As I nurse my flu symptoms, I’m struck in real-time by being a sick patient in a sick health system.

Last Friday 30th October, I was suffering classic flu symptoms and after 2 days of trying to muddle through with home remedies, homeopathic products and OTCs, I contacted my doctor’s office first thing in the morning. I was told that my doctor was out for the day, and was referred to another physician in the practice.

By noon, that doctor had phoned in a prescription for Tamiflu to my pharmacy. The office told me to follow up with my doctor via phone after the weekend on Monday. I then drove to the pharmacy and picked up the oseltamivir phosphate capsules and swallowed the first of ten pills prescribed for a five-day period.

A compliant patient, I followed up yesterday by phoning my doctor’s office. My call was given to the medical secretary responsible for my doctor’s patients. Let’s call her Mary. Mary asked me why I was calling — was this ‘just an FYI’ for my doctor? I said, no, I was instructed by the doctor who prescribed the Tamiflu on Friday to report back to my own doctor on Monday when he would be back in the office and be able to directly consult with me.

My doctor’s practice still doesn’t use electronic health records; thus, Mary grabbed a piece of paper and scratched out notes based on what I was telling her about my condition and health status. It was a hurried conversation — well, less of a conversation than a data dump by me — with no assurance on my end that the information was getting transcribed completely or correctly.
Mary did not pull my paper file to catch up with my situation. She didn’t access any notes in my file from last Friday’s telephone encounter telling her that I was prescribed Tamiflu. She did not know I had trouble sleeping and so was bumming Ambien off of my husband’s personal supply. When I told her I was doing just that, she berated me and told me what a terrible thing I was doing.
I had to laugh.
Mary told me to phone the office back at 4:45 pm if I hadn’t heard from her before then. Presumably, she would put her scribbled note in front of my doctor, who could then follow up with me directly.
Of course, there was no phone call back to me by 4:45 pm, so I phoned the office again and asked for Mary. When she took the call, she didn’t remember who I was, what my symptoms were, or even what doctor I was calling for. After a few seconds I said to her, “I’m the one you yelled at for taking the Ambien,” she vaguely recalled my identity. Vaguely.

My patience lost, Mary finally ‘heard’ that in my voice and said she’d “rotate” my file to the front of the doctor’s pile of records he was reviewing.
Around 7 pm, the doctor phoned me: he quickly got down to business with the question, “what’s up? and once he learned my fever had abated on Saturday, he was glad I had been fever-free for over 48 hours. His business was done, and he said he’d phone in a script for Tussinex to help me sleep.

30 minutes later, my local CVS pharmacy phoned me to say they would be out of Tussinex until 1 pm today.

So much for a good night’s sleep, at least from my doctor’s point of view. For me, an Ambien did the trick once again, albeit that sleepy little pill was not what the doctor ordered.
Health Populi’s Hot Points: I have a friend who is a senior executive with a pharmaceutical company who cannot find a swine flu vaccine for her young daughter in suburban Philadelphia. She is among the savviest health citizens I know and works for a company that makes vaccines.

I am a health economist and consultant who meets with and counsels some of the country’s largest health plans, suppliers to the industry on the Fortune 100, provider groups, and government agencies. I live in a community with five medical schools and more MRIs per capita than in most of the nation.

I cannot imagine how health citizens less empowered than me make it in this chaotic, flu-ridden, vaccine-deficited world that is U.S. health care in November 2009.

Not much in the 1,900-page health reform bill will get to reforming overwhelmed, under-servicing medical practices any time soon. Certainly not in this devastating flu season.