Tuesday, May 11, 2004
Oatmeal for breakfast. Installed Adobe Creative Suite. Doctor appointment at Kaiser Permanente. BK told me not to use Kaiser for health insurance, but I didn't listen to him and now I'm a little sorry I did. Today was my first appointment ever to Kaiser, visiting the primary care physician named Shelley S. Fung-Yeung, MD. The receptionist who checked me in was efficient but very cold. I arrived about 20 minutes early. I said hello, how are you? And she quickly replied something like, "it's been very busy." She checked me in within seconds and pointed me to a waiting area nearby, which was out of sight from her desk. She didn't acknowledge that I was a new patient—no "Welcome to Kaiser" with a smile. She doesn't know that she's the first human from Kaiser with whom I've made contact. Or maybe she did but just didn't give a damn. I went over to the next room and sat in the waiting area for 15 minutes before realizing that I was supposed to have put some papers she gave me in a certain tray on a desk nearby. If she had given me instructions to do so, I didn't hear them perhaps because I was disoriented from all the new surroundings. I looked at all the trays for my doctor's name, but didn't see it, so I went back to the receptionist who insisted that one of the trays did have her name on it. She said that if I couldn't find the right tray I could put it in the tray for another doctor whose name she wrote down for me. I went back and found the right tray with the wrong doctor's name on it. It had my doctor's name in very small type which I hadn't seen before next to the wrong doctor's name which was in very large type. While I waited, I saw other patients have trouble figuring out the "put the paper in the right place" hurdle to their healthcare. One woman held her paperwork over one tray, thought for a moment, then held it over another tray, stopped to think again, then held it over the previous tray, then dropped it in. Picked it up again, then dropped it back in. Another woman who had been waiting a long time went up to check if her paperwork had been taken away and discovered that she accidentally put it in the wrong tray. She was obviously upset with herself since there was no one else to blame (or is there?). Yet another woman couldn't figure out which tray to put her paperwork in, so she put it on the desk beside all the trays but not in any particular one. "Someone will come along and figure it out," she said to her friend. Why does Kaiser make patients responsible for handing off Kaiser's own paperwork from reception to healthcare workers? I think I waited about 30 or 40 minutes before being shown in. A woman weighed me (127 pounds—with my boots on), took my temperature (through my ear in about 2 seconds), showed me into a room, asked me brief questions about my chief complaints, took my blood pressure (fine). I gave her paperwork I had prepared explaining my chief complaints and other related information. She left. I waited about 15 minutes. Someone poked her head in to say my doctor was with another patient. I asked how much longer it would be. She said about 15 minutes. I waited. My doctor shows up. I didn't keep track, but I think she started writing a prescription within 3 minutes of talking to me. We talked for a few minutes more. Her English wasn't very good, and I had a hard time understanding her. She asked me a question which I answered and then she asked me another question which sounded like the exact same question she just asked me. I asked her, "Didn't you just ask me that?" and she said no and just repeated her question. So I gave her the same answer I did before. I have no idea if there was a misunderstanding, and she didn't seem to believe there was any despite my question. She said she agreed with Dr. Owen about my knee condition, referring to a copy of my orthopedist's report to my previous PCP which I had provided. I pointed out that Dr. Owen wasn't the orthopedist. Dr. Owen didn't even write the report she had read! She appeared flustered, but simply repeated the names she'd read earlier and repeated that she was in agreement with them. She hadn't even seen my knee or my x-rays! For my occasional and isolated but recalcitrant acne condition, she asked me what my current medications were (none) but failed to ask what I had tried in the past. She said my acne didn't look very bad to her without asking me where the acne was located, so then I showed her and then she seemed to change her mind. She handed me a prescription without discussing what she prescribed, then said some parting words, ending with "My assistant will help you." At the assistant's workstation, I examined the prescription I was given. I then told the assistant the doctor prescribed clindamycin, which is something I had used before and it made my condition worse. The assistant had to find the doctor again who had gone on to see another patient, so I waited. Eventually she returned saying the doctor said to just ignore that prescription. She handed back my prescription and the clindamycin was crossed out. The other medication she prescribed was naproxen (which she spelled using the Engrish variant: naprosen) even though I no longer had very much pain in my knee. (She couldn't spend an extra 10 seconds with me to figure that out.) Finally, I had to point out to the assistant that she still had paperwork I told her earlier she could photocopy but not keep. She handed me the stack of papers I gave her earlier so that I could pull out the ones that needed photocopying, then I waited while she made photocopies. While waiting, I wanted to scream nothing in particular—just scream—but I didn't. I got the 2 referrals I wanted. I just wish it hadn't been such an ordeal. I left the Kaiser office 75 minutes after my scheduled appointment time. I didn't bother getting the naproxen prescription. On the 24 Divisadero bus going back home three young boys sat near me in the back of the bus. One boy ate sunflower seeds. He'd put a whole bunch in his mouth, chew them up, then spit the shells out onto the floor of the bus. He did that pretty much the entire time he was on the bus. Another of the boys had a twig from a tree that had some hard-shelled brown globes attached to it. They'd pull the things off the twig and throw them out the window trying to hit people. They had bad aim, so more than once the object hit the window and bounced back into the bus. The boys also figured out that they could make marks on the bus walls using the twig, so they did that for a while, too. Practically all the seats in the back were filled. One woman smiled at them and said, "That's not a very nice thing to do," but then she had nothing more to say after one of the boys replied, "We know!" There is no justice in San Francisco. I alighted at Castro Street, took an underground train to Church Street. Got groceries at Golden Produce, went home. Snack: an Asian pear. Dinner at home by myself: baked potato with butter, cheddar, sour cream. Dessert: one peanut M&M. Installed Adobe Creative Suite, looked through the Goodies folders on the CD-ROMs, learned about Version Cue. Chatted with Patrick in China for about an hour using Skype. Unfortunately, his trip has turned out to be not what he had expected, and he's not happy with how Simmone has misled him. Only 19 more days left before he returns. Did dishes. Ate 1.5 grilled cheese sandwiches late. Finished reading and editing Second Island (first time around).