Riding Shotgun On My Healthcare Encounter

Being in relatively good health, I don’t often have a chance to see the healthcare system in action.  Aside from my childrens’ sick visits and my own annual physical (note to self – schedule annual physical!) I’ve not had a need to go to the doctor or to a hospital in a while. Not since I gave up active sports anyway…

This changed recently after an accident at my home on a Sunday night in late March.  Foolish me managed to hit my head pretty good in my basement.  We have a split level and there is a support column made of cement right smack in the middle of the room.  Having lived there for a few years, I figured I knew my way around, even in the dark. 

Well…without getting into more of the story, let’s just say two things will be happening on a go-forward basis: 1) I will be turning on lights everywhere I go in the house even if I think I know my way in the dark (my wife made me write this one) 2) I will be wrapping that cement column with some sort of cushioning.

Onto the rest of the story…

I did all…well, maybe most…of the things an informed healthcare consumer could do with the information I had after sustaining the injury.

I assessed myself as best I could and felt that an ER visit was not needed, though I probably could have used a few stitches. And by few I mean it probably would have been like 2-3 tops.

I waited until Monday morning to take action. 

On Monday, I called my insurance company’s 24 hour nurse line to see what they thought.  After describing what happened and my symptoms which included headache, eye pain when I move my eyes around, and a little bit of blurring in the eye that received the brunt of the blow, the nurse said that because it was a head injury and there is some residual pain, it may be worth a doctor’s visit. So I called and made the appointment for later that day. 

My PCP couldn’t see me so I was seen by another doctor in my PCP’s practice.  She assessed my injury and symptoms and was on the fence as to whether or not a CT scan was needed. She left to talk to my PCP who recommended the CT scan be done. 

This is where informed and shared decision making comes in…

I asked how much the CT scan costs as I am in a high deductible health plan and much of the cost would be my responsibility.  She guessed at the dollar – $1000 – which was high enough that I then asked the question that most of us don’t ask in healthcare, but should.

Is this test really needed? 

(I wondered whether or not I would have asked this question had I been in a rich HMO plan with a $20 office visit co-pay).

The doctor said that she had ruled out a concussion but she was not sure if I had some sort of fracture due to the headache and eye pain. We engaged in a brief, yet meaningful conversation about pros/cons and risks. 

After discussing, I decided to wait 24 hours and see if my symptoms persisted into Tuesday.

Skip to Tuesday…symptoms persisted.

I called the doctor that morning and left a message.  Later that morning, she called me back and I shared that I still had the headache and still had pain when I moved my eyes around.  As the sole provider for a family of four, I figured we were getting close to the “better safe than sorry” option.  I discussed it with my wife as well as my mother (who is a nurse) earlier that morning and had decided to get the CT scan but wanted to hear the doctor’s opinion as well. She felt the CT scan was needed.

That afternoon I went to the hospital for a CT scan.  In and out in less than 45 minutes.

Good new: CT scan is negative.

Bad news: Headaches and eye pain persisted.

I talked with the doctor on the phone again that day and she recommended I see an eye doctor. I called and made the appointment for Wednesday.

Skipping ahead a bit, the eye doctors assessed my eye and my vision.  Good news was that my vision is pretty darn good.  I don’t wear glasses and couldn’t remember the last time I went to the eye doctor. But 20/20 vision is still considered good so I was pleased. 

However, the doctor did discover swelling in my eye.  This earned me a regimen of prednisone eye drops, which I’m still on as of the date of this blog post due to the tapering schedule.  I had one follow-up visit with the eye doctor last week and things looked good. Less swelling, no pain, no blurry vision.  This earned me a “come back in one year” recommendation.

So…a little recap:

  • 24 hr nurse line – no complaints. Served its purpose.
  • PCP visit – not bad. Was able to get visits quickly and the doctor guessed the CT scan would be $1000. Actual billed was $1143.33 and allowed $914.66  Kudos to you, doctor!
  • Hospital visit for CT Scan – top notch.  In and out in 45 minutes? Wow. I did see three different (although each pleasant) people in that short stay, which was the one tiny drawback. Didn’t affect overall care, but laying down in the CT scan machine with one person and sitting back up with another person was a little weird. Thought maybe I’d dozed off and it was a new shift or something.
  • Eye doctors – Other than the waiting room (I had to wait quite a while both visits), no complaints. Doctor answered questions and was engaging.

I guess our healthcare system from a user standpoint isn’t terrible. But keep in mind that I know the system, knew what to ask, and was engaged enough (likely due to the high deductible plan) to question treatment options.

I hope you’ve enjoyed riding shotgun on my little healthcare encounter.  I also hope you don’t have to do it again anytime soon. 🙂

And for those who were wondering, the picture featured in my last post about having a long way to go in patient education came from one of the doctors offices I visited during this encounter.