I have, through my wife’s employment, a PPO. Consequently, I haven’t bothered to get a primary care physician since with a PPO, I pick the provider and go right to the specialist I need. When I learned of a heriditary problem potentially in my heart, I went directly to a cardiologist. (I didn’t inherit the problem, as it turns out.) But when it comes to a series of more generalized sorts of symptoms, I’m not going to make an armchair diagnosis and go to the appropriate specialist, because of the hammer-nail phenomenon, which would tend to reinforce my untrained, unskilled, and more often than non erroneous self-diagnosis.
So after my run-in with the world of illness last week, today I undertook to secure a primary physician, a general medicine practicioner, or at least an internist. My insurance gave me an impressive-looking list of local physicians from whom I might select to be my medical gatekeeper.
The first five numbers I called were out of date, not doctors, disconnected, or simply didn’t answer. The sixth doctor’s number was the local Big Medical Group, at which I’d had bad experiences poor customer service earlier. So I didn’t want them. It took until twelve doctors down the list who were credited with “accepting new patients” before I got a name that matched with what the receptionist said, and then it was voice mail. I’m still waiting for a callback.
It it just my area, or do people in other parts of the country have similar difficulties? It’s not that there aren’t doctors servicing the area — although it may be that there aren’t enough, since the doctors’ time seems to be in uniformly high demand. It’s getting an appointment with one that’s the challenge. Is this a symptom of an underserved area, or do all these doctors have enough money, or have all their practices been shut down for one reason or another, or what?
This is an area where my wife’s job came in handy here. I got an appointment with a doctor that isn’t accepting new patients. This is the first time that’s been the case. In my last two places, I basically just had to start cold-calling. Back in “Cascadia”, the first place I called actually turned out to be an abortion clinic. After about three I just made an appointment at the nearby Community Clinic and saw an MLP with a nose ring with a creative spelling and a need to explain it like “Lyndah-with-an-H”. My wife and I were not impressed with the care that I received, though somebody has to serve those who can’t pay, so good on her for that.
Before that, in “Estacado”, it took about three or four calls before I found a provider who would see me.
It’s mostly a matter of not having enough hours in the day to see the patients that they already have. There has been some movement towards leaving some “accute care” time open, so you can see people when time is of the essence (and so they don’t clog up the emergency room). Maybe that hasn’t hit your neck of the woods yet?
In January, I got hit with The Crud That Was Going Around. It was awful. More to the point, it was PERSISTENT. Halfway through January, we called to get an appointment with my doc. The earliest appointment available was Leap Day.
Full disclosure I am an internist but a hospitalist not a primary care provider. I belong to a division of general medicine within a larger department of internal medicine. One phrase I read that is like a splinter for my psyche, is general practitioner. That category essentially no longer exists. Primary care is provided, for adults, by internists and family practitioners (sometimes Ob-gyn too). Both groups have completed residency (specialty training) in their areas. The old GP completed a year of internship and then went out a started or joined a practice. This is a vanishing breed that is all but extinct.
Part of the PCP’s job is to coordinate specialist care and to make sure recommendations and results are followed up on. Some of the worst care I have seen is care provided only by sub-specialists. Elderly man of means sees his cardiologist and his gastroenterologist, but there is no one coordinating the care, making sure he gets his flu shot or screening for diabetes.
If it’s any consolation, I can’t get into see my PCP either.
Well, I work for the Local Hospital. Which is also the Local Insurance Company. Which is also the Local Doctors (or at least pays ’em), and is affiliated with the Local Uni. So no, I don’t have much problem getting a good doctor — I find someone who teaches, and I go to them.
I wrote an essay a million years ago (2009!!!) about Health Care Reform. (If you care to read it, you can read it here: https://ordinary-times.com/blog/2009/12/18/the-state-of-reform/ but it’s chock full of stuff that I say all the time, being one of those people who repeats him or herself.)
I was wrong about one part in my essay. I had assumed that queue would be determined by bidding. I had failed to note the other way that your place in the queue is determined is, of course, by when you got in the queue.