Once the patient, always the patient. This is something that we have told all our patients, when this conversation arises, but I would like to state it for the record here. We have had patients with comorbidities, who ended up not knowing where to turn to manage a condition and fall between the cracks in our medical care system. Insurance companies and even Medicare do not really care about patients. Insurance companies are concerned about making a profit for their shareholders and Medicare is primarily concerned about managing a hopelessly underfunded health care system, with too many recipients and not enough contributors.
On occasion, we will see patients in follow up where a comorbidity is not being ideally managed and the patient is obviously stressed. After we make an inquiry, we can oftentimes help direct them to highly qualified specialists well known to the practice. When asked why they never sought help from us, they say that it was because it was not our specialty. While that is true, we are happy to assist any of our patients with their medical needs by referring them to primary care physicians, dermatologists, general surgeons, gastroenterologists or any other specialty as necessary.
In the case of one patient, we noticed that she appeared stressed and had lost weight during her clinical follow-up. She had missed several appointments. When we asked her what the problem was, she said that she had developed an exacerbation of gastric reflux that was keeping her up at night and making it hard for her to eat. When we discovered that her treatment did not appear to be the best available, we intervened and referred her to a gastroenterologist well known to the practice. We followed her and made sure that she got the best care possible. Some may say that is the job of a primary care physician, but in many cases develop strong and lasting relationships with our patients and want to help them in any way that we possibly can and will not send them away if they turn to us for help.
Ramos, Maria
At the time of her original presentation, the patient was a 49-year-old Hispanic female with one child who presented with a request for an abdominoplasty.
Examination was notable for abdominal skin laxity, diastasis recti and a large midline, mostly infraumbilical scar that had been the result of a C-section done in Bolivia. The scar was extremely stressful to the patient and she strongly desired to not only to correct her abdominal contour but also to hopefully remove as much of the of the lower midline scar as possible. What she did not tell us was that she had also had liposuction of the abdomen in the past in an attempt to improve her abdominal contour. She was not entirely satisfied with the results.
At surgery, we performed a lipoabdominoplasty, a diastasis recti repair and removed a large amount of skin, removing the vast majority of the scar that she abhorred. Only a 2 cm remnant remained postoperatively. She was extremely happy with the results.