Wednesday, December 21, 2011

Surgery in the Age of Information

I am recovering from a little minor surgery I had last week. You know, "minor surgery"--the term we all use to describe surgery that someone else has.

Through this process I believe I have discovered the chief reason that our health care system costs so much in the U.S.: information management.

We live in an age in which it's fairly easy to find out anything about anybody in just a few minutes. Don't believe me? Google your name. Give me 24 hours and internet access and I can tell you what you had for breakfast yesterday.

Our health care professionals seem to have missed out on this explosion of information. It's hard for me to understand. They have the same gadgets the general public has--computers everywhere, tablets, smart phones, and reams of paper forms that must be completed by the patient OVER AND OVER AGAIN. Apparently, these highly-trained professionals are unwilling or unable to communicate with each other.

Let me preach on it.

I injured my right foot almost three years ago training for a marathon. I went to a specialist who took x-rays and ran tests. An hour later he made a diagnosis: "you need surgery." I balked. My foot was just numb. It didn't really hurt, and limping isn't so bad once you get used to it. It can even be an advantage in certain business and social situations ("poor man, I can't ask him to do that, he's a cripple"--or more likely "he's physically-challenged" in the P.C. nonsense vocabulary of today).

I should mention that at this initial visit I completed approximately ten pages of forms consisting of my complete life history. Every sickness I had ever had. Every place I had ever traveled. Every doctor I had ever seen. Everything I had ever eaten. I believe they even asked what I'd had for snack in preschool (grape juice and a graham cracker, by the way).

Fast forward three years and suddenly the numbness turns to pain. Not just a little ache, mind you, but a jump-out-of-bed-in-the-middle-of-the-night kind of pain.

I made an appointment with the same specialist.

Before the ink had dried on the register, the receptionist asked me the question I feared most: "How long has it been since we last saw you? Well then, hang on a second, we will need you to update your file."

This was no update, which to me would indicate the period of time since my last visit, but rather a complete rehash of my life story again. I purposely changed my answer to "apple juice and graham crackers" to see if they were paying attention. They were not.

They even took my picture on this occasion. For my file, of course. This gives me a much-needed peace of mind for the future. I wouldn't want an imposter to have any surgery on my behalf.

The interrogation continued at every step of the process. Questions I had answered in my previous biography were repeated, over and over again: by the little old lady (a volunteer!) in the outpatient waiting room; by the nurse who shaved my foot; by the nurse who put in my IV.; by the anesthesiologist; by my surgeon who came and actually drew an "x" on my foot with a Sharpie to make sure he operated on the right one (a real confidence builder, that); by the nurse who gave me the gas that put me to sleep. Seriously, I was still being grilled as I went under. I believe she said "now which foot is it?" to which I tried to yell "the one with the 'x'!", but I'm not sure if I got it out before I lost consciousness.

Now some of you will likely say "they are just being careful, and that's a good thing." And I might agree--a little. But how hard is it to share information in this electronic age? A 'one and done' question and answer system is surely possible. Before they went bankrupt, I could walk into any Blockbuster video store in the U.S. and learn I had a late fee on "Ernest Goes to Camp" from five years ago.

I am resting at home now, and I guess the system worked. The correct foot has been cut, and I think I am recovering satisfactorily. I even thought that maybe all those questions were somehow worthwhile, until I looked at my my post-op instructions.

They were addressed to Joseph Clinton.