My medical mystery tour: a long and winding road

07/26/2015 6:00 AM |

I’m happy Eastern Long Island Hospital chose Stony Brook University Hospital as its partner. Since Peconic Bay Medical Center selected North Shore-LIJ, this decision theoretically gives local health care consumers a much larger pool in which to swim.

But I do wonder whether patients — especially the oldest, sickest and most isolated among us — will float well in this pool.

Health care in America seems to have become a gigantic game of Pac-Man, with the richest and biggest “systems” swallowing up every smaller facility in sight. Economically, this is probably inevitable. But reading about the latest merger, I sensed more excitement among officials about efficiencies in administration and data management than about improving care or enhancing the patient experience. Maybe I misinterpreted, but it still bugged me.

My natural skepticism flared up after a recent emergency raised an issue I doubt anyone involved in these consolidations has considered. The top-notch practitioners, services and facilities being touted sound great on paper. But they won’t be worth much if patients can’t reach them from where they live in a timely and affordable manner.

My story: At 4:30 p.m. June 25 I learned I needed urgent outpatient eye surgery. I was squeezed into the next-day schedule with my doctor’s surgeon of choice and told to be in Hauppauge at 8:45 a.m. for pre-op, then report to Syosset Hospital, an LIJ affiliate, for the procedure. I panicked — less about the surgery than about whether I’d be able to find anyone to get me there from Greenport on such short notice.

I’ll be forever grateful to the pals who stepped up to transport me, but I later discovered I was right to be alarmed. If they hadn’t been there, I’d have been in big trouble. This wasn’t just a ride to a routine colonoscopy, to be followed by lunch and shopping. There was lots of waiting; post-op instructions, prohibitions and pain to process; medications and supplies to pick up. Overall, it took 14 hours, 7 a.m. to 9 p.m. Even worse, it was imperative that I show up at 10 a.m. the next day for removal of the bandages — in Great Neck! Luckily, my peeps rallied again, driving me round-trip.

What if I hadn’t had kind and generous friends or neighbors — folks with flexible work schedules who were willing, still able to drive and had functional vehicles? Here’s what: added stress, confusion and significant expense — none of which would have supported a positive medical outcome.

I did some casual research to see what transportation options I might have had. Sadly, the answer is not many — especially without advance notice, on a weekend or when travel outside Suffolk County is involved. (See below.) I calculated that, including four post-op visits, medical transportation could have cost me over $1,000 out of pocket. The ability to deduct these expenses at tax time would have been little consolation for the unexpected budget hit.

If Stony Brook and North Shore-LIJ are serious about improving health care on the East End, and really want to factor people into the equation along with profits, they’ll create a realistic plan for ensuring that patients who need care can get safely, efficiently, comfortably and affordably to wherever that treatment is available. Otherwise, “access” will remain merely a concept. As part of the consolidation agreements, perhaps medical shuttle service, running twice or more daily, can be established to transport patients among the many connected facilities in each new network.

As negotiations proceed, the leaders of ELIH, PBMC and Southampton Hospital must insist that this problem be addressed. These formerly independent local hospitals have been supported faithfully by their communities for many decades. The residents of those communities will be directly and profoundly affected by the many changes that surely lie ahead. At the very least, they deserve a guarantee that when it comes to quality health care — be it elective or emergency — they can get there from here.

Medical transport that is available can be costly and hard to arrange, is often geographically limited and is generally not covered by Medicare, though I’m told it is fully covered by Medicaid. If you’re younger than 60, which disqualifies you from virtually any “senior” service, you could be in an ever bigger pickle, so check your insurance. Here’s a summary.

Southold Town Senior Services provides round-trip transportation to doctor appointments in Stony Brook ($30), Southampton ($20) or Riverhead ($10) on a first-come, first-served basis. There are two “runs” per day. They will not, however, transport anyone to or from any kind of “procedure,” ostensibly due to liability issues.

Riverhead Town Senior Services will transport people at no charge to appointments and procedures within Riverhead Town on weekdays from 8 a.m. to 4 p.m. As much advance notice as possible is requested.

Suffolk County Accessible Transit (SCAT) service is mainly for the disabled but seniors who need medical transport can apply for inclusion via the Suffolk County Office for the Aging. Service runs seven days for $4 each way. Reservations required.

Local ambulette service: I was quoted a round-trip cost of $175, plus a $20 hourly fee for waiting time beyond 60 minutes. This service is not usually available on short notice, but there is a network of volunteer private drivers who can sometimes accommodate last-minute requests.

Taxi: I laid out my itinerary to random cab companies in Southold and Riverhead. One quoted $180 each way including a 30-minute wait. Extra wait time cost $40 an hour. Another gave a fare of $175 each way, plus $1 per minute of wait time, and they needed a day’s notice. I didn’t check Nassau-based cabs but I think it’s fair to assume they’d be no cheaper.

LIRR: Here’s a challenge: Schedule a procedure, then figure out how to get from Greenport or Riverhead to Ronkonkoma and from there to wherever you’re headed in time for your appointment. Better hope it’s planned a week in advance. No time? Try booking a hotel near the hospital for the night before — and maybe after. Ka-ching!

Suffolk County Transit bus: Dude, really? Where, if anywhere, does this service connect with public transit in Nassau County? And how do you get from the bus stop to your medical destination?

Decia Fates is copy chief at Times Review Media Group. After recuperating in Orient and at home in Greenport, she returned to work at half power July 13.

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