The Health Center at Fordham RH

Colleges & Universities A-Z Fordham University
1

<p>Throughout my past two and a half years at Fordham, I had never had to use the health center. Two weeks ago, however, I got very very ill and so I had no choice.</p>

<p>Once I got there, I made an appt. and waited. They eventually called me in and so I went into this small exam room. A "doctor" came in five minutes later and seemed friendly enough. He wanted to check my ears and so he got out the appropriate machine. He couldn't figure it out how to get it working so he called in another "doctor". It took her five minutes to determine it was broken so she went to get another machine. My original doctor checked my ears and said, "wow, your ears look red.. but I think I need another opinion." He called in two other "docs" to check my ears. They both said that my ears didn't look red and convinced my original doctor that they weren't. </p>

<p>Once we finally got past my ears, I told my doc my symptoms. I said that I had been running a high fever and had pretty bad coughing. He looked at my throat and said, surprise, surprise, "your throat looks red, you might have strep." I told him that my throat didn't even hurt in the slightest and that I knew I didn't have strep. He was convinced I had strep and so, again, he called in other "docs" for an opinion on my throat. They thought that my throat was a normal reddish color and that nothing was wrong but my doc still took me to get a strep test. I told him again that my throat didn't hurt at all but he opened the package and swabbed my mouth. </p>

<p>They also gave me a flu test where they stuck a q-tip up my nose-- ten minutes later, after the results came back, it took three people to match up the color of the q-tip to the chart in the kit.</p>

<p>My doc prescribed a throat spray for, according to the package, "sore and painful throats". He wanted me to spray that 5 times a day despite my telling him numerous times that my throat didn't hurt at all (and despite the other docs that told him my throat looked ok). He also prescribed penicillin "for my throat". Even I knew that docs shouldn't prescribe penicillin so easily since people can build up an immunity to it.</p>

<p>When I was feeling a bit better (and when I could finally get out of bed), I went to my own doc at home-- I'm very fortunate to live very close to fordham. Sure enough, I had pneumonia.</p>

<p>Furthermore, they diagnosed my friend with "strep" a month ago and put him on medication for strep. It wasn't working and so he went back. They insisted that it would work and so he believed them. A week later, his throat closed up and he was rushed to the hospital-- he came close to death. He had an emergency tracheotomy and it was found that he had a severe infection. Had he received correct care in the beginning, that all would've been avoided. He is considering some type of legal action in the future. </p>

<p>I'm definitely not trying to scare anyone away from Fordham-- I'm just venting severe frustration at the health dept. In my opinion, it's scary. If you get really sick on campus and you live far away, I'd honestly suggest bypassing the health center entirely and seeing a local doctor. It's going to be much more expensive but, in my opinion, any amount of money is worth spending to get back to normal health. Fordham is a great school that has a few major kinks to iron out.</p>

2

<p>Well, your post definitely raises some warning flags to me about your visit. I’m not going to ask the specifics with your vital signs, other physical exam findings, or more of the “history of present illness” that you gave, but, on the surface, it does not seem like your “chief complaint” was addressed in the first place (except via a rapid flu test) - specifically, a cough accompanied with fevers. As a side note, the machine you were referring to that allows further visual examination of the middle ear space is called an otoscope. It sounds like it probably had a burnt-out bulb.</p>

<p>I’m not sure if they were physicians, physician assistants, or nurse practioners that were evaluating you, but in any case, it is both an art and a science to being a very good clinician. It’s hard to say without full review of the medical record whether you were provided the “standard of care” which is the expectation in medicine. I do hope that, at the very least, a throat culture was done to confirm if you had strep throat or not.</p>

3

<p>your experience is not uncommon- many do not spot phenomnia</p>

<p>My went to a very good facility, and her swipe showed up negative for strep, the culture showed up negative for strep, but it walked like a duck, etc</p>

<p>a culture sometimes doesn’t show strep</p>

4

<p>Actually, the culture is the “gold standard” for diagnosing strep throat. A negative culture means that there were no viable streptococcal organisms on that swab, essentially meaning no strep throat. But, the big “however” to all this rests on some assumptions: the swabbing was done properly by contacting both tonsillar areas and the posterior pharynx, the transport media wasn’t expired, and it was properly processed at the lab.</p>

<p>There are times that I would bet money that someone has strep throat, but my culture has returned negative. It means that it was some other organism, probably a virus, that fooled both me and the patient/parent. Since I am the one who swabs the throat, and use an “in-house” lab for the culture, I fully trust my results. Bottom line, if the speciman was obtained, stored, and processed correctly, a negative throat culture is a negative strep throat. This is just a basic tenet in medicine, no matter what our hunch or suspicians would try to lead us to believe as to what the cause of that throat infection is. If the suspician is still there despite a negative culture, than a second culture could be done (assuming that no antibiotics have been started).</p>

<p>A more interesting analysis is required if a throat culture comes back positive for Group A Streptococcous but the patient is asymptomatic, essentially without complaints. A decision then needs to be made whether the positive culture was due to the person being in a “carrier” state, which does not require any antibioitc treatment as a general rule, or did the physician/provider miss something in the signs and symptoms from the history or on physical exam which would have hinted at being symptomatic (and requiring antibiotic treatment).</p>

5

<p>bottom line, if you are not feeling good, go get a checked out at a hospital.. there are quite a few around the area.</p>

6

<p>Sorry…that bottom line is wrong from this pediatrician’s viewpoint. Hospitals, and I am assuming you mean the ER at the hospital, are MOSTLY staffed by personnel that are trained to handle emergencies. You may find exceptions to this with some of their personnel, but they are the exceptions. Even in ER’s which have a “Fast Track” for non-emergencies, it is still an ER physician who is overseeing that physician’s assistant or nurse practioner. In my experience, ER’s tend to do 2 extremes with non-emergent cases: they either over test and over medicate, or under test and under medicate. This is because they really do not have the experience of following a particular disease over an extended time period (days/weeks in contrast to minutes/hours which ER personnel are more familiar with). This does not mean that they cannot properly manage semi-emergent issues correctly, which most of the time they do. However, I’ve noticed that the younger the child, the less optimal the ER care is unless it is from an ER at a Children’s hospital.</p>

<p>From this pediatrician’s viewpoint, the bottom line should be that if you’re sick you should contact one of your parents as soon as possible. Parents, in general (not all but most), tend to have enough experience and knowledge to make a reasonable judgment of how sick their child is and will give proper advice. And, despite what is thought of about the Student Health Center, a quick visit to be checked out by them should be done early on.</p>

7

<p>i agree with calling your parents, they do often know best. But with regards to health center, i do not. If the story is accurate, the service was quite bad, to be frank. The doctor obviously did not listen to the patients repeated claims that his throat does not hurt, and yet he proceeded to test for strep (which came back negative) AND prescribe a throat spray. Such a mis diagnosis would be considered unacceptable to many, that is why i would rather take my chances with a hospital or local physician.</p>

8

<p>There are 2 reasons why I recommend paying a visit to your student health center no matter how much you disagree with it. First, it is the main way the university can monitor if there is a particular illness epidemic brewing and make interventions earlier than later. Second, judging by most 18-19yo’s that I have followed, including my own son, this late adolescent age group is notorious for allowing health issues to go unchecked – illness and disease tends to be underestimated before it gets properly looked at. Using the above poster’s preference of seeing a doctor in the hospital or privately as the first choice, with all honesty, when would that opportunity arise? Would it be in 1 day, 2 days, 3days? How would you get there? Taxi cab, bus, train? Suppose you have a very hectic study/exam schedule, would you possibly wait until you have more time until you take care of a health issue?</p>

<p>Ilyasaber14, if you say that you wouldn’t wait in seeing a private doctor or an ER at the first signs of an illness, then you are definitely a minority representation of your age group with this type of maturity concerning your health. But, for most of the kids your age, they will wait too long before getting their illness checked out. That is why I recommend getting yourself checked out at the Student Health Center. It’s at O’Hare Hall in the basement. You can easily do it during the day. If you disagree with the medical judgement of the person evaluating you, then you can bounce it off your parents as far as getting a second opinion right after you get seen. The main thing is that you don’t procrastinate and delay getting checked out.</p>

<p>Another important point is if you and your peers, as students at Fordham, have no confidence in the care that the Student Health Center is providing, then you MUST contact the administration. Those that were directly involved as the patients especially need to do this. But, always remember the term “standard of care”. You can have 2 doctors seeing the same patient, making the assessment of 2 completely different diagnoses where one is correct and the other is wrong, and both still met the “standard of care” threshold that is expected – both provided acceptable medical care, even the one with the wrong diagnosis. This is critical in the judgement process when evaluating whether another physician/provider had made an unacceptable “misdiagnosis”. One physician can do everything right in evaluating and treating a patient, but end up looking wrong in the end; whereas, another physician can be completely wrong with the evaluation and treatment, but to the eyes of a patient, appear to be completely correct at the end of the process. I’ve done many chart reviews in my career, and you’d be surprised how often this happens.</p>

9

<p>I would agree that kids shouldn’t wait and should see the Health Center immediately, however, the care there was so bad that if things got bad, I’d have friends call the school ambulance instead. My friends’ circumstance there was definitely extreme and, to be honest, it scared me. I also agree with Willy that contacting the administration is a must-- I plan to do this soon.</p>