Not Your Parent’s Healthcare

Not Your Parent’s Healthcare

 A Warning to Boomers and Their Children

October 24, 2022

Reflections of John W. Palmer, a Baby Boomer

Writing this missive was not something on my agenda a week ago. A week ago, my digestive system was in turmoil. When healthcare was sought to calm my stomach, another kind of turmoil was uncovered. My health status is not what this reflection is about. The reflection is on how the response of the so-called healthcare system attempting to serve greater St. Cloud, MN performed on three cases that occurred on three successive days last week.

Boomers’ life experiences associated with their health and healthcare over the past 60 to 75 years have been positive. When they got sick or were injured prompt medical services were rendered. Waiting for hours, days or months was considered outside acceptable practice. Many things have changed over the Boomers' lives. Many of the changes were reflected in improvements health outcomes but in recent years, the changes have headed in a different direction. If you have been fortunate enough to not need treatment for an illness or injury, you are in for a shock which is not related to a loss of blood.

Fortunately, all three cases described in the next few paragraphs had positive outcomes but the journey through the only healthcare system (Centra Care) was unacceptable and potential life threatening. In all three cases an initial triage was not completed before having the patient simply wait to see someone who could complete a triage and then provide the necessary treatment. It is true that staffing shortages and the increased demand of aging baby boomers may stress the system but a failure to triage has nothing to do with either of those factors.

Early on Sunday morning, a friend began having severe back spasms. When the spasms persisted, the fiend got out of bed and then fell backward hitting the area that was in spasm. After trying unsuccessfully to get back into bed and with continuation of the back spasms, 9-1-1 was called and the patient was transported to the St. Cloud Hospital Emergency Room arriving at 4 AM. Following check in with the usual verification of who would be paying for the visit and confirmation of their identity, the patient was told to wait. After a few hours, inquiry was made regarding when the patient would be seeing a medical professional, they were told they needed to wait since there was not a room open in the ER. Upon the second attempt, the patient learned the delay was the short staffed situation.

When a medical professional finally saw the patient, four and a half hours had passed. The action taken was to admit the patient for observation. The ER had let a patient who was on blood thinners and had fallen on their back, a back that continued to spasm, sit unattended and untreated in the waiting room. No one checked vital signs or checked for evidence of bleeding the patient just waited. Once a cursory exam was completed, it was determined that the best course of action was admission for observation. Clearly, the patient’s condition was severe enough for admission. Waiting four and a half hours for that decision to be rendered is unacceptable.

Best practice when services are limited is to prioritize based need and. If the triage result is to refer to another location make the referral and move on to the next patient.

Following two nights of disturbed sleep and two days of digestive system pain with limited relief by not eating and drink lemon ginger tea, I decided to seek medical attention. Being directed to use “MyChart”, I tried to see if an appointment could be made that day. With no success in using the MyChart software to make an appointment and not being able to find a phone number to contact Centra Care, it was decided to try using a video appointment. Several attempts at scheduling did yield an appointment but my condition required an office visit. The attending Physicians Assistant took an excellent history but was unable to aide me in securing a follow up appointment but did mention that Urgent Care was an option. When no appointment could be scheduled for that day, the Urgent Care option was attempted.

Arriving at Urgent Care after a fifteen minute drive this is how I was greeted: What is your birthdate? Perhaps we are now a number rather than a name since numbers are easier to enter than letters to determine how the bill will be paid? Once my identity and means of paying were verified the reason for my arrival was asked. When my condition was shared and the fact that a video appointment resulted in a recommendation that an office visit needed to happen, I was told that I would not be able to receive service. It was suggested to go to the the ER or travel to Little Falls for service. Since my condition was not ER worthy and Little Falls is 32 miles from my home, I asked if the receptionists could help me find an appointment for the next day. The request yielded a card with a phone number to call for an appointment. The phone call resulted in securing the only available appointment in all of greater St. Cloud the next day (Tuesday).

On Tuesday late afternoon the third case began. My wife called me and in a panicked voice she said "I have cut my finger and it is bleeding heavily." She went on to say that the cut was long and deep and looked like stitches would be needed to close the wound. My wife is an MD’s daughter who was taught do not go to an ER unless it is really an emergency and a cut was not such an emergency. My wife’s father made house calls, stitched wounds in his office and had stitched cuts at the kitchen table.

With her experience her first effort was to contact her primary care physician at the MD’s clinic. Unfortunately, the clinic was closed. Having the doctors home phone, she called and learned from the Dr’s husband that the Dr was unavailable and that under these conditions he had overheard his wife suggesting going to Urgent Care or one of the ERs at hospitals located within 30 miles since the St. Cloud ER had a reputation for lengthy waits to be seen. We went to Urgent Care. Before anyone examined her cut, she was told it was over a 4 hour wait to be seen and the clinic closed at 9 PM, less than four hours away. With a concern for a long delay at the St. Cloud ER it was off too Little Falls.

The 26 mile trip to the Little Falls ER resulted in receiving treatment within 40 minutes following departure from St. Cloud’s Urgent Care. It took another 45 minutes to finish closing and bandaging the wound and checking out. We were back in St. Cloud a half hour later. If we knew what we know now, our first response would be to drive to Little Falls for medical attention and avoid the unproductive trip to urgent care.

In an effort to determine if the three cases were typical of how cases were being treated in today’s health care world a call was made to the family’s MD. I have know the family’s MD since he was four and now he is in charge of quality control for a large hospital system. After the three cases were described to my source, he said these stories were not outside the norm of current practice. He went on to say the problem of long wait times was a result of the expanding shifting demand for care caused by the aging baby boomers and changes in how patients access care.

Magnifying the problem of length wait times is a severe shortage of medical professionals. The shortage of medical personnel has been exacerbated by an exodus of experienced and skill practitioners caused by requirements that medical personnel must receive the experimental gene therapy. Communities with a high number of poor people and high population density are at greater risk than communities with a high socio economic status and lower population density are less likely to experience delays in receiving medical care.

Short of relocating to a community at less risk of having an overwhelmed health care system what is a patient to do? First, become informed about what is the status of health care in your community and then demand the providers do the best practices to insure quality and timely care. Have a plan for securing services to get the best care even if you might have to travel outside your community. Make sure to foster a positive relationship with your primary care provider. Do not use ERs when the condition can be addressed in a clinic or a video consultation. If you must be seen and a video consultation isn't appropriate or is unavailable, use urgent care as your first option.

Heed this warning and realize our health care system is not the system you grew up in. Finally demand your community’s providers are doing the best they can with the resources available.