This month we look at an unusual case where a patient made the wrong choice of where to go for treatment, and a walk-in care facility made the wrong choice in not referring the patient to a hospital, or following its own internal procedures.
It was 7 at night, as Mrs A drove her husband, Mr A, into town to seek help for his back injury. Mr A, 49, was a truck driver whose job involved a great deal of manual lifting and hauling of freight. Over the years he had periodically injured his back during work.
Earlier in the day, Mr A had been moving large, heavy boxes into his truck when he felt a terrible shooting pain in his back. He somehow managed to finish the rest of his shift, but by the time he got home he was in a great deal of pain. His wife, seeing his discomfort, suggested that he see his doctor and get some pain medicine. They called the doctor, but she had already left the office for the evening. The receptionist suggested the emergency room or the local urgent care clinic.
As the couple did not have health insurance, they were extremely concerned that the hospital would be costlier or might require an overnight stay. Mr A knew that a hospitalization could potentially ruin his family’s finances so he chose to go to the walk-in clinic.
At the clinic, the couple filled out paperwork and were called into the exam room where they spoke to a nurse. After that, the supervising physician, Dr P, 55, spoke to Mr A. The physician could see that the patient was in pain and knew that diagnostic tests, including an x-ray would be needed.
“Are you able to walk?” the physician asked Mr A. “If not, perhaps it would be better for you to go to the emergency department.”
“Oh yeah,” said Mr A. “I can walk.”
The physician then ordered a series of tests. For the next 2 hours, Mr. A was shuffled from test to test by medical personnel at the clinic. As time wore on, he began to have more and more difficulty walking and standing, to the point where the nurse had to report to Dr P that Mr A had been unable to stand for 1 of the x-rays.