Naval Shortcomings

At first I was against publishing this story. But I think it's best to make it all known.

You know all those questionaires patients fill out before they're seen? All the historical questions the physicians ask? Well a few of them were about Alison's biliary tract, abdominal pain, and hard spots in the abdomen. Though obscure, Alison and I remembered that about a year ago a doctor at the Naval Hospital found a 'hard spot' in the right side of Alison's belly. We didn't even remember at first, but Alison remembered the doctor sending her for an abdominal x-ray before she left that day. The Oncologist took that news as good and bad. Bad that they didn't follow up or correctly diagnose, but good that it meant the tumor wasn't as fast as he initially had to assume.

So last week, the doctor asked that we take regular x-ray of her hips at the Naval Hospital to look for breaks again in Alison's hips. She was hurting bad. I took the opportunity while Alison was under the machine, to find outwhat the xray she took about a year ago looked like. I wanted to know if it was true: that we missed an opportunity to catch it.

So I asked the nurse for her historicals. There was nothing from last year. I asked if she had anything before June of this year. I was thinking it could have been spring of '06. The nurse replied that she did have an abdominal x-ray DATED 15 OCTOBER 2004!

That's right, 04.

No abnormalities were noted in the XRAY, which really wouldn't have displayed a mass unless it was a big metal ball she swallowed. As soon as Isaw the XRAY I wanted to see the doctor's notes. I wanted to know why Alison remembered the doctor saying it was just stool.

The clerk in patient records let us see the record. She found that the abdominal abnormality was a chicken scratch on the checkup form, and there was no other about it. No follow up. No comment on the XRAY.Nothing.

Alison discovered by reading further, that she'd noted back pain three months later, and had had that complaint multiple times that year, leading up to our ER visit during Christmas. I even bought her a Posture-Pedic bed, because the doctor said she was sleeping with poor posture.

I believe this could have been caught back in October of 2004. The doctor should have sent her for a CT scan. An x-ray was not appropriate. The doctor knew it. She had to. She didn't send her for a CT scan because the hospital doesn't offer that service! She didn't even follow up a week later to make sure Alison had passed the stool. And finally, she didn't check for that stool when Alison came back in with back pain.

So here's what I'm left wondering: how many other people will suffer our same fate? How many other doctors will fail to send a patient with a hard spot in their abdomen to a scan that might reveal what it is? How many other doctors will fail to schedule a check-up later to ensure that their 'stool guess' was accurate? And finally, how many other people will have a stage-4 cancer before it's caught? Does it need to repeat itself?

I know this is me venting. But there's a problem there. It may be a policy not to send a patient out in town if at all possible. Maybe if they change a policy or two, someone else be caught at an earlier stage. Maybe this will make patients more cautious with Navy Medicine and their personal health. Maybe someone else will ask a question, Navy or not, to make the doctor do a little more, when they could hold their peace. Maybe 'simple trust' that they're always right and always atleast follow up is not enough. There are other short-comings that I've noticed. But I'm getting better at heading them off at the pass.