2012-13: Medical Services in Marin

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I had the first surgery in my life, a laparoscopic hernia repair, done at Marin General Hospital on December 5, 2012.  Otherwise, I am a healthy, very active 73 year old man.  Although I have not fully healed, I believe the surgery was successful.  But seven weeks later I am still dealing with post-surgical developments.  Unfortunately, I was discharged from Marin General even though I demonstrably could not urinate.  This created a chain of events that caused me to visit Novato Community Hospital’s Emergency Room that evening to have a catheter placed, and two visits to an Urologist to take out the catheter and check for an infection.  The doctor at the ER emphatically stated that I should not have been discharged in my condition and called the surgeon to tell him so.  As I later learned, he did not follow up on that as he had promised to do.  A friend who is a doctor also confirmed that I should not have been discharged. A secondary problem was an assurance by the surgeon’s office that I would receive post-surgery medicines as I departed Marin General.  That did not happen.  In fact, the discharge nurse called in a prescription to the CVS nearest to the hospital where I had to wait for one hour immediately after surgery to collect my prescription.   Moreover, the prescribed stool softener was ineffective.  I had to visit my local CVS and ask the pharmacist to suggest laxatives for my situation, which were the same as for cleaning my bowel for a colonoscopy.  I had to do that twice.

As I was advised not to drive for a few days after surgery, and I live alone, all of these visits were a logistical nightmare.

When I confronted the surgeon about my experience, he said “They should have called me before discharging you” and “They should have given you medicines as you left Marin General”.  When I pressed him, he admitted he was in-charge, but offered no apology.   Basically, he outsourced my post-surgical care to the Novato Community Hospital’s ER, the Urologist and pharmacist.

On December 30, 2012 a friend who is a retired doctor saw me walking strangely and asked to look at what I assumed was a bug bite.  He thought it could be a Staph infection causing an abscess that needed medical attention.   As my primary doctor’s office was not responsive, I consulted the Pharmacist at the local CVS who  directed me to the Urgent Care facility in San Rafael where I went for treatment early on December 31.  The doctor confirmed that it was a Staph infection. I have not had anything like this infection before.  I have hardly been out of my house and or gone anywhere unusual, other than the two hospitals, where I could have been exposed.

I was prescribed antibiotics and asked to follow other procedures, which I did for 4 days, but the abscess area did not diminish. When I went back on Jan 4, 2013, the doctor said that the infection was serious and I was given an intravenous antibiotic on two successive days.   For each for these visits, I was in the facility for 3 hours.  I’ve since been back thrice.   The abscess is healing, but not completely gone.  Worse, apparently this infection can revive so I have been advised to continue washing with a disinfectant and use an ointment in my nose for the undetermined future.

After a simple surgery, I have been to an ER once, Urologist twice, Urgent Care six times and the Pharmacist at least 7 times.  Poor patient care at Marin General and likely catching an infection there has cost me innumerable hours in travel and doctors offices.  Obviously, the process has cost Medicare and AARP Medigap, my insurers, a huge sum that could have been much less.

Although not directly a part of this issue, I noticed that I was handled by four groups of medical staff at Marin General—preparation, surgery, post-surgery recovery and discharge.  I never saw the same person twice.  I talked to the surgeon for 30 seconds and anesthesiologist for one minute before surgery.  In Urgent Care, I saw five different doctors.  I worked for an international agency in many countries on economic policy analysis based on in-depth reviews of business and government organizations’ efficiency.  My overall impression of my episode with surgery and its aftermath is that the medical services were careless, impersonal and disorganized.


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