In Healthcare, Be Squeaky


As the saying goes, the squeaky wheel gets the grease. This is particularly true in healthcare, where you are dealing with big systems that don’t always talk to each other. Today, I will tell you the story of how I squeaked loudly enough to get quick results.

Both my husband and I have chronic conditions, and we see a lot of doctors. We try to do as much as possible within a single large hospital system in our area. Because we are also both disabled, I need to get copies of our medical records on a regular basis. You might think, as I did, that keeping your healthcare within one system would make it easy to request and manage medical records.

Think again.

Over the course of seven months, I made multiple records requests to different providers and in almost every case the requests were either ignored or mishandled. The entire process is poorly designed and poorly executed. The longest time from request to receipt of records was 102 days. In one case, I received the same set of records and was charged twice.

I started to keep notes of every contact I made with the providers’ staff and the contractor who actually prints the records. Over those seven months, I documented a series of problems and roadblocks. So I did what I do best: I wrote a letter.

With a little research, I found the contact information for the Chief Administrative Officer of the health system. I wrote him a letter summarizing the problems I encountered:

The requester must contact each individual healthcare provider’s office directly, rather than going to a central request point.

At each provider’s office, there is no clear point of contact, and front office staff are either ignorant of the process and/or provide erroneous information.

Providers do not acknowledge receipt of requests, nor provide reference numbers to patients so that the requests can be tracked.

Requests take 10 to 14 days before the medical records contractor can view them in their own system.

Specific details of requests – such as a request to pick records up in person – are ignored.

Requesters must waste time repeatedly attempting to get status updates or tracking information.

Problems at multiple points in the process force requesters to resubmit requests, sometimes repeatedly.

Some providers’ offices circumvent the process entirely and provide records directly to the requester. While this is helpful in those instances, there is no rationale as to why other offices do not do the same.

When [the health system] changed contractors . . . no information was provided to requesters and pending requests were simply dropped without notice or explanation.

I also included an attachment with a the detailed chronology of all the requests. I closed the letter by saying:

The healthcare that we have received from [the system] has been very good. In stark contrast, the administrative experience of being a [system] patient has been dismal. I urge you to make rectifying the situation a priority.

I emailed the letter and attachment to the Chief Administrative Officer, and received a reply within three and a half hours. He promised to look into the situation, and apologized that I was encountering these difficulties.

Three business days later, the CAO apologized again and handed me off to the health system’s Corporate Patient & Family Liaison. She reached out to me immediately and scheduled a call to discuss the problem. She also repeatedly thanked me for providing so many specifics in the letter because it gave them actionable information for follow up.

By the time I spoke with the Liaison, the system’s Chief Information Officer was already working with the Health Information Management Department and the administrators within the clinical practices to address the problems I identified. I was reimbursed for the double charge (although I had not requested it), and was also given contact information in case I encounter problems in the future.

I shouldn’t have to go all the way to the Chief Administrative Officer of a major hospital system to get help with simple medical records requests. I didn’t want to spends spoons on it, but I also knew that I couldn’t be the only patient encountering these problems. Unfortunately, the nature of bureaucracy is to wait for a problem to be raised, rather than preventing the problem in the first place.

The moral of the story is simple: if a healthcare system is screwing up, say something. Contact the person highest in the chain of command for the issue you are encountering. Summarize the problem(s) and provide as many specifics as possible. And if you do not receive the response and assistance you require, be prepared to follow up.

It’s not fair. We shouldn’t have to expend energy to make sure people do their jobs correctly. But the reality is if you squeak, you have a better chance of getting the attention you need to solve the problem.

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5 Responses to In Healthcare, Be Squeaky

  1. Excellent post – and thanks for the detail.

    Sounds like being proactive might be a better choice: be squeaky by explaining you will be requesting copies of your records, and need to know how to set that up.

    Very timely, as we are moving cross-country, and are about to have to transfer medical records.

    Sadly, this is exactly what should NOT be our responsibility. But, since we are the ones most affected by our care, we NEED to take control. Better that than relying on ‘the kindness of strangers.’

  2. billie moore says:

    I have taken this position for years: get your own records every time you have a test or consult that is not fairly routine. No, we shouldn’t have to, but we do. Get the records directly from the doctor ordering the test. Have them faxed to you. Some of the better systems, even small medical offices, have online record keeping which you can log onto and see all tests you’ve ever had in that system and others that you give them that they copy into the system. (I have signed up for one system but not others, as I do not like their Terms and Conditions.) If I have one test that should go to multiple doctors, either I have the testing outfit send to both (you can’t be assured that will happen) or fax/email them myself. If you haven’t the energy to do this, which actually is not as much bother as it seems, possibly you can ask someone else to do this every-medical-visit record keeping for you. Ditto, if you have a person whom you have to care for, as I did for an elderly mother.

    Also, never fax to a doctor’s office in a hospital system unless you KNOW that a functioning human being will be receiving it, in the right office!

    That said, kuddos to you, Jennie. Writing works. I have had two very similar experiences with a local hospital near me. In both cases, I wrote to the CEO outlining my complaints and got immediate action from a designated responder. Conversely, after this same hospital’s ER people, hospitalists, and ICU nurses helped save my husband’s life after a cardiac arrest, I wrote to the Chief Administrator and got a list of all the nurses that served him, and wrote a thank-you letter, addressing all the nurses and thanking the entire staff who cared for him, copying the CEO. It was relayed to me that they appreciated that. (Did the same for our EMT’s and police responders.)

  3. Excellent, Jennie. You have made clear how important it is to document in a computer journal, every action and reaction anyone encounters. Your advice is good for everyone, even people who are not disabled. But, being disabled increases the stress, of course.

    • Jennie Spotila says:

      One of the best pieces of advice that I wish someone had given me way back at the start is: Document everything. Every. Thing.

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