Friday, October 2, 2009

Vets, bureaucracies and national health care

I showed up at the Vet’s office last night at the time they told me to be there. There was no one else in the parking lot, but one person was at the desk in the office. I told her I was there to pick up Ginger. “Ah yes,” she said looking at a sheet of paper, “Ginger Helm.”

She then read me the list of things I would be paying for before I got Ginger back. One of them was the removal of the “Right Upper Third Incisor.”

“What? You removed a tooth? What for?”

“Well there must have been something wrong with it,” she said. “Wait, I’ll ask someone.”

Another person came out, someone I hadn’t seen before. And the desk lady asked, “why did you remove Ginger’s tooth?”

“Well, I don’t know specifically, but there was probably something wrong with the pulp.”

“Pulp?” I asked. “What’s that?”

“The nerve running through the tooth.”

Gad, I thought to myself. Ginger is only 6 ½ and already missing a tooth. That’s pretty depressing.

I put Ginger into the back seat of my Jeep, much to the delight of Sage who had been moping all day and drove to the nearest place to let Ginger and Sage walk a bit before taking them home. After I got home, and after I shocked my wife by telling her the vet had removed one of Ginger’s teeth, I took out the packet of stuff they gave me and began reviewing it in detail. I looked down the list of charges on the invoice and noticed there was no charge for tooth removal. There was something on “Ginger’s Release Instructions” which did indeed say “Right Upper Third Incisor,” but that’s all it said. The release instructions didn’t say the tooth had been removed.

I rushed over to Ginger’s mouth, looked for missing incisor’s and didn’t find any. I got my flashlight and looked again and still couldn’t find any.

I noticed something else from the invoice. It said nothing about the main reason I had taken Ginger in, the flap in her gum that she had torn loose in the vicinity of her upper right incisors. Good grief I thought to myself. The checkout list didn’t mean the upper right third incisor had been removed. It probably meant the gum flap above the right upper third incisor had been removed.

Is my experience with this vet unique in our modern world? No, it is very common in any organization that has created a bureaucracy. My vet is very bureaucratic. She has intricate procedures and copious forms that must be filled out by her underlings. Maybe one of her underlings was supposed to describe what was done in the vicinity of the “right upper third incisor” but got so busy she didn’t get around to it. Then the clerk at the desk misinterpreted the form because when it mentioned a tooth it usually meant that tooth had been removed.

So it was left up to me to read the vets bureaucratic forms, notice the inconsistencies and actually look in Ginger’s mouth.

I have to take Ginger back in a week so one of the vets can check to make sure everything is healing properly. I shall bring up the matter of the missing tooth that doesn’t seem to be missing. It is possible that I am misunderstanding something still. Maybe they filled a cavity in the “right upper third incisor.” But when I tell her of the confusion caused by her system, will she slap her forehead and tell me her system needs revamping? Of course not. That is not what bureaucracies do. The fault will be mine for not understanding their system properly.

This isn’t unique to my vet. You can encounter the same sort of problems when you get your driver’s license renewed or visit the post office. If you don’t understand their confusing systems instantly that makes you a moron.

Now take my Vet problem and imagine a national bureaucratic health-care system. Pardon me if I seem overly pessimistic, but I’d rather you removed my right upper third incisor – and the left one too – rather than force me to go through something like that.

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