Sunday, March 9, 2014

Year Three, Week Fifty - Scheduling......

It is no secret that I consider Children's Hospital of Philadelphia to be the greatest hospital, ever.  If you have to have hard times, you should have them in the best place possible, right?  This post comes under the "there's always room for improvement" category, though.  Because no one is perfect, right?

Getting an appointment with the neurology department has always been a challenge.  The department's insistance that no appointments be made more than two weeks in advance has been a horrid challenge for this organizationally-deficient mom.  Nephrology plans months, nay, years, ahead.  And we are four hours' drive from the hospital and have to plan around my office schedule as well as Babygirl's school schedule.  So here is how this usually goes:

We see neurology.  They say, see you in six months.  We say, give us an appointment.  They say, call two weeks before you are supposed to be seen.  We leave, already scheduled for nephrology three months from now.  Six months minus two weeks later, if I remember, I call to get a neurology appointment.  If I forget, and am one day late calling, there are no appointments left because the organized moms have taken them all.

This time it went like this:  After 45 minutes on-hold I am told that Babygirl's neurologist is on inpatient duty for the week we need an appointment to match up with our already-planned trip to Philly.  We have a two-day window, since she is being seen Tuesday and Wednesday for other appointments.  The scheduler connects me to a nurse, who tells me she will email the doc and ask if he will see Babygirl anyway.  This is how she was seen last time, so I have no reason to suspect this won't work.  She suggests that we make Monday available since that will widen his window for fitting her in.  I make Monday available.  A week later I call to find out if we have a specific time to show up on Monday.  The 45 minute on-hold stymies me - I am at work, and I really don't have a lot of sit-and-wait kind of time available.  I try daily.  The day I finally get through and am chatting with a scheduler (Yes, I know he's doing inpatient that week, he was supposed to have been emailed about our situation, I'm checking on the response to that request) when a woman arrives in the office, stroke in progress.  I explain, briefly, to the scheduler, and ask her to call me back when she's figured this out.  She says she will. She does not.

Friday I tried again and was unable to wait out the on-hold.  Finally, toward the end of the day, I dialed in yet again, and handed the beeping phone to one of my nurses and asked her to come and get me if a live person came on.  Half an hour later, I am once again speaking to someone who tells me that Babygirl's doc is not seeing patients outpatient that week.  I explain about the email, about taking an extra day off because of this.  She investigates.  The email was sent, and replied to in the negative - two weeks ago.  Seriously?  I pointed out that I had no way of knowing that, and WHY did no one call me to let me know?  I ask if there are ANY docs that will see her - she's having a lot of trouble and we really need to update with somebody.  Not one doc has even one appointment available Monday - Wednesday next week - scheduling has been tighter, she tells me, since they eliminated the you-can-only-schedule-two-weeks-in-advance rule.

Up until this point I've been pretty reasonable.  Some of the problem has been my inability to have time available to make the appointment with exactly two weeks notice.  Some has been the doc's schedule.  The rest has been missed opportunities for communication.  But this piece of information, the knowledge that I could have called in January and had this all worked out months ago?  Nephrology would have had no problem changine their appointment!  It's infuriating - even more so when she tells me that they sent out letters in January announcing the change.

I may not be perfectly organized, but I will tell you that there is not a snowball's chance that I ignored a message of any kind from CHOP.   She is empathetic, but helpless to change any of this crap.  She looks for an appointment and nothing at all is available for the rest of March. this time I've had a patient waiting in a room, half examined, for half an hour.  I ask her to figure it out and call me back, although I assure her that I'm not sanguine about the odds that she will since we are zero-for-two so far.  She assures me that she is a woman of her word, giving me her name so I can track her down if she doesn't call.

Not that it matters at this point.  I'm going to have to make a separate, extra trip to Philly for whatever appointment she gives me.

My current plan is to make a pest of myself at the neurology clinic while Babygirl is at nephrology.  Oh, and those letters they sent out in January?  I opened mine yesterday, postmarked March 3rd.  So the trigger to tell me that the scheduling rules had changed was me trying to schedule an appointment, apparently.

In the every-effing-cloud-has-a-stinkin'-silver-lining category, I was able to see my niece's high school production of Rent last night.  And maybe I'll have time to finally get a haircut while I'm down here.  But given the amount of trouble Babygirl's been having with school attendance, this all just sucks.


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