Sunday, July 25, 2010

Hospital politics the same no matter which country

Unfortunately, I had to go to the emergency room last night. I slipped on a paving stone outside a coffee shop while carrying William. I broke his fall with my elbow - it hurt, but wasn't excruciating, so I didn't go to the ER right away. After four hours, though, I tried to pick up Patrick and couldn't. Greg (correctly) pointed out that medical care here is (relatively) inexpensive, so I should just go get an X-ray to rule out anything serious.

I went and had an xray (during which the staff thought I was nuts for insisting on wearing the lead apron, but we'll put that aside). The attending ER physician couldn't see anything, but my regular doctor had advised me over the phone not to leave without asking the on call orthopedist to check the X-ray. That dr (fairly junior guy, it was Saturday evening after all), thought he saw a hairline fracture. He called my regular doctor, who then in turn called the head of the orthopedic department of the hospital.

The on-call orthopedist recommended a split and follow on CT scan Monday morning after swelling was down - and just ibuprofen for pain since it only really hurt when I twisted my arm. The head of the department (who talked with me and my regular doctor on the phone) concurred. With everyone in agreement with what sounded like a reasonable treatment plan to me, I agreed. We were good to go.

But then things got complicated. Someone called the director of the hospital to inform him I was in the ER ... not sure if it was my regular doctor or someone in the ER (I had given my business card so they would spell my name correctly). Then, the director of the hospital called the head of the orthopedics department to tell him he had to come in personally to treat me. The department head pointed out with the rain and traffic, that would delay me by one to one and a half hours. But the head of the hospital said if the department head didn't go in person, he would go. Needless to say, the head of the department got in his car to come, and the junior on call orthopedist wouldn't do my splint until his boss came to triple check the X-ray.

One and a half hours later, hospital politics were smoothed over and I had my splint. Everyone is pretty sure it's just one fracture; I'll have the CT scan on Monday morning to confirm (with the department head). Turns out, there's big competition between two hospitals here for serving the ex pat community, and my trip to the ER got caught up in the middle. After all, if I have a good experience, then this hospital will stay on the list we hand out to Americans in distress (by law, we can't provide recommendations, but we do maintain a list of places to give to people if they are in trouble).

The funny part is, I hear treating political big wigs in DC ERs is the same - department heads called in and heads of hospitals kept abreast of treatment. This time, though, I probably would have gotten out of the ER faster had I kept my job out of the picture!

No comments: