March 1, 2013

After 25 years of “buying local” medical support, this week I returned to the standard of excellence demonstrated at the Mayo Clinic.

The last time I received medical services at Mayo, the Gonda Building had not been built; the plazas had not been built; the streets surrounding the Mayo Building had not been closed.  So I arrived by cab at the Gonda building with a bit of trepidation…do I know where I am going?  Will I get registered and still make it to wherever I need to be for my first appointment at 7:30?

I hesitantly walked to the Admissions Desk, gave my name and was asked my first question.  Did I know my clinic number?  Why yes, in fact I have my card right here – although it is 25 years old, I said apologizing for its outdated appearance.  The person assisting me looked at the card, and immediately welcomed me home; sharing that having a number starting with “1” was indeed special and signaled a long time patient.  Yes, I said, I was born here. Well, within a minute or so, two other staff joined the conversation, extending a welcome back; glad I was returning….and explaining that clinic numbers beginning with “1” were special….less than 500,000 persons had been registered as new patients before me; and numbers issued today begin with a 7….so more than 6.5 million new patients have been processed since I was first registered. 

And then I was off to GONDA 15S to the Hands Clinic…within seconds I was welcomed and escorted to the x-ray technician for the necessary picture of my hands.  As they were being taken, I thought to myself- isn’t this nice?  No long wait; and better yet, I was getting the test the doctor needs to diagnose what is wrong with me-instead of not only paying for but going thru the “torture” of an MRI first, and THEN learning an x-ray will be a better tool.  Imagine the novelty of that.

I have spent the last 10 years being subjected to MRIs as the FIRST diagnostic tool (in 2011, 4 in one month – 3 of which were dismissed by the specialist to whom I was referred and replaced with the ordinary x-ray.)  So when we went right to the x-ray, I was impressed and comforted….as well as reminded that at Mayo, physicians earn a salary…they do not get referral fees like the physicians at the clinic I frequent.  A good sign, I thought, – I am already getting a signal that the patient and the diagnosis still comes first; not how much the referring doctor can rake in in fees which then incents him to start  with the $6000 MRI diagnostic tool first.

I was then escorted to a consultation room…and RIGHT ON TIME at 8:30, there was a knock on the door and the resident physician entered. We talked; he showed me my x-rays and explained them in detail; he tested range of motion and strength, and did many a measurement of same….and he even did range of motion and strength measurements on my neck – the source of trouble the last time I was a patient at Mayo in 1985. I was impressed with that kind of follow up.  And I was impressed that for the first time in 25 years, I am seeing the test results and having a doctor explain them to me.  What a novel idea.

I made a comment that the neck was doing well, although it had been a battle last year to get a referral to Sister Kenny for traction to treat a flare-up.  We chatted about the neck issue; I explained I now have  a second vertebrae beginning disintegration but that last year was only the second flare-up since I had visited Mayo for it 25 years previously.  I shared that my current physician had immediately started to talk surgery for a fusion last year and I had explained to him that I was specifically told by Mayo when diagnosed, that if anyone in the future recommended surgery, I was to immediately ask for a referral to Mayo – and NOT succumb to surgery without a second opinion.    We laughed that I could not remember the vertebra number that was impacted, but I had clearly remembered the rheumatologist’s advice and was adamant that surgery would NOT be done in Minneapolis…in spite of that, my Mpls. doctor sent me to an orthopedic surgeon at Sister Kenny – who took an x-ray – NOT an MRI and validated that I did not need surgery; but perhaps a little traction would give me some relief.

Fortunately the shared story led to the opportunity for me to explain that I had actually asked my Mpls. doctor for a double referral – one for the hands, and one to address the rotator cuff issue, as well as the concerns I have with my right leg and foot…residual problems from my fall in 2002. Unfortunately, my doctor in Minneapolis gave the referral for the hands only.

Now, knowing the “system” in Mpls., I presume it was an intentional overlook, as it cut my own doctor “out” of referral fees, but I admitted I had grown very distrustful of the guy and would be searching for a new doctor once I was returned from Mayo.

At this point, the doctor excused himself to have a consult with my actual staff physician to whom I had been assigned.  After a few moments, they returned together; the staff doctor asked if I was related to Sonja Kranz (she is a therapist that works with these doctors and is my nephew’s wife). We chatted about the relationship and that she had recommended at Christmas that I should now get to Mayo since I was not better.

By this time, we were all one big happy family and I was silently marveling at how well they do this; how comfortable I felt; and no anxiety for whatever may come next.

They gave me the diagnosis on the hands; they gave me three options for treatment complete with descriptions, time commitments, and success ratios; we talked a bit about fact that I was concerned whether it might be all based in rheumatoid arthritis because of history of same in my family, but that I had asked for the last two years to have my blood tested for the rheumatoid factor but it had never been done to my knowledge.  As part of the referral process, they did have the most recent blood tests from January and confirmed that no test had been done for rheumatoid factor BUT that the readings of the standard blood tests did show in three categories that something was going on with my auto-immune system. 

 Hmmm.  Isn’t it interesting that my local doctor had not picked up on that?

At any rate, I picked the medication as the first choice for treatment.  They advised the prescription was a bit expensive so that if I was NOT realizing relief fairly soon, I should call them directly and we’d make arrangements to move to the next step.  That, too, was comforting.  If it DID work, they had prescribed 3 refills and if I wanted to continue after that, again, call them directly for renewal of the prescription.

So at this point, I thought we were close to the end when the staff physician suggested if I had time, we could schedule all the tests yet that morning that would be needed for the shoulder exam and the foot/leg exam and that I could work with the Desk for a date to return for the consultation with both staff physicians.  WOW!

So off I went to the desk – where the attendant found two staff doctors with openings on the same day, and sent me to another floor for an appointment in 30 minutes to do all the needed tests.

By 11am, I was dismissed until mid-March and was on my way across the street to meet my sister for lunch.  As I waited for her in the lobby, I marveled at the experience I had just had.   YES!  This is quality of medical treatment I grew up with; this is the kind of treatment I expect and do not get in Minneapolis.  Instead, I visit with a doctor who acts like it is the first time he has seen me; remembers nothing about me and sends me to specialist after specialist – located all over the metropolitan area for tests and consults….Why in the world don’t I just go to Rochester once a year for an annual physical and be done with it?  I am sure if tests were needed, I would get them the same day, at the same facility, scheduled via an integrated system on-line …followed by resulting reports being added to that growing history – instead of vanishing into a file folder stashed somewhere non-retrievable!  

All in all, I had a wonderful Mayo Homecoming and may consider making them my “Home Base” once again! 



One comment

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