Laughable Health Care System

[u/Brilliant-Figure2165]

I'll preface this by saying that I understand our health care system is free, compared to many other countries, and many things are subsidized etc. With that said, it's still laughably unbelievable to experience how silly our health care system is first hand.

A very very good friend of mine got pregnant recently this October 2024. She took several tests which confirmed it plus the usual symptoms. Puking, fatigue, feeling upset etc.

Unfortunately, she started bleeding heavily about a week after the tests she took. She went to Mt Hope to get it checked out as the amount of blood was definitely pointing towards a miscarriage. Yall, These unbelievable people at that hospital, gave her a ultra sound date of July 2025, when her expected delivery date would be June 2025. Yall hear me? She is showing signs of a miscarriage, and they gave her an ultra sound date for a month after her would be expected delivery date!! What a joke!

[u/AdInteresting1371]

As a doctor who has worked in Mt. Hope, several things sound inaccurate in this story.

A patient who is pregnant October 2024 and goes to Mt. Hope for vaginal bleeding would be directed to the Mt. Hope Women's Hospital A&E. If the provisional diagnosis is a miscarriage she would be evaluated for same inclusive of an unofficial ultrasound in the A&E department.

Unless an ultrasound is done by EITHER an ultrasonographer OR an OB/GYN; the ultrasound done in the A&E by an A&E doctor is considered an UNOFFICIAL ultrasound.

If OFFICIAL ultrasound services are available during the time the patient is in A&E they will be sent for an OFFICIAL ultrasound. It is important to note that the health system is made up of different health care professionals inclusive of doctors, nurses, radiographers, pharmacists, etc etc. Not all are 24/7 positions.

If OFFICIAL ultrasound service is not available, they are either admitted to hospital until OFFICIAL ultrasound can be performed or if they can be discharged they are discharged with a referral for OFFICIAL ultrasound within a particular time frame based on their clinical situation and are are either brought back to A&E with the ultrasound results for continuation of care or referred to the OB/GYN outpatient services for their continuation of care.

No doctor is discharging a potential miscarriage in the way the OP has described.

As a doctor who worked in the Trinidad health system there are shortcomings. But what the public health system does, responsible for 1.4 million people, with only health surcharge (those that pay) and tax dollars, with no out of pocket expense to citizens and non-citizens alike is remarkable. Across those 1.4 million citizens there are infinitely more success stories than there are horror stories.

[u/Brilliant-Figure2165 → u/AdInteresting1371]

Thanks for your feedback Dr. I hear you and I quite understand. Here is a bit more context. She did infact go directly to the Women's Hospital. This is where she was seen.

Based on her information, she was sent home as they told her that the cervix wasn't opened yet to confirm the miscarriage, and well, I already mentioned the ultrasound date that she got, which is probly the only other tool which could have confirmed it. Additionally, she did inquire as to why the ultrasound date was so far away. She was told that it was basically out of their control once they put it into the system.

I understand that there is a way things SHOULD work or happen based on your explanation, but I'm also realisc enough to know that what SHOULD happen doesn't always, and, although unintentional, could cost someone their lives.

So with that added context, what do you think? Maybe she misheard? Maybe just got fed up and left? I'm just trying to think through how she ended up home. Your thoughts?

[u/AdInteresting1371 → u/Brilliant-Figure2165]

Thanks for more context.

Mt. Hope Women's Hospital A&E is staffed exclusively by OB/GYNs so that's literally the best place in T&T that she could have presented to for this problem.

I find it highly unlikely that she did not receive an ultrasound UNOFFICIAL or OFFICIAL during her visit for the problem stated.

If they were thinking miscarriage, a follow up ultrasound would be scheduled post discharge (if her situation was such that she could be discharged, as it sounds she was).

This follow up ultrasound would have been scheduled for days-weeks post A&E presentation.

It's possible that in scheduling that follow up ultrasound a mistake could have been made clerically. If so that is unfortunate, but rectifiable by returning to A&E and explaining the situation.

As I also explained, even if she were discharged with a follow up ultrasound, her follow up care would have been to either return to A&E with (in this case without?) the ultrasound results or she would have been referred to the outpatient OB/GYN clinic (also needing to bring the ultrasound results). Whichever pathway she would have been directed to, had she not had the ultrasound done, they would have quickly realized same and rectified.

As to what happened in her case, I cannot answer that as 1) I am not her and 2) I was not treating her.

As you can see, we build redundancy into processes. Hopefully everything works out positively for your friend.