 should not take most medications because of the POTENTIAL – often low potential and/or potential without a lot of scientific support.

I came away from this interaction was that this doc was a certified , card carrying, self-centered, narcissistic IDIOT and like the cardio doc… his ethnicity was from the same world geography.

So Barb was discharged.

She was handed a packet of 13 pages of “educational crap” that is generated from EPIC that – IMO – is mostly “cut/paste” from Beers and DEA medial opinions.

This EPIC system has the ability for pts to login to a “portal” and review various things concerning there medical records… Including all the medication(s) that have been prescribed by all the practitioners within the system.

As I was going thru Barb’s records… this ASSHOLE doctor – who was in charge of her care for some 18 -20 hrs DISCONTINUED ALL CONTROLLED MEDS – with the exception of one – probably because he didn’t know that it was a control or what she was taking it for… in this centralized EPIC database.  He even DISCONTINUED some OTC meds that was listed in her medical records.

These are medication that mainly her PCP has prescribed and her pain clinic – that manages her implanted pain pump – has full knowledge of her entire list… in fact she just had her pump refilled a couple of weeks ago and they go over her entire med list every time.

Today I talked to the nurse assistant to our PCP to make a followup appt and she said that Barb’s CAT SCAN showed that she had some PNEUMONIA in one lung… AND she was only given a single dose of antibiotic while in the hospital and discharged with NO ANTIBIOTICS.  I have ask the nursing assistant to see if one of the other practitioners in the practice to call in some antibiotics for her because we could not get an appt with our PCP until Monday.

This ASSHOLE doctor… failed to understand … is that the now President of the hospital is also a practitioner in the practice that we go to and his parents/family patronized our independent pharmacy years ago… I have known him FOR DECADES.

Since our PCP doesn’t come to the local hospital any more, we live in a metro area with about a population of about 1.6 million and the teaching hospital that Barb goes to for her pain clinic has the only LEVEL ONE TRAUMA CENTER for around 100 miles. and another major hospital complex two blocks away and both are about 10-12 miles from our house.

Of course,  I may just decide to go down the list of entities that oversees this ASSHOLE DOCTOR and the hospital complex and start filing complaints and I may have to explore the fact that he discontinued all her pain/anxiety controlled meds… may just be a discrimination under Americans with Disability and Civil Rights Act.

Filed under: General Problems