[Hifred]

I just read the Villages Magazine about health care and was wondering who to write regarding an issue I have had with the health care system. What my husband and I as well as several neighbors have experienced is that indeed The Villages is uping their game on hiring new doctors. We were delighted with our first visits and were looking forward to receiving good care. What we found to be substandard is following the initial visit no matter what the severity of the problem we experienced we were only allowed to see a physician assistant (PA) as our doctor was fully booked. The PAs have made mistakes with diagnosing and ordering tests. They are not physicians and even the doctor after seeing the tests ordered that we paid for acknowledged the PA made an error. What I would like to propose is that TV start a concierge medical program where you are guaranteed to see a real live doctor when you need one. I have a history of cardiac issues (two heart procedures and one heart and lung procedure). When I needed to see a cardiologist I couldn't get an appointment in TV so I ended up calling my doctor at Northwestern in Chicago who immediately fed ex'd me a monitor and his nurse went over a video of how to put it on. I had my problem fixed within a week. Where as I would have had to wait weeks to even see a doctor here. I would definitely be willing to pay for concierge medicine. The other thing is that specialists and primary care doctors I saw in Chicago had Master's in nursing with additional training in their specialty area who would review email questions and discuss with the doctor what course of action was needed. Here in TV and at Shands if I call with a question for a specialist the person handling the question is a CNA who doesn't begin to be able to make the determination of the seriousness of the problem. As a next step to world class medical care I would like to ask:

1) Can they examine protocols and put in place basic procedures to insure proper care? i.e. at TV the nurse who took my husband's blood did not even put a label on the tube of blood. She said she was going to do it as soon as she was done with us. She didn't even write his name on the tube. The protocols here are loosie goosey and are poor medical practice. When the results came back they didn't even resemble my husband's past blood work results with elevations he had never had before. We ended up at Shands and new blood work was done. The two results were not even similar. So we ended up paying for two sets of blood work rather than relying on the one taken at TV.

2) Can they guarantee patients can see a doctor by assigning less patients per doctor and reserving some spots daily for doctors to see emergency patients rather than relying on PA's? Or at least allow patients to see a doctor rather than a PA. At Northwestern Memorial if your primary doctor can't see you, you always see an MD not a PA. I understand this level of care costs more but I am willing to pay for it. I have private insurance and would gladly pay to see an experienced doctor over a PA.

3) If they can't do step 2 would they be willing to have an MD review the PA's recommendation instead of having them order tests? In our case we paid a lot of money and were sent for the wrong tests because the PA didn't know he was ordering a useless test for the symptoms my husband had. This significantly delayed treatment and he required additional work ups. The cost for the useless test was more than $500 after our insurance.

No one wants better health care in TV than I. Can't they develop a higher level of care than what exists at present? Who can I write to for an answer?