The point of this post is not to argue either for or against healthcare and/or immigration reform. It’s simply a story to remind us of how things interact, and how sometimes things interact in ways we never quite expected.

 

This is the story of an immigrant fromMexicoto theUnited States. He originally came to the country in a not quite legal fashion. (I know absolutely none of the details.) He was not trying to freeload off the system; he was not trying to get free anything. He was here to work, to provide for his family. He worked a physically intense and not exactly safe job at a chemical factory.

Then one day there was an explosion at the chemical plant he worked at. He received some burns to his face, but the biggest concern was his eyes- he was not at his work station at the time of the explosion, so wasn’t wearing safety glasses, and some of the chemicals got in his eyes.

After being treated at the ER for the facial burns, he was sent to the office of the ophthalmologist on ER call that week (which is the office I happened to work in as a medical receptionist). He gave us a name. It turned out we had a chart already, and we pulled it and got him into the doctor.

This was not a one time visit. He would have many follow ups in the first few weeks and need to come in after that for regularly monitoring to make sure his eyes were healing correctly.

Despite the serious nature of his injury, he always had a great attitude and quickly became a favorite patient of the receptionists and assistants. He was memorable not just for his injury, but for his positive outlook.

 

One day, I got a call from this man. It had been a few months since he had been in, and he was scheduled for a follow up appointment later that week. He was calling to tell me that he wanted his own chart.

It turns out that he had not been in theUSlegally. In order to get the job at the chemical plant, he had used his brother’s name and green card. It was his brother’s name we had been given when he first came in for treatment, and he had been afraid to tell us the truth for fear of immigration issues. But now, he had his own green card. He was legal, and he wanted to be seen under his name, and, more importantly from our perspective, separate his medical history from his brother’s.

 

Remember that I mentioned we already had a chart? We had seen his brother a few years before for a basic exam and that’s the chart we had been using. Thank goodness, due to the nature of his injury, the medical history we had in that chart hadn’t been relevant, but it could have been.

Even for those who don’t work in the medical field, I bet you can imagine the risks that come from two different people sharing the same medical chart.

 

I created the new chart. I put notes in the computer system. I put notes in the chart- both on the patient information side, and as a sticky on the records side (as a non-medical professional, I could not make official notes beyond rescheduling/cancellation of appts on the medical record side, so it had to be as a sticky). Every where I thought someone would look, I put a note explaining the situation, and my initials.

When the patient came in for his follow up, the doctor’s assistant came out to complain that the name on the chart didn’t match the name on the records inside. I had to explain the situation to her.

The patient went back to see the doctor. The doctor came out to complain that the name on the records didn’t match the name on the chart, and that there should have been earlier records, too. I once again had to explain the situation. (Does this mean my MDs and their assistants didn’t read the notes? Maybe, but it was a confusing situation, so I understood the questions.) Despite documenting everywhere I could think of, if I hadn’t been there that day (and I called in sick a lot), there would have been even more confusion around this man’s medical records.

 

This was never a case of getting paid or not. The explosion at the chemical plant had been felt throughout the area and everything was covered under a worker’s comp claim number. It was a question of the health and safety of two different men. What would have happened had the brother needed emergency eye treatment before the first man got his own green card? Would have he have skipped it for fear of outing his brother and the fraud they were committing?

Because they were committing fraud. What they were doing was illegal. At the same time, they weren’t harming anyone. (This was in the late 1990s, trust me, they did not prevent any legal citizen who was willing to work at the chemical plant from doing so.) But they were putting their individual health at risk by sharing a medical record.

As a person who works in the medical field (even if it’s on the administration side), that’s scary- terrifying really, and a system that makes people feel as if that is an acceptable risk is just as scary.

I don’t have the answer to healthcare reform or immigration reform. All I know is that those who need medical treatment should be able to get medical treatment, without having to risk the health and safety of friends or family members by sharing a medical record.