-She visits her primary physician, Dr. Jones, who said he can take care of the diabetes. First, she needs a general checkup, including a colonoscopy.
-When it comes time for the lumpectomy, the GYN wants her to see Dr. Blood, the oncologist for chemotherapy recommendations.
-She sees Dr. Blood. He orders additional testing and sends her for a consultation with Dr. Butte for a colonoscopy.
-At the colonoscopy, she is found to have two polyps, which are removed.
-She returns to Dr. Blood, and he explains that one of the polyps also was suspicious, and she is going to need a repeat colonoscopy in six months. They go ahead with a course of chemotherapy as a precaution for her breast lesion. This means monthly visits for injection of the chemotherapy and blood work the week before each injection. This will go on for six months, and then they will repeat the mammogram and sonogram.
Fast forward one year.
Alice has completed the chemotherapy for her breast lesion, and she has continued treatment for her diabetes and had a second colonoscopy. At that colonoscopy, another suspicious polyp was removed and she is now back in the office of Dr. Butte to discuss her third colonoscopy. He feels that the third polyp is abnormal enough that he wants to do a partial colon re-section and schedules her for that surgery.
Before that surgery, which is to be done at Mega Medical Center Hospital, she needs several more tests to look for possible metastases.
What we have is a woman who thought she was in good health and wound up with visit to half a dozen providers, three hospitals two imaging centers and three labs. Does this sound familiar to anyone?
Fragmentation issues here and problems are many but very real in our system.