Upon reading Tara Parker-Pope‘s article, “Too Much Medical Treatment,” I was moved to compare and contrast my experience at San Francisco Kaiser Medical Center for the same issue: a moderately-severe sprained ankle that occurred on a Sunday. I checked in to the Emergency Room and was immediately placed in an examining room. A nurse-practitioner promptly obtained medical history and preformed a preliminary exam. She noted and confirmed drug allergies. The E.R. doctor appeared five minutes later and also performed a physical examination. He then sent to me to Radiology for an x-ray. No wait there either. I returned to the exam room and was offered Tylenol or Advil while waiting for results. The radiograph images were available within minutes. The physician studied them and advised R.I.C.E. (rest, ice, elevation, compression and elevation) as well as keeping weight off of my foot until the pain diminished. I was provided a compression wrap and measured for crutches. The doctor was concerned about the level of pain and offered stronger medication, such as Vicodin, if my discomfort increased.
I scheduled a follow-up exam with an orthopedic specialist the following day. This physician reviewed the x-ray, examined my injury and provided a second, better-adapted compression wrap. He asked to follow up in two weeks absent any increasing discomfort or other symptoms of worsening. I was offered physical therapy.
I never saw a bill other than the $100 co-pay I had to supply at admission. The total time spent in the E.R. was approximately one hour.
Four months later I’m almost entirely healed; there is just a bit of very occasional residual pain.
As a patient advocate, I actively watch and intervene for errors and oversights. There were very few and they were quickly resolved without any rancor from the staff. By the way, everyone washed their hands or used cleaning gel without being asked.
I give Kaiser an A+ for efficiency, quality and effectiveness.
The Department of Health & Human Services did review Kaiser’s system as a model for a nationalized health care system. We could certainly do worse.