I received in the mail today responses to my complaint about St. Elizabeth’s from Tufts Health Plan and the Division of Health Care Quality of the Massachusetts Department of Public Health.
It’s not terribly surprising that St. Elizabeth’s lied to Tufts and the DPH just like they lied to us. After all, once they made the decision to evade and lie rather than admitting to having made mistakes, they had to be consistent about it. What’s surprising is that they weren’t consistent about it — the story they told to Tufts, the DPH and me have different elements and are in some cases contradictory. Some interesting tidbits:
- According to Tufts, “Dr. L…’s answering service informed [the ER physician] that Dr. L… was not on call that day.” There are three problems with this claim: (1) Dr. L… doesn’t have an answering service; (2) she’s the only doctor in her practice and is therefore always on call, except when she’s on vacation; and (3) she wasn’t on vacation and has confirmed to my wife that she was available.
- According to the DPH, “Attempts were made to call, fax, and email the lab results to Dr. L……. the email address was unavailable.” However, the letter St. Elizabeth’s sent to us said nothing about attempts to email Dr. L…, and she has since confirmed that her correct, valid email address is available in the hospital’s records.
- Just as the letter St. Elizabeth’s sent us offered no explanation for why Dr. L…’s staff was unable to obtain my wife’s test results through repeated calls to the hospital, they also made no effort to explain this to either Tufts or the DPH. This is funny, since this is in fact the crux of our complaint.
According to Dr. L…, doctors at hospitals fail to follow up with primary care physicians all the time at most hospitals, so although it’s incredibly annoying, there’s no point in making a fuss about it. Similarly, it’s also common for ERs to fail to send lab results to PCPs. What is not normal is that Dr. L…’s office wasn’t able to get the results by calling the hospital, and yet that is the only problem the hospital has made no effort to explain.
The hospital may be telling the truth when they claim that the ER tried and failed to contact Dr. L… (however, as noted in my previous postings, they clearly did not try hard enough). The hospital may even be telling the truth when they claim that the ER tried and failed to fax the test results to Dr. L…’s office because they had the wrong fax number. However, where the hospital’s story breaks down is in their failure to explain why the test results were not provided to Dr. L…’s office when they called. There is no possible explanation for this which doesn’t involve the hospital doing something wrong, and this, presumably, is why they’ve avoided trying to explain it at all.
Here’s what I think happened…. The test results were, indeed, sent to the ER and “available at the lab at St. Elizabeth’s on Monday, January 18” as the hospital claimed in the letter they sent us. But notice that extremely careful wording: the test results were available at the lab. In other words, they were available on paper at the lab but were not entered into my wife’s electronic medical record immediately, as they clearly they should have been and as hospital policy no doubt requires. This is why Dr. L… couldn’t see them even though she has access to the St. Elizabeth’s medical record network. This is why the hospital couldn’t provide the results to Dr. L…’s office when they called. Somebody in the lab didn’t do their job.
So, how should the hospital have responded to my complaint? They should have apologized for not trying hard enough to contact Dr. L…, and they should have apologized for not entering my wife’s test results into her medical record immediately. That’s it. If they’d done those two simple things, my wife and I would have been satisfied, and that would have been the end of it.
I have written back to both Tufts and the DPH and asked them to reopen their investigations, starting with speaking with Dr. L… about her version of what transpired, which is clearly rather different from the hospital’s. We’ll see what comes of it.