Heart Strong

I had the first of 8 routine follow up appointments yesterday: Heart Transplant.

Great news: my heart is well with no evidence of rejection. There was no need for any adjustments to my anti-rejection regimen, and my labs [kidney, liver, lipid, CBC, CMP, and Prograf level] were all normal.

But, here’s my issue:

In an ideal world, I would have also had an EKG, Echocardiogram, and a stress test done while I was at the medical center yesterday; however, third party payers are refusing to allow for that level of care coordination demonstrating an absolute disregard for the patient experience in my humble opinion.

Their rationale is how can a provider know that these diagnostics are necessary before seeing the patient in clinic. I think it’s fine for them to ask that question, and in many cases, the question is indicated; however, in transplantation medicine, the question is wonky.

Obviously, clinical examination is key, but diagnostics as outlined above are standard of care and necessary for adequate surveillance of heart function and the development of coronary artery disease across time.

Bottom line: What should have been one full day of follow up, including diagnostics, has been divided across two days several weeks apart forcing me into an extended waiting game with final results rolling in around 5/22.

I can only speak for myself, but I think it’s high time that common sense be injected into the delivery of healthcare and that the patient be front and center rather than any third party payer’s profit driven agenda.

I return for 6 month follow up in November for a history and physical plus labs, but no diagnostics. Diagnostics are performed around my anniversary appointment.

By the way, It’s been 9 years already: ah-mazing!


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