The local clinic has outsourced its appointments
with the result that if you call the line, you get
put in this everlasting hold loop, and Lilli was
getting tired of my not having gotten through, so
she took it on herself to drive to the facility and 
refuse to go away until she had a set of appointments
for me, which was impossible for my regular doc, but
she got me in with somebody who had free space, which
means that either the person has a bad reputation or
(as it turns out) was new.

I talked to the crew there when I arrived; they 
admitted to being as frustrated as the patients, the 
result being that they try to schedule the next 
appointment at the previous one (kind of normal, 
actually) and bypass the telephone reservation
system altogether. This would be fine if they had 
full access to the computer systems (forehadowing).

Time to visit the new doctor, who is a freshly minted 
DO and seems to be of the impression that I am her 
med school preceptor in disguise or his doppelganger;
so I entertained her with stories of my various evil
twins, one a rather ungood violinist (bad for me),
one a vice president at HP (good for me), and one
the mayor of San Francisco (neither good nor bad).
(The mayor guy was two days older than I and died of
a heart attack within a couple days of when I had my
last one, a coincidence that I find entertaining.)
Reception thought I was in for a flu shot and nothing 
else, ignoring the fact that I had my flu shot there 
a couple weeks ago; so I have gripes not only against
the appointments system but also the recordkeeping 
one. Lilli strenuously requests that I transfer to
her medical center off in Rancho Bernardo, of which 
when she's not urging this upon me, she's complaining 
about their incompetency. I tend, as you know, to 
think that people go into medicine and the hangers-on 
professions for all the wrong reasons, but what the 
hey. there's not much to be done about the underlying
institution, as its eventual downfall will leave us 
with a situation that is likely going to be worse.

The medical staff seems okay if naive, but for anything 
interesting, referral to the specialist, which is
mostly okay, though Scripps has numerous fiefdoms
connected by computer systems designed by idiots,
with the result that lots of things get lost in lots
of nooks and crannies. The young doctor enthusiastically 
reported that as of November 13, all the various record
sets will be consolidated into one system. I just laughed.
I looked at what she had, and my heart stats have not
been transferred from the one office to the other, and
my (I thought incidental) asides have been reported as
"note per pt," which is heartening as they apparently
believe me, but I'd rather my memory not be the only 
source of information about my test results. The doc
seemed to be a bit taken aback by my cardiac numbers,
which are indeed extremely unattractive, compared to
most of my metabolic figures, which are pretty good.
A question is why I can maintail 99-100 oxygenation
on 10% heart function - well, she gladly left that to 
the cardiologist; unfortunately the cardiologist has 
left that to the cardiac surgeon, whom I don't like.
Edited to say: 9%, overheard at the hospital.

Anyhow, I endured the waiting (though basically there 
was only one other patient while I was there) and then 
the doctor's evidence-based platitudes and the nurse 
making a hematoma trying to get my blood, and finally 
the appointments computer of course being down - the 
nurse ended up having to override bunches of prompts to
schedule me for two weeks, I should be out of the 
hospital in one way or another by then, which none of 
the front desk people was authorized to do.

The system is changing its name from North County Health
Services to TrueCare, which in itself is ominous, as it
signals a wish for market expansion, which as far as I
can see is bad for everyone and is undertaken mostly by
administrations who are so desperate that they can't 
figure out to make money with the setup they have.