So today has been a fairly unusual Monday for me. Yesterday I started to feel a bit of pain in my abdomen on the right side. I assumed it was probably just something I ate and continued to have a normal Sunday, went for a jog (which was a bit painful) and as usual worked, since as a startup founder I do find myself working most weekends. This morning I woke up and things weren’t better, I wasn’t in a lot of pain but I could tell something wasn’t right.
We moved to Austin three years ago and while I love this city (seriously, Austin is an amazing place!) the quality of health care is something that always scared me. Since moving here from California we’ve seen the quality of care drop massively, from Doctors visits to the Emergency Room, there’s a clear difference from what I had in LA, San Francisco, Pittsburgh and Boston.
There are a number of studies that show how bad things are in Texas but the Austin Statesman (the local paper) recently covered this one in August that ranked Texas as one of the ten worst states for quality of care in the US:
Texas isn’t a great state for health care quality, according to a new online list from WalletHub. In fact, it ranks in the bottom 10 out of all 50 states and Washington, D.C., coming in at No. 41 on the website’s list. (Source – Austin Statesman)
Now that being said there are cities like Houston that buck the trend with a truly exceptional hospital and high quality care. But I’m in Austin and Seton Medical Center, which is the #1 Hospital in Austin is the 7th best in Texas according to US News and World Reports. So if you have a health emergency in Austin, you’re stuck in a state with some of the worst quality of care in the country…and even in that state you don’t have access to a top five hospital.
So today when I had to go to the doctor for abdominal pain I was pretty scared, if anything immediate needed to happen I was really concerned about the quality of care I would end up getting. I like my Doctor here, he’s a nice guy and definitely seems to know his stuff, but he can’t help the system he’s working within so when he heard of my symptoms and pressed on the right side of my abdomen he said, we need to get you a CT scan to make sure you don’t have appendicitis.
Having known a few people who have had surgery here, and all of whom had serious complications often due to sloppy work or lower-quality surgeons I thought, oh no, I need to get back to California. That’s when my Doctor informed me that if I do have appendicitis, I would need surgery today.
So I went to the medical imaging center, got my CT scan and sat in the back room waiting for the results. For those wondering I actually found the facilities to be really nice, new machines, helpful staff, nothing too crazy there. It’s what happened afterwards that shows why Texas ranks close to last when it comes to quality of care.
A nurse came to get me and said they had the results but that someone wanted to talk to me. It was my Doctors office, but not my Doctor. They said they had the results, couldn’t tell me what they were but said I needed to go to the ER and take a CD of the scans with me. Yikes! So I guess I did have appendicitis. I started asking questions about what the results were, was I having surgery, what did the CT scan show?
The nurse told me that she couldn’t actually tell me the results, I just had to rush to the ER. I decided to dive a bit deeper. “What Doctor reviewed my scans?” I asked. I got his name and told them to contact him so I could talk with him. When I talked to him he first started by telling me that I didn’t have appendicitis, I did seem to have some kind of inflammation or infection but he was actually surprised that they recommended I go to the ER. He said I needed to see a GI specialist and that going to the ER probably wasn’t the fastest or most efficient way to do that. He suggested I talk to my Doctor because something about that advice didn’t sound right to him.
So I called my Doctors office back and asked the nurse who told her that I should go to the ER. She told me that my Physician Assistant did. So I asked, “I have a Doctor but I don’t remember having a Physician’s Assistant.” She told me a name that I didn’t recognize. I asked, “so is this another Doctor that gave the recommendation?” She explained that it wasn’t a Doctor, but it was a Physicians Assistant who saw the results from the CT Scan. I told her I needed to talk to my Doctor.
I did talk to my Doctor who said that somehow what was explained to the office was incorrect, the results had been confused (maybe with another patient?) and that I didn’t need to go to the ER. He said he would talk directly to the Doctor who reviewed my CT scan and would get back to me. So it turns out that yes, the wrong data was sent to the Doctors office and a Physicians Assistant that wasn’t my Doctor was giving me advice based on bad data, and without consulting my Doctor.
My Doctor confirmed what the other Doctor who had reviewed my CT scan had said. There’s something wrong but I don’t have appendicitis and yes, I should see a GI specialist. I definitely feel like my Doctor here did the right thing and in my book, he’s awesome, but the quality of care here in Texas and ability to diagnose something like this isn’t something I feel super comfortable with.
So tomorrow morning I’m flying back home to the Bay Area to see a GI specialist that my Mom has known for years (she’s been a nurse for 40 years). I want to figure this out but have lost faith in Austin as being the place that can properly diagnose and handle it. Now don’t get me wrong, I love Austin, it has been a great city to live in, a great city for startups, music, food, lakes, hiking, biking – honestly there’s something really special about Austin. We’re moving to San Francisco in November and while I’m definitely looking forward to coming back home (the Bay Area will always be home) there are definitely lot of things I’m going to miss about Austin…but I can tell you I’m not going to miss the health care.