‘‘ Screw-ups’’ 123
Nancy had never before either looked at her own office procedures from this alternative perspective, or realized the extent and implications of the problem.
Overworked, many physicians were too overwhelmed to remember or follow key aspects of patients’ treatments. Ill physicians now sympathized with their providers’ plight. Ronald, the radiologist, said his doctor regularly forgot critical parts of the medical history.‘‘ He’ s a sweetheart, but burned out.’’
Still, physicians’ lack of ongoing attention generated dismay. In particular, several complained of surgeons who did not even visit postoperatively. Nancy continued:
My neurosurgeon never came to see me. He obviously thought:‘‘ I am working for an academic salary. My fellows can see the patients. It’ s safe, they know what they’ re doing.’’ But that is so unprofessional: he’ s teaching his students and fellows to blow patients off! I was angry. I’ m sure he thought it was this little harmless procedure. And he thought I was pushy. I was probably being a little pushier than a normal patient, but they hadn’ t really taken a history, so they didn’ t know I had problems that could affect anesthesia. They were totally being surgeons, and putting things off.
After surgery, Nancy’ s covering doctor never even answered his page to see her, and the staff did not know what physician was responsible for her.
The surgeons didn’ t come by, and gave very confusing orders. It took the nurse six hours to figure out who was covering me. We paged him several times and he never answered.
Harry was told by his surgeon, half-jokingly,‘‘ I never need to see you again.’’ As a result, Harry‘‘ sent him a postcard every year, on the anniversary of my operation!’’
In fact, such decreased attention may be spreading. Faculty used to read through all the charts in the past, but may no longer do so. Nancy added:
The generation before us was stricter. The chief residents used to go through every patient’ s chart and leave little sticky notes. Now, I don’ t think the attendings even look at the charts of their patients. It’ s very lax.