Another side of the changing pattern of medicine became apparent to me when one of my patients had to be hospitalized at a hospital in different county in Florida. Under the current system, when a patient is admitted to the hospital, they are frequently put under the charge of a hospitalist M.D. as their admitting physician.
My patients had significant problems with her admission. Again, this emphasizes the lack of understanding of the problems of medicine.
I had treated this patient in home care visit the day before she was admitted to the hospital. She was having severe pain in her hands, neck, head, and low back. The source of the pain was unknown.
She had previously suffered myocarditis (inflammation of the heart muscle) and had some ongoing respiratory problems. Due to the pain in her hands and difficulty walking, she was barely able to let me into her apartment.
Her hands were swollen and discolored, suggesting the possibility of vascular insufficiency. She also had a severe headache, along with neck, dorsal, and lumbar spine pain. She had had a history of scoliosis, but these symptoms had significantly progressed.
The next day, she went to the emergency room and was admitted to the hospital. The hospitalist that took care of her would not administer baby aspirin, which she had been taking, and delayed in ordering MRI of her head, cervical spine, dorsal spine, and lumbar spine.
When they were finally taken, the MRIs were interpreted as showing arthritis.
The hospitalist never ordered an ultrasound of the arms and hands, but did order an ultrasound of the carotid arteries, which was reported as negative.
Because of her history of myocarditis, a nuclear medicine heart scan was taken and the patient was told that there was a problem in her heart, though the hospitalist later said that she had no heart problem and would not admit that the patient had difficulty walking.
The patient was discharged without a diagnosis as cause of her hand problems — other than arthritis. That was also the diagnosis for her vertebral column pain in all of the areas.
Due to the persistence of her symptoms, and the absence of a definitive diagnosis or effective treatment for her symptoms, she is now considering being admitted to another hospital in the area where they have some prior records for comparison.
This is another example of the administrative control of medicine, which in my opinion is interfering with the recommendations of patients’ primary care physicians.
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