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The NSPA Blog

When Physicians Have Tunnel Vision

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Posted on April 26th, 2016 by Teri Dreher, under Patient Advocacy, Take Charge, Tips & Resources

This story comes to us from someone who could’ve used a professional advocate last week. Mark, an extremely intelligent, savvy, and articulate 80 year old male, had been experiencing severe shortness of breath with walking. He brought himself to his local hospital emergency room, where he was assured he “wasn’t having a heart attack”, and he was discharged home the same day with no explanation given for his shortness of breath. The following day, a concerned family member phoned his cardiologist’s office and spoke with the physician about their loved one’s breathing issues. Hearing the story and knowing about the trip to the ER the night before, the cardiologist told the patient he was having a medical emergency and needed to return to the emergency room for admission.

Fast forward to the second visit to the emergency room. Mark was admitted, and the following day underwent heart extensive heart testing, including coronary angiography. All the heart tests were normal, and no other tests were done or specialists called in to try and identify the cause for his severe and frightening breathing difficulties. His loved one, while very well-meaning, trusted that the medical establishment at the hospital had done what was best for Mark, so they did not question the discharge, and Mark did not speak up either for the same reasons. Mark left the hospital with the same severe symptoms that he arrived with, without any explanation or treatment. He is eagerly waiting to see specialists as an outpatient later this week.

The emergency room physician on the first visit as well as the cardiologist clearly had cases of tunnel vision, something we’re seeing more and more of in medicine today. Why did the ER send Mark home on the first night? While the cardiologist did a very thorough job checking Mark’s heart, why did he not ask for a lung specialist to examine Mark while he was in the hospital? Why send a patient home with breathing difficulties? Doesn’t that seem dangerous, even to the medically untrained? Was his discharge driven in an attempt to keep medical costs down? We don’t know the physician’s reasoning, but offer the following suggestions if you find yourself or a loved one with a physician with tunnel vision:

1. If discharge from the hospital doesn’t feel right to you, or you don’t understand the diagnosis or the treatment plan at the time of discharge, try and find the courage to speak up. It helps to be aware of your right to an explanation of your medical condition and treatment. It can be helpful to write down your questions and write down the physician’s answers. Unfortunately, the physician may still be a poor communicator, or still attempt to discharge you when you don’t feel ready.

2. While loved ones are well-meaning and concerned, they usually have no understanding of medicine, so they don’t know the right questions to ask, or the right words to use when speaking with your physician. A private, professional healthcare advocate with a medical background will know what questions to ask and how to speak “medical-ese” with your physician, giving you a much greater chance of thorough and quality medical care. The money you spend on the advocate could be a fraction of what will be saved not only monetarily but also in terms of medical safety and quality care. In this story, Mark had two trips through the emergency room in less than 24 hours (imagine those bills!), and is still at home with unexplained shortness of breath.

With over 36 years of clinical experience in Critical Care nursing, home based health care and expertise as a cardiovascular nurse clinician, Teri is well acquainted with the complexities of the modern healthcare system. She has served as a nursing leader, mentor, educator, and consistent patient advocate throughout her career in some of the best hospitals across the country. Her passion to keep the patient at the center of the model of nursing care led her to incorporate NShore Patient Advocates, LLC in 2011, serving clients throughout the northern suburbs of Chicago.

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