You hear all the time from patients, physicians and healthcare workers that the health system is broken. This weekend was an example of how broken the Worker’s Compensation system is. I fear that private insurance and Medicare are not far behind.
On Friday morning, my surgery scheduler called me and indicated that one of my female patients, who is almost 6 feet and weighs almost 250 pounds, was insisting on a raised toilet seat to use following her knee surgery that was coming up in 3 days, Monday. She had a very small bathroom and I felt this was very reasonable since getting your knee bent far enough to get into a bathroom in the first couple of days is occasionally very difficult.
Normally, in the sane healthcare world, I would give the patient a prescription for a raised toilet seat, they would go to the local pharmacy, and purchase one for around $20. Unfortunately, in the California Worker’s Compensation world, insurance companies feel that everything needs to be approved in advance for payment. Of course we could put in the appropriate paperwork, we called the insurance company’s adjuster, got a voicemail, faxed over the request, and knew that there was no way that this raised toilet seat would be approved in time for the patient’s surgery.
We explained that to the patient who then went out and tried to procure one on her own. She went to the local medical supply houses, since her local pharmacy did not carry them, and was told that the least expensive toilet seat would be about $100–120. She obviously could not afford this, and called to indicate she would cancel her surgery on Monday unless she could get this approved.
It takes on average, 2-3 hours of work to schedule a surgery, getting all the appropriate authorizations, coordinating anesthesia and equipment, preoperative tests, and writing out all the paperwork that is involved. The cost of changing this woman’s surgery date for a raised toilet sear seemed ridiculous.
So my surgery scheduler, Jessica, and I went online and googled raised toilet seats. Viola! At least 20 raised toilet seats under $30 were easily found with just 2 clicks of the mouse. So I went to Amazon on Friday afternoon, ordered a raised toilet seat that cost $15.99 and to have it delivered to my home the next day, cost an extra $3.99. Well, a total cost of $21.99 including tax of course. Thanks you Amazon Prime!
It’s a beautiful Saturday afternoon in early fall, and I’m sitting in my office working on a power point presentation for a national meeting next week on complex ligament injuries. I see the FedEx truck arrive at the top of my driveway, the dog started barking, and I find myself getting very excited and happy that the FedEx driver is bringing me the coveted raised toilet seat. Not only will my patient pee in comfort postoperatively, but her surgery will go on time on Monday, and I have had enough laughter over this to account for the $21.99 that I will never get reimbursed from the worker’s comp carrier. That doesn’t matter.
After 30 years of practicing orthopedic surgery, I am now relegated to a toilet seat delivery person. No wonder physicians are leaving medicine in droves.
-Lesley Anderson, MD