Failures of U.S. Healthcare, Specifically Doctors

Experiencing the ER and a serious health crisis for the first time in my life, I got to feel firsthand the frustration of misdiagnosis, misinformation, lack of information, and just overall a crappy level of care from medical doctors. Here are some of the things that went wrong:

  1. My first ER visit doctor misdiagnosed me with costochondritis rather than a PE and sent me on my way with a shot of the wrong medicine (an anti-inflammatory drug). I had no sensitivity whatsoever externally around the area in my chest/ribs, so costochondritis didn’t seem appropriate from the start, but she seemed to know her stuff, right? The ER doctor failed to even request a simple blood test that could have shown evidence of blood clots. When I called the ER the next morning in worse pain, I was told I couldn’t talk to any doctor at all, that it “takes awhile for the pain medicine to work” so I should wait longer. If I’d listened to the admin assistant, I’d mostly likely be dead right now. The fact that I couldn’t even talk to a doctor on the phone was ridiculous.
  2. Only 1 of my 4 hospital doctors even attempted to explain anything. The other three repeated the diagnosis (“you have a blood clot in your lung”) and ran out as fast as they could. In fact, I stopped a few to ask questions and they looked annoyed, gave me generic answers, and looked at me like I was stupid when I asked if should be on bedrest or if I would have permanent lung damage.
  3. No hospital doctor asked me about my pain level. When my last hospital doctor stopped by, I told him I still had chest pain and needed pain medication and he looked baffled or surprised. Why? I’m pretty sure my chest just went through some major trauma!
  4. One of my hospital doctors vastly overprescribed Norco, which left me to pay for it out-of-pocket. My insurance said his script didn’t justify the prescription for 80 Norco pills for chest pain. I didn’t even want or need anywhere near that much.
  5. No hospital doctor accurately described my blood clots or where they were. The doctors said “blood clot in the left lung” when my primary physician reported to me that I had multiple clots in the periphery of my left lung, but that they were small and caught early. Thanks, hospital docs.
  6. All hospital doctors and my primary physician failed to warn me about the effect of blood thinners on menstruation. A huge miss given that my PE was provoked by being on birth control, which I immediately stopped when hospitalized. All of my doctors knew this, but none warned me about what blood thinner periods look like.
  7. My primary physician didn’t request a blood test to assess iron levels (hemoglobin) in the past 3 months, despite me sharing that I was worried about heavy bleeding on blood thinners. Fail.
  8. Two of my doctors contradicted each other in terms of whether pregnancy was advisable or not. Not necessarily a fail, but no one could actually break down the actual risks (of DVT/PE OR bleeding out) when pregnant, which leaves me in a gray, nebulous space with no hard facts.
  9. Two of my doctors contradicted each other regarding painkillers/pain medication while on blood thinners. My temporary PCP said it was okay to take Ibuprofen as long as it wasn’t for weeks at a time, while my temporary OBGYN stated that NSAIDS were prohibited. According to the internet, the only safe medication to take on blood thinners is Tylenol (acetaminophen), and some studies support the notion that bleeding risks increase (up to 2x) on NSAIDS. My temporary PCP didn’t seem to think it was risky for me to be on NSAIDS for 2-3 days per month.  So which is it???? (Disclaimer: I do not advise taking any NSAIDS while on your period, but I took them during my period for a few months until my OBGYN discouraged it. He didn’t recommend any other medication for menstrual cramps despite my complaint about them, so that was a fail in and of itself).
  10. All of my hospital doctors downplayed my risks and minimized the seriousness of the PE. You would have thought they were announcing that I had a bladder infection for all of the seriousness they expressed or time they spent with me (or didn’t).
  11. My ER doctors requested 2 chest X-rays within 24 hours of each other, as if you would catch something on the X-ray the second time (neither showed anything, and the 2nd X-Ray seemed to be a blatant waste of money).
  12. No one described the risks of blood thinners to me. I was left to read about the plethora of unpleasant common symptoms and bleeding out/stroke risks on my own.
  13. I left the hospital not having a clue what to do next (other than attend my follow-up and take medication).

In sum, I’m horrified at the poor level of care that hospital doctors provided. In the 3 days I was in the hospital, a total of about 10-15 minutes were spent with 4 doctors, which means an average of about 3-4 minutes talk time with each doctor. That’s it. Three were male, one was female, and only the female doctor didn’t patronize me and tried at all to discuss blood thinner options (although without the discussion of risks). Essentially, she spent the longest time with me, and the 3 male doctors spent as little time as they possibly could and had terrible bedside manner, attempting to rush out before I could even ask questions (recent research has shown that female doctors provide better care, although I must admit, the first ER visit doctor who misdiagnosed me was female, so that washes out any advantage the kind ICU female doctor had over the impatient/patronizing male doctors).

Given the poor treatment of doctors, it’s amazing any of them managed to figure out that I had a PE at all, and I can clearly see how so many people slip through the cracks and become misdiagnosed when there is zero continuity of care from shift to shift. Several contradictions between doctors also makes for bad healthcare. When two doctors completely contradict each other about multiple concerns, whom are you supposed to trust?

Why has our health system deteriorated to this level?

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