Jim's Heart Attack

My friend and co-worker, Jim, had a heart attack shortly before Christmas. He also has the worst doctor in the world as his PCP. This is Jim's story.

5am to 8am

Jim woke up in the morning with what felt like indigestion. He dropped some Tums, to no avail, and came in to work. He was worried because a heart attack often masquerades as indigestion, and Jim was aware of that. When the indigestion didn't go away, he suspected it might be something else. Precisely at 8am, he called Dr. Stanley Horowitz's office. He got voicemail. Jim had a heart attack several years ago, and then had a stint put in in about May of 2002. He thought he should probably talk to someone right away. He did the "hit zero" thing, and was transferred to someone who took the message personally. Thinking this would provide a more timely response, Jim left his office and cell numbers and began to wait.

8am to 2:30pm

Jim went about his everyday business. We were installing a 120 pound printer when his phone finally rang at 2:30 in the afternoon. It was the office of Dr. Stanley Horowitz, returning Jim's earlier call--six and a half hours later. They had a few more questions, which Jim answered. They said they'd talk to the "doctor" and call him back. About a half hour later, they called back and told him to go to Urgent Care. (As an aside, why do all of Dr. Horowitz's patients receive better care from Urgent Care than from their PCP? That's a rhetorical question, you don't need to answer.) The voice on the phone wanted to know why Jim had waited this long to do anything. He explained that he was complying with the insurance rules, which state that the PCP is the gatekeeper. He can't just call the cardiologist without first getting the referral from the PCP. They told him he should have just called his cardiologist from the beginning, and that they'd work out the breach of insurance etiquette between the partners in the group.

Later that afternoon and the next day

Jim went to Urgent Care. They put him in a $550 ambulance and drove him a block to Thunderbird Samaritan, where they monitored his enzymes until they were sure that he had indeed had a heart attack.

Heart attack it was. Jim was wheeled into surgery, where they loaded his chest with over $20,000 worth of stints, then sent him home the next day.

Analysis

Stanley Horowitz is an associate fellow of the American College of Cardiology. He did his internal medicine residency and cardiology fellowship at the University of Michigan. What word keeps cropping up here? Cardiology. His medical group specializes in the practice of cardiology. Yet it takes him or his staff nearly seven hours to realize that their patient--a patient who has a history of heart problems-- has had a heart attack, and deal with the situation.

Is it any wonder why I view Dr. Stanley W. Horowitz as the worst doctor in the world?

And by the Way

Jim was already irked with Dr. H. before the heart thing. Jim had a doctor's appointment in November, and he'd been waiting for it for several weeks. Several hours before the appointment, he received a call from Dr. Stanley Horowitz's office. The voice on the phone said that Jim would need to come in later that afternoon, as Dr. Stanley Horowitz had urgent business at the time of Jim's originally scheduled appointment. Jim had another appointment scheduled, which conflicted with the time of his "rescheduled" appointment. He reluctantly cancelled his afternoon appointment to accommodate Dr. H.

When he got to Stan's office late that afternoon, he was made to wait for over 45 minutes before the "doctor" would see him. What was the urgent business that forced Jim to reschedule his appointment? Was Dr. H. doing heart surgery? Brain surgery? Kidney transplant? Nope. It was the staff Thanksgiving party! An office party. I just have nothing to say to the hubris of rescheduling patients to accommodate an office party. Talk about customer service. And then, while Jim was waiting, he could hear Dr. Stan, right outside the exam room door, chatting with a nurse about her malady. He spent about ten minutes with her, making Jim wait, before he finally wandered into the room and saw Jim.

Back to Dave's Gall Bladder