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And continuity of care?

June 13, 2012
Fairmont Sentinel

To the Editor:

I have struggled trying to put my thoughts together to address the June 7 front page article "Mayo puts new model in place."

Mr. Bartingale, the hospital administrator, stated he has "not heard any negativity" from patients, nursing and physicians. This may be because not everyone has been made aware of all the changes that have already taken place.

The spin being put on these changes is quite convincing - that Mayo is concerned first with patient satisfaction and employee satisfaction. Sounds pretty good. Here's something that might have gotten lost in the shuffle, though: continuity of care.

My recent experience with this process demonstrates this and leads me to be concerned for my own future care. My 89-year-old father, Al Harper, was admitted on May 14 to the ER with breathing difficulties. He was then diagnosed with pneumonia and admitted to the hospital.

In the past, we have received exceptional care from our family physician, Dr. Jeffrey Green, and the hospital staff. I visited my father again that evening and made sure to tell the three nursing staff that he had been in for pneumonia before and contracted C-Dif. This is a condition, simply stated, in which the good bacteria necessary in the gut are destroyed by the treatment used for the pneumonia.

By Tuesday, he was showing signs of a reoccurrence of C-Dif. I didn't receive a call from hospital staff until Wednesday morning to inform me that my father's kidneys had shut down, the C-Dif had spread through his spastic mega-colon, and he was dying. When I asked if our family physician, Dr. Green, had been made aware of this, I was told that Dr. Ortiz was the new "hospitalist" who had been handling my dad's case. I asked Dr. Ortiz if he had been told about my dad's propensity to develop C-Dif. He said the nurses had relayed my conversation from Monday to him. Then he said softly, "I will use this as a teaching/learning ..." I didn't hear what followed.

I don't know if the outcome would have been any different given my father's age and co-morbidity issues. But the last time he was in the hospital and essentially the same thing occurred - pneumonia to C-Dif - our family physician knew to treat the more aggressive problem first. Again, I stress our family physician, the doctor we've come to trust and rely on, knew his history and susceptibility to C-Dif.

As my dad lay sedated and a difficult decision had to be made by me, I asked if Mayo chaplain Russ Steele could get in touch with Dr. Green. I just wanted to make sure I was doing the right thing for my dad and wanted his assurance. Dr. Green wasn't at the clinic but Russ found him at home. He came to the hospital right away. Dr. Green didn't know my dad was in the hospital. Apparently, the new Mayo model was already in place and the communication between ER/hospital and clinic no longer existed.

My father gently passed away that morning. Whether the outcome could have been different is no longer important. What is important is that "continuity of care" must be assured by Mayo. As an aging baby-boomer, all of us should be concerned about our impending health care needs. The trend to no longer employ family physicians and replace them with a sort of triage approach that utilizes nurse practitioners and physicians assistants is alarming. We have all been spoon fed Mayo propaganda as we've stood by and watched one good doctor after another leave. It is time to speak up and protect the future of our health care. If we don't, we might just as well drink the Kool-Aid that Mayo is preparing.

Ramona Harper




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