medical malpractice?? Any one here a MD?

[~*Alexis*~]

Ok so Sunday morning I went to the local urgent care down the road to get my throat checked out.
I got there around noon and I was #5 on the list....so the receptionist called my name and I entered all my insurance information and the like....I sat down again and was then called into the back. The nurse took my BP and my temp and my temp was high at 99.8. I had a sore throat and some spotting on my throat and I was sure it was strep. The nurse did a rapid strep test and walked out...I sat there for 15 minutes until the doctor said the test was negative and she took a 5 second look at my throat and determined I just has a bacterial infection of my left lymph node. She prescribed me some azithromycin and sent me on my way.

I paid a $75 copay for a 133 dollar bill. Then I had to get the precription from CVS for another 30 bucks.

So I have almost completed my entire srip and I still feel like absolute crap, in fact I feel worse. My white spotting on my throat has spread to the other side of my mouth and I cannot swollow water without wanting to cry. I have not eaten anything since last saturday and then it was still just noodles.

I went to webmd and looked at tonsilitis and that is exactly what I have. Now, here is the kicker. I work for the hospital that is affiliated with the Urgent care and the Dr that is on staff. My copay to go to the ER is $200 on top of the 75 and 30 I have already spent on horrible scripts and care. Now, I have not missed work, because they would take my vacation time since I do not have any sick leave.

What should I do? I am miserable!!!!!!!!!!!!!!!!!!!!!!!!!!!!

 

[neatfreak]

I think malpractice is a very strong word, and not something that would be taken seriously with such a small claim. Especially because no harm has really come to you other than a few more days of misery and a relatively small additional bill. I know it isn't small to you, but in the world of medical bills it is small.

First I would go back immediately. And let them know everything. Second, I would write a letter to the hospital/clinic where you were treated and ask to be reimbursed for the second visit. But you really need to be *sure* that they diagnosed you incorrectly, which looking online won't do for you. Then take it from there. I would think they'd likely try to help you out.

Good luck!

 

[ljmorgan]

Well... tonsillitis is either bacterial or viral. Your doctor gave you antibiotics which will treat it if it''s bacterial, and if it''s viral, the only treatment is pain relief. So I don''t see what anything else that can be done, and to call the situation malpractice is insane.

From wikipedia:

Treatments of tonsillitis consist of pain management medications[4] and lozenges.[5] If the tonsillitis is caused by bacteria, then antibiotics are prescribed, with penicillin being most commonly used.[6] Erythromycin is used for patients allergic to penicillin.

In many cases of tonsillitis, the pain caused by the inflamed tonsils warrants the prescription of topical anesthetics for temporary relief. Viscous lidocaine solutions are often prescribed for this purpose.

Ibuprofen or other analgesics can help to decrease the edema and inflammation, which will ease the pain and allow the patient to swallow liquids sooner.[4]

When tonsillitis is caused by a virus, the length of illness depends on which virus is involved. Usually, a complete recovery is made within one week; however, some rare infections may last for up to two weeks.

Chronic cases may indicate tonsillectomy (surgical removal of tonsils) as a choice for treatment[7]

Additionally, gargling with a solution of warm water and salt may reduce pain and swelling.[8]

 

[~*Alexis*~]

malpractice is a strong word, so lets use negligence instead. Any hoot that is not my point. i work for the business office and I know what will and wont be reimbursed.

Its just frustrating that the Dr was in there less than 5 minutes and made a snap judgment about my condition with out even doing a thorough exam. No breathing checks, heart checks. The medicine I am taking is not making it better it has actually made it worse, along with the side effects. I cannot sleep, I cannot eat.

The problem is this, when I go back and they do decide to remove my tonsils (yes they are that badly infected) what is my course of action. Keep in mind I work for this place.

I have asked a nurse who is a friend of mine and she said I needed to take all my pills before I even could get looked at again....

its just irritating...especially since we are conditioned to trust doctors with our lives and they do not seem to want to take the time to make a correct diagnosis.

 

[Kaleigh]

Not medical malpractice. They treated you as was warranted. Strep test, prescription for an antibiotic. Tonsilitis can be viral in nature, viruses need to run their course and will not be helped with an antibiotic. It''s painful I had them growing up, more than I can tell you. But doubt you have any case for legal action. Try Chloraseptic spray, it numbs your throat. Popsicles, sorbet, nothing acidic and drink plenty of ice cold water. Hope you feel better, that pain is bad. Tylenol or Advil as needed. I am no Doc but have dealt with this with my daughter recently.

 

[San Diego Bride]

i'm not really sure what you're asking. we've already covered that this is nothing close to malpractice or negligence. you feel like crap. you're taking medication and it's not getting better. that's frustrating. i get that. but you were given a diagnosis and treatment at an urgent care center. these centers aren't set up for in depth stuff. if you want a more thorough assessment i'd suggest seeing your regular doctor. or call the clinic where you were seen. it seems odd to say they won't see you again because your friend who is a nurse said so. i'd call yourself.

and, just for the record, people don't have their tonsils removed when they're acutely infected so this won't be the next step for you.

 

[~*Alexis*~]

thanks Kaleigh...wanna come take care of me too?

I think its bacterial given the previous diagnosis, its just a frustrating predicament to be placed in. I work for these people and have always thought that the doctors and staff that I have worked with have been top notch and excelled in their field. I now have a scewed perception of the staff there.

So now its all over my throat, now on both sides and its getting worse. I have been taking advil and motrin for the swelling but I can only take it every 4-6 hours and cannot exceed 8 pills without over dosing....they wear off in 2 hours....I can''t win...

oh well....lets see what the next dr says....

 

[laine]

They prescribe 800mg ibuprofen to people, so you''re ok taking more that the 2 pills every 4 hours dose that the bottle recommends. You can also alternate ibuprofen and acetaminophen every two hours 9so each one every 4 hours). Gives you more pain killers, but doesn''t overdose you on either drug.

Sorry you aren''t feeling well--hope it gets better soon!

 

[Miranda]

Awww. I''m so sorry you aren''t feeling well. It sounds to me like you have a virus which antibiotics cannot treat. Unfortunately, so many Drs. prescribe these strong medications like candy so when they need to work they simply don''t. How long have you been sick? It takes about a week to get over a virus so perhaps you should give it a few more days. The best thing you can do is to keep yourself hydrated and as comfortable as possible. If you have symptoms of a secondary infection you should see your doc promptly. Also, did they do a throat culture along with the quick test? I could be wrong, but, I was under the impression that false negatives are common with this test.

 

[diamondseeker2006]

I am so sorry you are sick! I do think we need to realize that doctors are not gods and cannot always accurately diagnose everything, especially if it was in the early stages. The antibiotic would normally have taken care of a bacterial infection. It sounds like you may need to return and let them check you again.

 

[San Diego Bride]

Date: 5/6/2008 11:18:11 PM
Author: laine
They prescribe 800mg ibuprofen to people, so you''re ok taking more that the 2 pills every 4 hours dose that the bottle recommends. You can also alternate ibuprofen and acetaminophen every two hours 9so each one every 4 hours). Gives you more pain killers, but doesn''t overdose you on either drug.


Sorry you aren''t feeling well--hope it gets better soon!

the maximum dose of ibuprofen/motrin is 10mg/kg. so 800mg would be fine for a 175lb person, but not terribly appropriate for someone smaller. also, ibuprofen can only be taken 4 times a day. yes, the drugs can be alternated, but every 3 hours, since ibuprofen can''t safely be taken more often than every 6 hours.

 

[Haven]

I dont'' know anything about the medical malpractice stuff, but I wanted to add that you may have something else if you''re self-diagnosing. I am not a doctor and can''t diagnose, but I know that some people get thrush from certain medications, which appears as white raised lesions in your mouth. Your symptoms sound similar. Thrush can be very painful, and is often the result of an adverse reaction to medication, or serious stress. If it is thrush, you''ll need an anti-fungal medication.

 

[cara]

One can take ibuprofin and tylenol simultaneously and it should provide additional pain relief than either alone. Do not exceed the recommended dosage of tylenol, it can be toxic in relatively low levels over the recommended dose. (But is very safe at recommended dose.) My doc told me to take 600 mg of ibuprofin every 6 hrs for pain/inflammation relief in addition to the normal tylenol dose, but I am not a particularly small person.

I don't know about tonsillitis, but I get lots of viral sore throats and try to drink lots of liquids, sometime hot tea with honey or cold carbonated drinks, anything that feels good or decent on the throat.

You don't have any malpractice issues, I'm not even sure you got suboptimal care at your appointment!

Yes it sucks that you are sick, still sick, and not responding to medication. It sucks that your copays are substantial and you have no sick days. But if you are miserable, you should get back in front of a doctor and perhaps take some days off work as vacation days (while it feels like a waste, it is your health - you deserve to get better!)

 

[crown1]

i am not sure what you mean by white spots? strep that i have seen is not so much a spot but white on the tonsil or throat area. i don''t know if this could be your problem but maybe you could google tonsilloliths. these are fairly common and cause discomfort. i hope you will soon feel better.

 

[Lorelei]

I am no expert, but I do know sometimes a different antibiotic can be needed if the problem is bacterial, as not all will respond to one type of anti'B. Also throat infections/ tonsillitis can take a while to ease, I used to suffer from chronic tonsillitis and I was in significant discomfort for about 7 to 10 days with each bout. I hope you feel better soon.

 

[~*Alexis*~]

Ok so I am at work in my office, thank goodness I get my own....here is a pic from my camera phone....its not a good pic but it is actually worse on the other side.

I very rarely get sick but when I do get sick I am usually down for the count.....

 

[Lorelei]

Oh Yikes, I would definitely go back and see your doc Alexis!! No wonder you feel like cr-p with a throat like that, you poor thing! I am no expert, can only say what I have seen and been through myself, but it looks like both tonsils and each side of your throat is infected. Doc ASAP!!

 

[Independent Gal]

Is anyone else shocked that even HOSPITALS don''t provide good insurance to their employees?

I can''t believe you have to pay that much to see a doctor.

Also, I don''t see any malpractice or negligence. Just like the rest of us, doctors do their best with the information they have. And it''s BECAUSE of the excess of malpractice suits (at least partly) that regular people can''t afford to go to a doctor in this country.

 

[neatfreak]

Date: 5/7/2008 12:03:24 PM
Author: Independent Gal

Also, I don''t see any malpractice or negligence. Just like the rest of us, doctors do their best with the information they have. And it''s BECAUSE of the excess of malpractice suits (at least partly) that regular people can''t afford to go to a doctor in this country.

VERY good point Indy! Well said.

 

[Miranda]

Oh my, Alexis. Go back to the Dr. It''s time to try a different antibiotic!

 

[Lorelei]

We are lucky here in the UK to have the NHS, it isn''t perfect, but at least getting to see a doctor seems easier.

 

[Maisie]

I was eating toast when I looked at that pic of your throat.... oh my!! I felt a bit sick so I can only imagine how you are feeling.

You said that you have tonsilitis based on reading something online? I would seriously go back and have your infection diagnosed right away!!

I really feel for you. I have had tonsilitis many times and its horrible.

Get well soon!

 

[Independent Gal]

Yes, please don''t go to the Emergency room. A throat infection hurts, but it''s not an emergency!

 

[Munchkin]

First off, I''m sorry you feel lousy.

Second, rapid step tests are most accurate if you have had a sore throat for at least 24 hours. If you went to the clinic before then, a repeat swab is warranted.

Third, I very seldom prescribe zmax for strep - I just don''t think it does the job all that well. I typically only use it for throat stuff if the person has med allergies.

Fourth, as others mentioned, there was no malpractice involved. I have my own theory about urgent care clinics. (If the following offends anyone - I''m not trying to be insulting or malicious!)

By their very nature, urgent care centers have rapid turnover. The visits are "directed" which means they focus on the primary body system that you are complaining about. If you complained of cough, they would have listened to your lungs.

Typically a provider is unlikely to see the same person twice in a few months/years time. The patients who present to a clinic on a weekend do so because they don''t want to wait for their PCP to open on Monday. These same patients often expect a "quick fix." There is no patient/provider trust relationship to lean on. A person is (I think) a lot less likely to listen to a provider they don''t know explain to them that their horrible sore throat can not be helped by anything but motrin and time. In primary care - you know us. You trust us. We can say to you "Unfortunately, antibiotics won''t fix what you have. They could actually make you feel worse as they kill good and bad bacteria. However, don''t hesitate to call me if you get worse or anything new turns up." You know that we are there 5 days a week. You trust our opinion.

Urgent care center providers are more likely to deal with people who just want meds - and want them now. I think, over time, it becomes more habitual for providers in those settings to dispense meds a bit more liberally. Adult care is especially difficult (I''m in Peds) because your patient has lived decades prior to the onset of very judicial use of antibiotics/superbugs and is accustomed to being giving meds for all that ails them. In peds we can stress our point by explaining to parents that we want antibiotic to work on their child''s illnesses when s/he is an adult.

Finally, white stuff doesn''t necessarily mean strep. I actually see far more exudate (white crud) in kids with mono than strep; and mono is a virus.

So, call your PCP. If you don''t have one, it''s time to find one. Feel better!

 

[Miranda]

Date: 5/7/2008 9:34:11 PM
Author: Munchkin
First off, I''m sorry you feel lousy.

Second, rapid step tests are most accurate if you have had a sore throat for at least 24 hours. If you went to the clinic before then, a repeat swab is warranted.

Third, I very seldom prescribe zmax for strep - I just don''t think it does the job all that well. I typically only use it for throat stuff if the person has med allergies.

Fourth, as others mentioned, there was no malpractice involved. I have my own theory about urgent care clinics. (If the following offends anyone - I''m not trying to be insulting or malicious!)

By their very nature, urgent care centers have rapid turnover. The visits are ''directed'' which means they focus on the primary body system that you are complaining about. If you complained of cough, they would have listened to your lungs.

Typically a provider is unlikely to see the same person twice in a few months/years time. The patients who present to a clinic on a weekend do so because they don''t want to wait for their PCP to open on Monday. These same patients often expect a ''quick fix.'' There is no patient/provider trust relationship to lean on. A person is (I think) a lot less likely to listen to a provider they don''t know explain to them that their horrible sore throat can not be helped by anything but motrin and time. In primary care - you know us. You trust us. We can say to you ''Unfortunately, antibiotics won''t fix what you have. They could actually make you feel worse as they kill good and bad bacteria. However, don''t hesitate to call me if you get worse or anything new turns up.'' You know that we are there 5 days a week. You trust our opinion.

Urgent care center providers are more likely to deal with people who just want meds - and want them now. I think, over time, it becomes more habitual for providers in those settings to dispense meds a bit more liberally. Adult care is especially difficult (I''m in Peds) because your patient has lived decades prior to the onset of very judicial use of antibiotics/superbugs and is accustomed to being giving meds for all that ails them. In peds we can stress our point by explaining to parents that we want antibiotic to work on their child''s illnesses when s/he is an adult.

Finally, white stuff doesn''t necessarily mean strep. I actually see far more exudate (white crud) in kids with mono than strep; and mono is a virus.

So, call your PCP. If you don''t have one, it''s time to find one. Feel better!

That''s so interesting. Thanks for the clarification. I have always been under the impression that ''white crud'' meant it was a bacterial infection and not viral. Good to know.

How are you feeling Alexis?

 

[icekid]

Date: 5/7/2008 12:03:24 PM
Author: Independent Gal
Is anyone else shocked that even HOSPITALS don''t provide good insurance to their employees?

I can''t believe you have to pay that much to see a doctor.

Also, I don''t see any malpractice or negligence. Just like the rest of us, doctors do their best with the information they have. And it''s BECAUSE of the excess of malpractice suits (at least partly) that regular people can''t afford to go to a doctor in this country.

Eeeek I can''t wait until I get sued for no reason. Medical malpractice is a HUGE part of the problem with our healthcare system.

Anyway, my biggest issue here: Alexis, is there a reason that you do not have a primary care physician? They are much more useful than this urgent care business, as you''re much more likely to get follow-up and then they will know what you looked like a few days ago if you are continuing to get worse. Also, I assume they did a throat culture in addition to the rapid strep? This may help with the diagnosis as well. You also may want to consider that seeing your primary care doctor is probably much cheaper for you as far as a copay goes. And going to the ER will be more expensive still and is also not appropriate for your problem.

And I agree w/ Muchkin, from my experience, exudative tonsilitis is often mono and won''t get better w/ antibiotics. And the mono sore throat can take a loooong while to go away. I think it would benefit you greatly to see your primary care doctor, Alexis. Good luck, and I hope you''re feeling better soon.

 

[arjunajane]

Wow, I just have to say the health care in the US sounds sooo confusing! I work for a health ins co in Australia, and I can''t tell you all the horror stories we hear about health ins. from visitors from the states.
Lorelei, you are so right that you guys are lucky with the NHS - apparently you have an amazing system there that puts us to shame! Government paying for your dental..? Wow!

Anyways, sorry about the off topic, and I hope i haven''t offended anyone in the profession in the US - I know as medical professionals you do your best of course, but are restricted by convoluted legislation.

Alexis, i am not familiar with your system but i agree that you should go see your regular Dr where you can receive attentive care. I hope you feel better soon! I feel so sorry for you that you have to be at work still.

 

[Lorelei]

It does have it''s faults AJ and of course things do go wrong, but we don''t have to worry about not getting medical help, be it from a PCP/ GP or ER etc. The downside is that there are long waiting lists to be seen by a specialist etc, but I am grateful for what we do have.

 

[arjunajane]

Date: 5/8/2008 7:57:37 AM
Author: Lorelei
It does have it's faults AJ and of course things do go wrong, but we don't have to worry about not getting medical help, be it from a PCP/ GP or ER etc. The downside is that there are long waiting lists to be seen by a specialist etc, but I am grateful for what we do have.

Yeah I hear ya. Similiar to our system in that we have a pretty strong public system too, however you guys don't even have private funds is that right?

From what I've heard, surprisingly Sth africa is very good in that if you have a job, Everything is paid for by employer - dental, operation whatever. But I guess not so good for the poor/unemployed

 

[~*Alexis*~]

Ok so I went over to the medical office building for me to get a PCP and to make an appointment....the first date availible is May 22....

So what would happen to a normal patient? They would die? I just don''t get it...its horrible.