Yesterday I had a mucocele removed from my lip (yes, it’s now swollen from the stitches and surgery to roughly the size of the Super Guppy), and had a wonderfully un-fun time with the bureaucracy that defines modern healthcare.

To start things off, I had the mucocele examined a couple weeks ago, on the 11th. While doing that, I discovered that insurance companies interpret the COBRA law (a law that says that you can keep your employer’s medical coverage for a period after you stop working) as meaning that they need to forget all your personal information, primary care physician, and all that, and have you reset it all. They do not of course tell you that until you try to access your account.

My next little surprise was when I called to find out what time my appointment was on the 25th. Even though the appointment had been set up on the 11th, there was now no record of it. Fortunately, they were able to put me down as an add-on. So I got to go and get the procedure.

I had to arrive two hours before the procedure was expected to take place (although it didn’t end up taking place for another two hours after that), because of all the paperwork and anti-litigation actions that the hospital had to complete.  Now, getting a mucocele removed (or at least the one I had) is an incredibly minor procedure. We’re talking about something the size of your typical cold sore on your lip that the doctor cuts out with a scalpel. Getting wisdom teeth removed is a considerably larger procedure. When I had my wisdom teeth removed, I simply arrived about 10 minutes before the procedure, signed a paper, sat down on the dental chair, had the procedure done, and then went home with a friend to help me, since I couldn’t talk. After having my wisdom teeth done I was on vaicoden for almost a week, since they had to break up my teeth before taking them out, and had to renew my dose of novacaine half way through the procedure, since it was taking so long. Compare all that to a surgery that took roughly 15 minutes, involved a scalpel, a bit of novacaine, something to cauterize the damaged mucos vessel (basically a medical sodering iron), and a needle with thread for probably six stitches. I could talk just fine after the procedure (except for my “F”s). Now, here’s what I went through to get the procedure done:

I had to dress in full medical pajamas, go through the paperwork three times, talk with two anesthesiologists, get an IV, refuse partial sedation three times (even though my doctor didn’t think I needed it or the IV), get strapped to a gurney, have an ECG taped to my chest in 4 locations, and have something taped to my leg. I was told multiple times before the procedure that I could not leave the hospital alone if I had any sort of sedation (which i didn’t want anyways) but that it would be fine for me to leave on my own if I didn’t have any sedation. Despite this, after the procedure (I wasn’t sedated) the nurses refused to let me leave on my own because of the hospital’s policy of not releasing anyone who’s been sedated.

Health care is an industry in the U.S. that is stuck operating with an organizational structure from the 1970s, fearing modern litigation. If ever an industry is ripe for a makeover by the computer industry, health care is that industry. I’ve got one idea that will affect bureaucracy in all industries, and should considerably speed up and protect anything dealing wiith medical records, but clearly a lot more can be done. While a lot of the silliness I had to deal with was to protect the hospital from litigation, an equal amount was the classic situation of the left hand not knowing what the right hand is up to.  It seems like there are many major improvements that could be done at an organizational level, the question is, are there any improvements that can make a significant difference that are simple enough they have a chance of being implemented?