By Manny Roman
On October 30, I had a reverse total right shoulder arthroplasty (total shoulder replacement). My rotator cuff was essentially nonexistent, and the bones involved in the shoulder movement were bone-on-bone and partially dislocated. My range of motion was severely restricted, and the pain was quite intense – especially while attempting to sleep.
Yeah, I know, poor me. Why did I wait so long to have it repaired? Answer: Fear of complications and of losing the arm. All went well however, and I am extremely happy with the results so far after three weeks. So, why am I bothering telling you about this? Well, for one, it is not too late to send me a nice check in a glad you are well card.
My health care is provided by the Veterans Administration earned specifically by my “boots-on-the-ground” during the Vietnam War so many years ago. The VA hospital here in Las Vegas does not perform the requisite surgery so I was referred to an outside group. The process of referral to “civilian” providers went smoothly and professionally.
The civilian orthopedic surgery providers were efficient, professional and caring. Not one glitch. From initial consultation, scheduling, completion of the surgical procedure and follow up all was outstanding.
The hospital experience was also stellar pre-surgery. The staff was efficient and proficient. There was that one small issue with finding the right spot to inject the block to anesthetize the shoulder area. However, the guru was called and all went well. The glitch came after surgery.
I was on the “go-home-today” list meaning that I would be sent home a couple of hours after surgery to be taken care of by St. Ruth. The “go-home-today” room was full so they sent me to the “stay-overnight room” but did not tell that staff that I was a go-home-today patient. The occupational therapy and the doctor needed to sign me out had left the hospital.
The nurse started a process of calling and reporting. Calling everyone he could and reporting to me that no one was available, but that he would find someone. It took hours to find an occupational therapist to visit me. After determining that I could walk down the hallway and sit and get up from a toilet she gave the thumbs up.
I now only needed the right doctor to sign my release. After a few more hours one was found across town who was willing to drive to see me. The drive took over an hour apparently. The doctor came in, asked how I felt, checked my neck for some reason and signed. The entire process took over 9 hours instead of the couple of hours for the go-home-today people in the correct room.
I have stated often how communication is key. Good communication requires feedback. If they had given the stay-overnight group the correct communication, it would have included a feedback requirement: A verification that it was received and understood that I was a go-home-today patient. The staff could have prepared for me and I would have been home in daylight instead of after 10 p.m. Interestingly they charged room and board for my stay in the room.
Looking at the charges is a crossword puzzle. There are some charges that I am not sure I received, especially in the therapy area, and the VA noticed some apparently double charges. Total billed so far, not including surgeon’s fees, far exceeds what the VA is authorizing. The VA, of course, must have some special arrangements. I get the feeling that this process is not over. Bottom line for me, I am so glad that I have VA health care. I cannot imagine the suffering of those who do not have access to quality health care.
Manny Roman, CRES, is association business operations manager at Association of Medical Service Providers.
