This past Saturday, the chiropractor that has been treating my arm as a rotator cuff issue suggested it was time for a second opinion. He wanted to refer me to an orthopedic specialist with expertise related to state-of-the-art orthopedic care, focusing on hand, wrist, elbow, and shoulder problems. I was stunned. First of all, the suggestion highlighted for me the professional ethics and commitment of the practitioner who has been treating me. He is clearly at the top of the leader board and very skilled in his profession. I really like the guy. Secondly, it added a layer of concern. What was the real origin of the presenting problem and how easily would it be resolved?
I’m going to spare you the details and simply say, I was grateful to negotiate getting an appointment with the orthopedic specialist as quickly as I did. I saw him yesterday morning. His office receptionist suggested I arrive about twenty minutes early and go to the radiology department on the second floor and get an x-ray of my shoulder. The doctor would have immediate access to it and it would be instrumental in the examination. They would then make additional x-rays if indicated.
I’ve been around the block a time or two related to negotiating medical treatment and I know from experience, the hope of negotiating any kind of x-ray “sign in, take a number and wait approach” would never be accomplished in twenty minutes. Who were they kidding? Consequently I arrived early.
I was impressed with the doctor’s office before I arrived. I was also 40 minutes early for my appointment. They had provided a realistic timeframe for accomplishing the x-rays. I was in and out or radiology in less than ten minutes.
Surprise of surprises, the waiting room in the doctor’s office was totally unoccupied when I arrived. I couldn’t believe it. The receptionist was very pleasant and handed me a packet of paperwork to complete. I smiled and declined the stack. I had completed the paperwork online and was more than a little impressed that the forms were fillable. First impressions are lasting and I was favorably impressed. When the receptionist asked for my co-pay, she did say, “I have one other form I’ll need you to complete.”
The content of the form was a little out of the norm related to my experience. I was surprised by the request, but I opted to concur. After all, what are you going to do if you don’t? Actually, I know that answer, “You’d do without.” The doctor wanted to ensure payment of any outstanding balance not covered by insurance by requesting the patient to provide credit card information and authorization to utilize the credit card to collect payment on any outstanding balance beyond $100.00. There aren’t many people I’d authorize to use my credit card at will, but I was in a desperate situation. When one is desperate enough to reduce the pain that consideration of removing the arm had become a recurrent fantasy, I’m willing to throw caution to the wind. In addition, I’ve heard horror stories of physicians attempting to stay in business and successfully negotiate the hurdles related to the National Health Care Plan. Color it any way you want to, but medical care is going to cost more.
I was escorted back to the treatment room and the physician’s assistant immediately met me. She provided a brief examination and expressed the need to get an x-ray of my cervical spine as well. In her opinion some of the issues could be neck related rather than shoulder. By then I knew the drill, I made it back to radiology and returned in under ten minutes. My day was going really well. I hate “hurry up and wait.”
I did have one concern when I saw the doctor’s name. The concern was simply name recognition related. I had a doctor with the same last name when we lived in Ft. Worth in 1974. He routinely set appointments for patients at least 2 ½ hours before he ever arrived at his office. I think it was an ego booster for him to walk into the office to a room full of patients. Did I mention he came highly recommended? I always suspicioned that he started those rumors.
In short order, I met again with the physician’s assistant and met the doctor. Following a thorough examination, a treatment plan was developed. I was told the first recommended step was to inject steroids into my left shoulder. I immediately had visions of grandeur and hopes of playing football for the New England Patriots (I couldn’t help myself – bad joke – my apology). The doctor and nurse practitioner left the room promising to return shortly with the medication.
Within three minutes the physician’s assistant entered the room with a folded pad and said, “Don’t look at this. It has a needle in it.” I let her know that next to snakes, needles top my list of things I fear. She set the folded pad down on a desk next to the door and exited again.
Someone else then came into the room and moved one of the office chairs to the center of the examining room facing the outside window. She asked that I move to that chair. Maybe I have a tendency to be a little paranoid, but I don’t generally sit with my back to the door. However, I did as I was told. It felt a little awkward sitting on a chair with my shirt off in the middle of the room facing the outside window. Consequently, I decided to take some deep breaths and try to relax. The needle would be less painful if I could relax. I’m not sure I accomplished my goal.
It seemed like forever before the doctor and physician’s assistant returned. He apologized and said, “I thought I was engaging in a brief conversation, but I couldn’t get out of it. I’m sorry for the delay.” He then said, “You are facing the window, so the shoulder we are injecting is the left one.” Was he asking a question or was he making a statement? I still don’t know. I responded, “It is important to get right. It is the left shoulder.”
In the midst of my injection (which was commensurate with the level of pain I anticipated), the doctor asked, “What would you have said to me if I were doing this to the wrong shoulder? My immediate thought was, “Is this a trick question?” I responded, “I would tell you that you only had one other chance to get it right.” The doctor laughed and said, “That is far more gracious than any of the other answers I’ve been given.
The doctor barely had time to lay the syringe back down on the table before he asked, “How does your arm feel now? Did the injection make a difference? Does your arm feel better? I thought to myself, “the doctor may be good, but he’s not that good”.
The doctor cautioned me that medicine isn’t an exact science, but that we’d get it all figured out. I assured him that I had high expectations for mobility in my arm and I wanted it to be totally pain free. He responded, “So you’ve got high expectations.” I responded, “Yes I do and they are non-negotiable.” He laughed and we parted with a sense of mutual understanding.
All My Best!
Don