PATIENT-CENTERED CARE – HOW DO WE GET IT IN AMERICA?
My interest in writing this TODAY comes not with politics in mind but on the heels (no pun intended) of my own recent injury.
I dislocated my tibia from the other bones in my left ankle in Mexico on Halloween night – NO SUBSTANCE ABUSE INVOLVED; NO DANGEROUS COSTUME (in fact no costume at all) – just simply walking down a cobblestone street with debris of concrete, rocks, uneven grades and an overly-zealous curiosity to see inside an giant and beautiful abandoned hacienda.
After my fall, my husband drove us home and called a doctor (most make house calls here), and a very kind, compassionate doctor, well-educated & bilingual GP drove to our home within 15 minutes, gave me informed consent about everything, as a matter of his dignity it seemed to me. Down to the brand and make-up of the needle he was using for a shot of steroids and B-12, and when I did not like the brand of needle he had with him. Many needles are/were made of non-sterile Polypropylene plastic which have been sent to 2nd/3rd world countries since the bad press in U.S. caused them to fall out of favor in the early nineties. I couldn’t verify this needle was not polypro, so Dr. Jorge Garcia D’La Rosa, M.D. WENT WITH MY HUSBAND, in street clothes on Halloween, TO THE PHARMACY TO BUY THE B/D SAFETY NEEDLE I ASKED FOR to ensure my safety and his ethics.
I explained I wanted NO NARCOTICS, and that I cannot tolerate Acetaminophen or Erythromycin. He politely asked to borrow my computer and if he could sit at my bedside to look up the Spanish translations of the drugs he was giving me for my injury, and he brought his huge heart to this house call.
He explained everything to me as he was performing his duties in a polite and caring voice, even calling me “Honey.” OMG- get the politically-correct police here, STAT! He let me read the packages; asked me to watch as he opened each item and administered my treatments; sent me to an imaging center; asked me to look him in the eye so he could explain the gravity of my injury and how it could affect my ability to walk for the rest of my life if I did not follow his orders. He explained this was very important to him, because I am young and have a very good life ahead of me. He thanked God that my tibia was not broken. OMG -GOD! Get the God-Police out here, STAT! He called me by my first name, wiped my tears and stroked my arm as he treated me in the comfort and dignity of my home, with my husband present and at-the-ready. He left; told me I would be ok, and that he would come back tomorrow. He came back THE NEXT DAY to check on me.
My Treatment Plan and Rx?
-Stay off of foot for one month; wear stabilizing boot from imaging center.
-One orally administered B12 vitamin supplement combined with a mild muscle relaxant and an NSAID for pain, every 12 hrs.
-One home-administered steroid shot in the bum for pain and inflammation every other day.
-A two-times per day ritual of physical therapy, which he showed me how to do at home instead of referring me to an expensive rehab center. This ALL (including the imaging, which I walked out of the hospital with!) cost me USD $130.
-A month of the medicines cost another 735 MXN (again, nothing to sneeze at, but do-able in a compassionate healthcare system). For an average Mexican national, probably a lot of money; but no third party (or hidden fourth and fifth parties) driving up any costs, and no danger of ruined credit or someone losing their residence because of unpaid medical bills. I have actually had a dentist here tell me that I could pay her whenever I could afford it. Um, what? OK- I’ll gladly bring back 700 MXN tomorrow, but THANK YOU!
WHEN WAS THE LAST TIME ANY OF US OR OUR FAMILY MEMBERS WERE TREATED WITH SUCH COMPASSION AND KINDNESS? IS THIS NOT PATIENT-CENTERED CARE, or at the very least, one definition of it?
SHOULD WE REALLY BE AFRAID OF THE MEXICAN DRUG CARTEL; MORE SO THAN OUR OWN MEDICAL MAFIA, dressed in pressed shirts and expensive suits? And yes, I realize we have a larger population than Mexico, but you can do that math on that one.
1) Death by drug side effect = 106k
2) Bedsores (really, bedsores???) = 115k
3) Medical Error = 98k
4) Infections = 88k
5) Surgery = 32k
6) Unnecessary Procedures = 37k
TOTAL= 783,926 AMERICANS KILLED EVERY YEAR by MEDICAL ERROR
DRUG CARTEL RELATED VIOLENT DEATHS IN MEXICO FROM 2006-2012 = in a Report published by Human Rights Watch criticizing Mexican security forces and estimating more than 60,000 people were killed in drug-related violence from 2006 to 2012.