“When doctors and other health care providers can work together to coordinate patient care, patients receive higher quality care and we all see lower costs.” - Centers for Medicare and Medicaid Services
Amanda walks slowly behind me down the long hall from the waiting room to my office. “Watch you step,” I tell her when we get to the small rise, “Take your time.” Phrases I repeat many times a day. Most of my patients, baby boomers, have joint problems. This is the first time I am seeing Amanda. I work in behavioral health, every patient is like a present to me, a mysterious gift, what will I find when I unwrap their layers? The labels they wear, schizophrenia, bipolar disorder, don’t provide any clarity to who they are. Some are playful. Some are fashionistas. Some are guarded. Amanda sits in the chair opposite me. The chair is strategically placed, near me but not too near, to give the appropriate amount of psychological space. Not blocking the doorway in case I need to make an egress.
Amanda hugs a spiral notebook to her chest. “What brings you here to see me?” I ask. She looks at me, clearly distressed. “I don’t know where to start,” she says. Slowly we unpack her story. In her notebook are phone numbers to doctors, appointments, notes about her symptoms: chest pain, stomach pain, chronic join pain, problems with her vision, and urinary incontinence. Amanda is in care for her depression and alcoholism. She is overwhelmed and confused by her multiple medical problems. She has achieved one of the proposed solutions for her problems; she has a primary care provider she is connected with. For these problems she has been referred to cardiology, pulmonology, ophthalmology, and chronic pain. No one has really addressed her incontinence. She’s had CT scans, stress tests, and eye exams. The end result? She doesn’t know the results of her tests despite several visits, and she still doesn’t understand what is going on with her or the cause of her symptoms.