American Association for Physician Leadership

Self-Management

Our Patient Named Charles

Jennifer Prassas

October 8, 2019


Abstract:

Many healthcare professionals say that patient care is what keeps them anchored in their careers. Working in healthcare can be emotionally draining but, at the same time, most rewarding.




Many healthcare professionals say that patient care is what keeps them anchored in their careers. Working in healthcare can be emotionally draining but, at the same time, most rewarding. One of the secrets of the best-run practices is having staff members who will have empathy and will use the skills they have to get the best care for their patients.

Working in the medical field for the past 14 years has given me the opportunity to meet wonderful individuals (as well as some not-so-wonderful people). But there is one patient who, after several years, stands out in my mind—Charles.

A few years ago, Charles visited the primary care practice where I worked. He was booked as a new patient visit for a full checkup, because he had not had a physical exam for quite a while. He reported that he had not had health insurance coverage for a long time but was now part of an Affordable Care Act (ACA) plan. I had taken his original phone call when he made his appointment, and I can distinctly remember when speaking to him that he had mentioned that he was as “healthy as a horse.” He said that he never really had the need for medical insurance since he was never sick. I noticed that with the ACA plan he had he was out of network with all our affiliated specialty practices, as well as both of our affiliated hospitals. Fortunately, though, he was in network with our primary care practice, so we scheduled the appointment.

Meeting Charles on that first day for his appointment, I remember what a genuine, kind, and outgoing person he was. He was a personable and happy guy. All our staff members took a liking to Charles immediately. Some patients are like that. Charles checked in, was taken back by the medical assistant, and then examined by our nurse practitioner, Julie. About an hour later Julie came out to me and asked if I could call the insurance company to find out where Charles could go to have an abdomen/pelvis CT done immediately—and to attempt to obtain prior authorization STAT. I was surprised to hear this, because Charles had come in just for a routine physical, but I went into action. I told Charles I would contact him with all the information he would need for the CT scan. After about two weeks (yes, I said two weeks) of going back and forth with the insurance company to get the testing authorized, I was finally able to set everything up for Charles.

I will never forget the feeling I had when Julie told me the results of Charles’s CT report. There was a mass on his pancreas. This man had never been sick a day in his life and had not visited a physician in a decade and now, he presents with a mass on his pancreas? Julie had bumped Charles’s case up to our lead physician to see what the next step could be. My instructions were the following: (1) get on the phone and find out where his insurance would allow him to get a biopsy done; and (2) find out which pancreatic cancer specialists were covered under his insurance plan.

Here we have a man who’s been healthy his whole life and now he’s sick and can’t even receive the necessary care he requires.

I was on Team Charles; we all were. I spent the next two days on the phone with the insurance company fighting for Charles’s case and was told that the only specialists in network were in Arizona. Charles lived in Pennsylvania! I was infuriated and could not understand how this could be. Did the insurance company reps really expect Charles to fly all the way out to Arizona to have a biopsy done and to see a specialist? I reported this information back to my lead physician, who was just as angry as I was. Here we have a man who’s been healthy his whole life and now he’s sick and can’t even receive the necessary care he requires. I was having difficulty understanding how the insurance company could dictate the rules like this. I worked with my lead physician and ultimately we were able to find specialists through our hospital network who were willing to do the work for Charles pro bono. I once again arranged all of Charles’s appointments for him and gave him detailed instructions as to what the next steps would be. I could tell after speaking with Charles that he was extremely nervous but very eager to do whatever it took to ensure that he would remain healthy.

About a month later I got a surprise visit from Charles. I was called up to the front reception desk and there stood Charles with a big smile and a bouquet of flowers for me. He had asked if he could speak to me in private. It was nice to see him. Once we sat down together the first question he asked was if he could give me a hug. I had never in all the years of being in the medical field had a patient ask me if they could hug me. So I jumped up and gave Charles a big hug and told him how happy I was to see him smiling. He hugged me so tight and thanked me repeatedly for all the hard work I did in getting him set up with all the necessary appointments. He said he had never in a million years thought he’d ever get cancer but that because my nurse practitioner, lead physician, and myself had worked so quickly to set him up with all his appointments that he felt he was going to be OK. He had also shared with me that he had recently lost his wife to cancer and that he had three daughters. He said he simply couldn’t leave them without a parent, so it was vital for him to fight his cancer diagnosis and get better. We both got teary-eyed and hugged again, and I just remember feeling so happy that I was able to take part in getting this man the care he needed. I knew pancreatic cancer had a dreadful prognosis, but I hoped he would make it and he would be there for his three daughters.

Charles was a memorable patient, and I was happy that I could help him. That’s why I’m in healthcare—and working with patients is why I love my job.

Jennifer Prassas

Urology Residency Program Coordinator, University of Pennsylvania, Philadelphia, Pennsylvania; email: jprassas808@gmail.com.

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