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Granite Falls Advocate Tribune - Granite Falls, MN
  • Kathy’s Conundrums

  • Conundrums, conun-drums. This week I have been faced with conundrums – situations – that I believe can only have conjectural answers. My first conundrum: Why is it so cold out this week? Why are the weather people forecasting snow in mid-April? The only answer I can come up with is that som...
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  •     Conundrums,   conun-drums.
        This week I have been faced with conundrums – situations – that I believe can only have conjectural answers.
        My first conundrum:  Why is it so cold out this week? Why are the weather people forecasting snow in mid-April?
        The only answer I can come up with is that somebody up there hates me!
        My second conundrum revolves around some stories I have heard about recent medical care decisions.  I want to be upfront and honest.  I only have one side of the story; the patient’s side.  However, I want to relay the information I was given.
        I got a call from my sister who lives in Vancouver, Washington last weekend.  I wrote about her a couple of times several years ago.  She moved to Granite to wait for a liver transplant at the University of Minnesota hospital.
        Here is what she told me.
        The past 6 – 8 months she had been experiencing bladder infections over and over again.  She also has her kidney functions monitored as a precaution to watch for liver rejection. She went to her primary physician about yet another bladder infection. He checked her and decided he wanted to hospitalize her for a round of IV antibiotics and run additional tests.  I was told that the doctor told my sister that he could not admit her to the hospital, she would have to go to the emergency room at the hospital and he would let them know she was coming.
        She went to the emergency room where an emergency room physician examined her, did some tests and indicated that her primary physician was correct in his diagnosis – she did have an infection.  However, there would have to be additional tests to determine if the infection was in the bladder or in the kidney. The emergency Doc said he needed to check out some other things and said he would return. An hour later he returned and told her that the hospital admitting doctor had decided that she did not meet the criteria for admission to the hospital and was sending her home with a new, stronger antibiotic.  This was on a Friday.
        On Monday she did not feel any better. My sister called her transplant coordinator at the University of Minnesota hospital and explained what had happened.  The coordinator from the U was not happy. Bottom line the coordinator made some calls and Mary returned to the hospital emergency room to be admitted.
        The same ER Doc saw her.  He told her that he had gotten all the information from the University of Minnesota and her primary doctor, and he would once again bring her condition to the admission doctor. He told her he would do his best to plead her case but could not guarantee that she would be admitted.
    Page 2 of 2 -     Think about this: A doctor who has never examined the patient makes the final decision whether the patient will receive hospital care.  The decision appears to be made by checking the symptoms against a checklist of criteria.
        My question is ‘who makes up the criteria?’
        She was admitted.  A series of tests were completed that showed she might need delicate bowl surgery.
        If she needs the surgery my sister is trying to get the surgery done at the University of Minnesota.
        I heard another story about a local man who went to the emergency room in Montevideo with a bad cold and deep cough. The doctor he saw said that he would like to admit him to the hospital but his symptoms did not meet the criteria for admission.
        Who makes the decision to admit sick people to a hospital for treatment?  A doctor or a criteria checklist?
        When mulling over these two conundrums the only answer I could come up with is a one word question: Obamacare?

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