Kafka’s Mammogram: Even being insured, breast exams exist in a bureaucratic maze

I have been told repeatedly that I need to start a blog. My experiences on the road are filled with screwy business trip hilarity. My wacky world of non-profits could be a “real world” show. You think celebrity Apprentice (which I have seen live) is tough? Got nothing on non-profit management where you have to balance on a daily basis paper jams, intergenerational staffing issues, cut-throat competition for limited funds and pooper-scooping (literally and figuratively-but I will get back to those in a later post) all while on the road.

What finally motivated me to write? Well, on the eve of the Supreme Court’s healthcare reform, I was having my own surrealist healthcare experience. I am a die-hard and fiercely loyal New Yorker, yet I will readily admit that finding an Ob-Gyn in NYC is near impossible without a detailed map, an intelligence analyst, and several arcane rituals, and even when you track down an elusive Ob-Gyn, getting them to actually return your calls has about the same likelihood as hitting the jackpot in Las Vegas, or getting a cab in the rain during rush hour in Manhattan. I actually had a great ob-gyn, but then I gave birth; kind of lost touch with her. Since then I have taken on the secret identity of a woman worried about my fertility to get an ob-gyn appointment – because apparently, a concern for one’s future ability to give birth is akin to a secret handshake – it opens doors you didn’t even know were there. Having worked out this aspect of my covert operation to get a simple ob-gyn appointment, I contacted a conveniently located fertility doctor that I saw an ad in a window front for….the ob-gyn equivalent of the lawyers that advertise on the subway.

I recently got a call from a radiologist telling me it was time for me to get a mammogram done. Nice to know someone is concerned for my health. Well, it so happens that I had received from my last ob-gyn a prescription for a breast ultrasound for some pain that I had been experiencing. I mentioned this to the radiologist that called. She was very pleasant but said that instead of the ultrasound I needed to get a mammogram first and that I needed a prescription for that. Huh? Whatever! I called my ob-gyn’s office who took a message and promised to call me. Work was insane so two weeks passed before I realized that the ob-gyn office never called me back. I then called the ob-gyn and asked to have the prescription faxed to the radiologist. I called the radiologist office to inquire as to whether they received the fax and was told that they wouldn’t be able to tell me that for another 48 hours since faxes go to their medical records department and it takes them 48 hours to process and there was no way they could call me. Evidently their medical records department is in another dimension with a different concept of time and distance than ours. Given the fact that its hard to get anyone to call you back, its likely that cell phone service doesn’t extend to that dimension either. So, somewhere in the virtual world there may or may not be a prescription for a breast ultrasound. I have visions of scary old nurses in trenchcoats running a sordid black market in breast ultrasound prescriptions.

It sometimes seems like there are rules when it comes to medical appointments, but that we are always regarded as being in violation of rules, which no one has ever bothered to share with us. Is it the overcrowding of patients that leads to dysfunction or does the medical system exist in a strange alternate universe? Is it that the system is just broken and needs to be fixed from the ground up.

I don’t know what Supreme Court will decide tomorrow and whether it will make a difference either way. We learn in elementary school that the shortest distance between two points is a straight line. Well, it seems that the healthcare system never learned that lesson. Is there a supreme court decision that can impact common sense? And can anyone recommend a good ob-gyn with a phone that works?

I welcome your thoughts

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