A Sunday afternoon in the ER



On Father’s Day, my wife and I were sitting in church when her jaw popped while chewing gum. “No big deal,” she thought, until after church services when we noticed the side of her face swelling. Of course, she thought it was nothing and tried icing it down. But the swelling didn’t stop.

During our Father’s Day lunch, we decided urgent care was a smart bet. My wife has experience with medical referrals and authorizations needed for services outside one’s primary care provider during non-business hours. She made a call to the answering service for her doctor’s office. After a little persuasion, we went to the closest urgent care. Good deal! Nobody was in the urgent care at 1:00 p.m. on Father’s Day. The urgent care had not seen my wife in over a year so they addressed questions about insurance, co-pays, and type of plan, while exchanging piles of paperwork. As we checked in, the doctor approached my wife, took one look at her and said, “You will need a CAT scan, and you will need to go to the ER.”

Not the place I'd planned to spend Father's Day.

Not the place I’d planned to spend Father’s Day.

At least he did not call 911, so we felt okay. My wife was pleased she would not have to fill out paperwork again as it is the same system and should have everything on file. At the ER, we told the same story to three different people and caught up on reality TV shows in the waiting room and exam rooms. We were in and out in 3 hours. Turns out, the CAT scan was clear, and the next step is visiting an Orthopedic Maxillary Specialist for TMJ…Google it!

Pleased that the problem wasn’t more serious, we continued with Father’s Day plans, although I lost 3 hours of my Father’s Day.

Five days after the event, my wife was dealing with her primary care physician to get a referral to a specialist and to inquire about this being a side effect of another treatment she had. The nearest specialist is about 35 miles away. She received the authorization on Wednesday to see the specialist, which isn’t bad timing. However, after contacting the specialist for an appointment, she learned the practice is not taking any new patients under her insurance plan. While contracted with our insurance company, it seems the insurance company has progressed to electronic filing only, and the small business is still filing the old fashioned way.

That leads me to last night, when she was still searching for a contracted specialist who will accept her insurance, is accepting new patients and is able to submit claims with our insurance company electronically.

Apparently, this is not a rare occurrence when dealing with private healthcare.

A recent article notes: “Yet, on average, veterans don’t appear to wait longer for care than other Americans.”

I am really glad that Veterans will continue to see improvements in access to VA care and those resources will likely improve for our Veterans due to recent events. But it does not mean that a Veteran cannot get quality timely care at VA, especially now. VA leaders are taking many additional steps to ensure that the problems are addressed and that the service, access and care improve. Much of this will be done with dedicated healthcare providers at VA and the new stay that will come on board to improve access.

Bring your healthcare skills to VA by applying at VAcareers.va.gov.

Author

Darren Sherrard