Why is there such a long wait to see Dr's and Specialists? vent

[dancer67]

Is there a shortage of them or something?

 

Generally, I do not have to wait to long to see my regular Dr for something. Sometimes, same day. At most 2 days.

 

But what is the deal with specialists?

 

I have had this cyst on my upper eyelid margin for about a month now. Although it has gotten better. It has not completely healed. My optometrist isn't to concerened about it, but feels I should see a specialist about it. The first appt?? January 7th!!!! HUH????

 

So I call my dermatologist last week. The first appt I could get was for this Friday, the 19th. Okay. Not TO bad.

 

So, let us take this scenario. What if this thing turned out to be a cancerous lesion, and they waited this long to get me in to see someone????

 

What is going on with our healthcare system?

 

I also want to know this.

 

In my state, we have to have mandatory health insurance. Or you are penalized on your tax return.

 

My health insurance lapsed this month(they claim they didn't get their premium on time, but that is a whole other story). So my health insurance does not pick back up until December 1st.

 

In the meantime, they have community health care centers you can go to, if you have no insurance.

 

Okaaayyyy. So I call to see if there is an opthamologist I can see. Ummmm, yea right. They have, get this....a SIX month wait to get an appt to JUST see a regular Dr.!!! And this is a waiting LIST!!

 

So what are you supposed to do? Go to the ER. And what the heck is the ER going to tell you about an eye cyst? Can they tell you if it is a cancerous lesion? NO. Can they remove it?? NO. Would they biopsy it? NO. You know what they would say?? See a specialist!!!!

 

And how are you supposed to do that if you haev no insurance? Or you cannot even get into a free health care clinic? Or, you have insurance and you have to wait for 2 months??????

 

I remember a few years back I had rectal bleeding. I had to see a GI. My stomach also hurt really, really bad. They said they had no appts for 3 months!!! This is even my own Dr calling to get the appt. It wasn't until my MIL called, who is a nurse, and yelled at them to get me in. And then, I still had to wait a month.

 

I feel like this is all lawsuits waiting to happen.

 

Am I missing something here?

Edited November 13, 2010 by dancer67

[LittleIzumi]

Well, there usually IS a shortage of specialists. I mean, we had to wait 4 months to see the pediatric gastroenterologist, and then we also had to drive about an hour to see her & be treated because she is the only pedi gastro practice within that whole hour's drive (and probably within an hour in the other direction), while there are whole practices jam packed with regular doctors all over. So yes, the wait for someone who is the only one of a handful, or the only one period, in a very large area will be a lot longer than for a family doc. Although it is maddening, yes.

[dancer67]

I remember back in the "old" days where your own Dr. did everything. Nowadays, it seems that you see your GP, and they all say "You have to see a specialist". Uggghhhhh............It is maddening.

 

To wait 6 months for something is inexcusable. We live in America. How can we tote the best Dr's and healthcare system, if we cannot even get IN to see them? I mean, you could be dead by then. :smash:

[kalanamak]

20 lbs. of potatoes in a 10 lb. bag.

 

You could argue lowering doc's fees (via insurance groups and medicare) would make them see more patients a day, but then they would be moving faster, and relying more on "physician extenders". And the more clever of the generation that follows would be busily going into a different field.

 

 

(I sympathize. I had to wait two weeks in a lot of pain to have a non-urgent surgery, and when I had a gall stone, I had to wait 30 hours, getting sicker and more febrile, for OR space.)

[G5052]

I live near a major metropolitan area where there are multiple medical schools and multiple world-class hospitals. We've waited 2-3 months to see certain specialists, and some of the specialists have a review process where you send a packet of records meeting certain requirements before you can even make an appointment. I've heard that this is because fewer doctors are going into the specialities because of the expense and time involved.

 

This last summer DH had three surgeries with a doctor that requires a phone interview with his surgical coordinator, then submission of a packet of information meetings certain criteria, and then the doctor reviews everything and they call you back to make an initial appointment if he agrees to take your case (which is only 10% of the time from what his surgical coordinator told me). He has a 2-3 month wait for the consultation, which is two hours, and then if you want surgery, the wait is usually 4-6 weeks before they can do it. This surgery is done in three phases, and if there is any hitch along the way, you lose your three slots and have to wait for a cancellation or be rescheduled.

 

Way different than going to see a primary, indeed!

[Crimson Wife]

I don't think it's so much that there's a shortage of specialists, but that many doctors are splitting their time between their regular practice and a more lucrative cosmetic procedures one. This is especially true with dermatologists and ophthalmologists. I would be willing to bet if you called them up wanting LASIK you could get that procedure scheduled sooner than January. :cursing:

 

We have friends who are physicians and they all claim it's "necessary" to do this because insurance payments are so low (especially if they see Medicare and/or Medicaid patients) and their student loan payments so high.

[amey311]

Sometimes it's a timing thing. Lots of GP can see many patients in the course of a day because those appointments are short (a swab for strep, a general pediatric physical when the parents think everything is going fine, etc), while specialist appointments are often longer AND involve more of the doctor's time OUTSIDE of the exam room.

 

For example: the specialist needs to read your current chart, review any tests you've had done already to see if your GP may have misinterpreted the results, determine if any test should be redone or if any new ones should be run, research a little if there's something in your chart that triggers a memory of "oh! I've seen this before in that article by Jones and Smith on XYZ." And then he needs to meet with you and review with YOU everything that's happened so far and ask questions that your doctor may have already asked, but this time you might remember something extra related to your condition (like talking to the police detective for a second time), what he thinks should happen next, etc.

 

I know for minor (but outside the GP's expertise) this seems like a huge wait, but there may be other people ahead of you with really HUGE problems and the specialist does need to take time and be careful.

 

I couldn't understand any of this until I knew with a problem that was eventually linked to genetics. Her medical file was physically HUGE with contradictory lab results, differing opinions, repeated in patient visits - and so on. The geneticist appointments were scheduled for an hour. The amount of time he'd also have to spend comparing any new results to old stuff, plus research and research to find that tiny paper that someone wrote 3 years ago that sort of touched on the same things... The things to rule OUT, the list of things to rule IN as possible, etc. It was a huge deal.

 

That doesn't necessarily help, and I've heard it really helps to be friendly with the front office staff (both of your own GP and the specialist) and to be open to the idea of a last minute cancellation appointment ("Can you be here in 30 minutes? We've just had a cancellation.") and to let the staff know that.

[DianeW88]

Wow, where do you live? I'm in Utah, and last week when my ballet dancer was having knee problems, I called our orthopedic surgeon at 7:30 AM and got an appointment at 10:30 AM that same day. Our pediatric practice is open 24 hours a day, 7 days a week, holidays included. My personal ped works M-Th, 9-5, but if we have an emergency, we can see a board certified pediatrician at 3 AM if we needed to. One who has all our records and medical history at his fingertips. I have never waited more than 24 hours for an appointment with any specialist here in 12 years.

 

So, I think it must depend on where you live, how high the malpractice premiums are for docs in your state.....high premiums lead to a shortage of medical providers. How well docs are treated by hospitals and insurance providers, and salaries for medical professionals all figure into the equation as well.

 

Sorry you can't get in sooner.

[dancer67]

It still takes me back to the question of lawsuits? What if you really have a problem, and it gets worse because you have to wait so long for an appt?

 

I see the ER waiting rooms PACKED. I wonder why? Probably because nobody can see a Dr or they have no insurance.

 

Oh, and about the LASIK surgery? Oh yes. I can bet if I wanted to schedule a consult they could have me in the very next day. Sad but true.

[regentrude]

There is a shortage of specialists. In some disciplines is it almost impossible to find somebody (for instance pediatric neurosurgery), because the cases are high risk, and thus the risk of being sued is high - so the insurance premium for liability is so high that it is not worth it to anybody to become such a specialist.

 

15 years ago, a friend of ours who is a normal OB/GYN had a $100,000 insurance payment yearly. That can only have gone up in this litigious society.

[joannqn]

Between increasing malpractice insurance costs and reduced payments, I think many doctors are leaving. I know my husband's doctor left private practice because of reduced payments.

[LittleIzumi]

Wow, where do you live? I'm in Utah, and last week when my ballet dancer was having knee problems, I called our orthopedic surgeon at 7:30 AM and got an appointment at 10:30 AM that same day. Our pediatric practice is open 24 hours a day, 7 days a week, holidays included. My personal ped works M-Th, 9-5, but if we have an emergency, we can see a board certified pediatrician at 3 AM if we needed to. One who has all our records and medical history at his fingertips. I have never waited more than 24 hours for an appointment with any specialist here in 12 years.

 

So, I think it must depend on where you live, how high the malpractice premiums are for docs in your state.....high premiums lead to a shortage of medical providers. How well docs are treated by hospitals and insurance providers, and salaries for medical professionals all figure into the equation as well.

 

Sorry you can't get in sooner.

 

My 4-mo wait for a pedi GI was in Utah last year :).

[Carrie12345]

In my experience, it's often a lack of specialists.

 

Yes, I can get in with my GP (and pediatric) practice same day for an illness, and usually within 24 hours if I decide to schedule a routine visit at the last minute. But there are 3 GPs (and 4 pediatricians) in that practice, and I have a choice of dozens of GP practices within a reasonable distance.

My choices for endocrinologists is much more limited.

 

There's also prioritizing. When I broke my foot, I got in with an ortho in less than 48 hours (after ER visit and temp. cast). To make an appt. with them to evaluate my arthritis was a 2.5 month wait.

 

And then there's time allotment. It's pretty easy to become a new patient with my midwives if you're looking for basic annual care. If you're pregnant, good luck! I've been with them for 8 years, and several of my early pregnancy appointments this time were made after being put on the waiting list. They can't commit to as many pregnancies as they can paps!

[TravelingChris]

Well as the OP said, she lives in a state with mandatory insurance. That means the same number of doctors to look after a lot more people.

 

In other areas, the problem is not enough specialists. In Florida, there were shortages of pediatric specialists. No shortage of doctors for my problems which often hit elderly people (but I just happen to be young with them). Some of the less populated states are medically underserved communities. That includes New Mexico and maybe Utah too???

 

Here in the DC area, we haven't had to wait very long for any specialist except a neuropsych evaluation.

[daughterofsarah77]

It is probably varies from region to region, but in the healthcare system I work for, your primary physician can enter a referral for you. Part of the referral is a statement of what timeframe you need to be seen in. So if your primary physician determines that this is serious and you need to be seen in 1-2 days, then that is what happens. Specialists typically hold spots in their schedules for these scenarios.

So, it would be good to ask your physican to enter a referral. Also, sometimes if someone from the clinic calls to schedule your appointment for you, it helps.

[DianeW88]

My 4-mo wait for a pedi GI was in Utah last year :).

 

Really? Did you go to Primary Children's?

[Murmer]

It still takes me back to the question of lawsuits? What if you really have a problem, and it gets worse because you have to wait so long for an appt?

 

I see the ER waiting rooms PACKED. I wonder why? Probably because nobody can see a Dr or they have no insurance.

 

Oh, and about the LASIK surgery? Oh yes. I can bet if I wanted to schedule a consult they could have me in the very next day. Sad but true.

 

My daughter was having allergic reactions to milk...the earliest we could get in to verify she was allergic to milk was 6 months later...I do wonder what would have happened if we hadn't had a friend tell us to take her off milk would we have figured it out before she had a deadly reaction in the 6 month interim? Interesting when the blood test came back we were in the office that afternoon to learn how to use an epi-pen. Seemed they had time then.

[Starr]

We do not even have enough doctors to go around in our area of any kind. Plenty of people are not getting the treatment they would if they lived somewhere else. It amazed me that people don't think something needs to be done about our health system.

[Melissa in Australia]

Here in Australia specialists prioritise. You cannot see a specialist without a referral from a GP If it is something urgent, like cancer, you will be put at the top of the list and seen within a few days.

 

An example of prioritising is my Husband had a burst blood vessel in his eye. he got to see the specialist the next day, which was great as it took us 7 hours to drive to Melbourne to see him. My DH also has glaucoma, and there is a 6 month waiting time to see the same specialist for follow up treatment. the specialist only visits the nearest big hospital ( 100 km away) 2 days per fortnight.

[Mergath]

My dd has a genetic disorder, and back when we were trying to figure out what was going on, it took us around four months to get in to see a developmental pediatrician two and a half hours away. With so many kids now having everything from autism to ADHD, the wait to get in for one of those around here is REALLY long. Our dd's wait was actually shorter than some, I was told, because she had a lot of issues at the time and they had no idea what was causing them. Luckily, we were able to schedule our appointment before we had to fill out the massive packet of paperwork. Then it took a few more months to see the geneticist.

 

Even our family doctor is usually around a two week wait, though there are other doctors at our clinic we can see sooner.

 

There are just too many people now getting sick, and not enough specialists to treat them in a timely manner.

[Melissa in Australia]

It really doesn't sound like you need to see the specialist urgently. Jan isn't that far away. wouldn't you prefer that people with a urgent need to see the specialist, like something that was going to cause them to loose their vision, got priority over something that was not urgent?

[dancer67]

In my situation now, it is not urgent. But here, we do not need a referral to see specialists. I think that is why so many Dr's have long waits. Unless, your primary Dr calls and demands an appt right away. But even with that, good luck.

 

A friend of mine needed to see a cardiologist. The primary called all the cardio Dr's on her insurance and the soonest they could get her in was a month.

 

She had a heart attack before that appt and nearly died. Some Dr's, because they are not trained any longer in specialties, sometimes don't know if things are urgent or not. And the specialists secretary's who make the appt's only go on what the primary Dr is saying. And even then, they tap their little computer and non-chalantly throw out whatever appt is there.

 

I was dx with anemia. My primary referred me to a hematologist. The soonest I got in was a month and a half. In the meantime, my ferritin levels were so low, that the Dr. said if I had waited any longer, I may have needed a blood transfusion. And whose fault is that? My primary just thought I needed an iron pill. Not the case at all.

 

The problem as I see it, there are WAY to many hands in the pot. To many specialists, and not enough primary care Dr's trained in specialized fields. And, if you have 3-4 specialty Dr's, one does not communicate with the other. I found this out a few years ago the hard way.

 

Who ever heard of an eyelid specialist???? I mean really!! Come on already. I think an opthamologist is as far as you should go, specialty wise. What are they going to have next? Eyebrow specialists? Nosehair specialists? Unreal.

 

Sorry, I just get so darn frustrated with the medical system.

[LittleIzumi]

Really? Did you go to Primary Children's?

 

Her scope was done there. Her consult was at Cottonwood Pediatric Gastroenterology, which both her pedi and her allergist recommended/referred us to.

 

In my situation now, it is not urgent. But here, we do not need a referral to see specialists. I think that is why so many Dr's have long waits. Unless, your primary Dr calls and demands an appt right away. But even with that, good luck.

 

A friend of mine needed to see a cardiologist. The primary called all the cardio Dr's on her insurance and the soonest they could get her in was a month.

 

She had a heart attack before that appt and nearly died. Some Dr's, because they are not trained any longer in specialties, sometimes don't know if things are urgent or not. And the specialists secretary's who make the appt's only go on what the primary Dr is saying. And even then, they tap their little computer and non-chalantly throw out whatever appt is there.

 

I was dx with anemia. My primary referred me to a hematologist. The soonest I got in was a month and a half. In the meantime, my ferritin levels were so low, that the Dr. said if I had waited any longer, I may have needed a blood transfusion. And whose fault is that? My primary just thought I needed an iron pill. Not the case at all.

 

The problem as I see it, there are WAY to many hands in the pot. To many specialists, and not enough primary care Dr's trained in specialized fields. And, if you have 3-4 specialty Dr's, one does not communicate with the other. I found this out a few years ago the hard way.

 

Who ever heard of an eyelid specialist???? I mean really!! Come on already. I think an opthamologist is as far as you should go, specialty wise. What are they going to have next? Eyebrow specialists? Nosehair specialists? Unreal.

 

Sorry, I just get so darn frustrated with the medical system.

 

:grouphug::grouphug:

[Trish]

The "lawsuit waiting to happen" actually IS one of the reasons for a shortage of doctors. Malpractice goes up and up.

 

Secondarily, more than half of med school students are women, and women tend to work for a while and then go part-time. So even though the number of medical school slots tends to be fixed, by virtue of having more women doctors you're not getting a full-time doctor for a full career out of a lot of them. Hence, fewer doctors.

[kalanamak]

I

 

Who ever heard of an eyelid specialist???? I mean really!! Come on already. I think an opthamologist is as far as you should go, specialty wise. What are they going to have next? Eyebrow specialists? Nosehair specialists? Unreal.

 

 

 

Scar an eyelid, and you lose a lawsuit. Scarred eyelids are a problem, with constant overflowing of tears, constant foreign body sensation, etc.

 

A few people want all but the worst problems reasonably managed by a PMD. Most want to see the specialist. Post a concern on this board, and you will be exhorted to see the allergist, the pulmonologist, the GI doc, to go to such and such a national center in your disease. Everyone else is hearing this from their friends and loved ones, too. Medicine is so complex, it is approaching the balance point of how much we CAN do vs. how much we SHOULD do vs. how much can we AFFORD to do vs, inevitably, how much we WILL do. Verily it is a Dickens said "it was the best of times, it was the worst of times".

 

One of the things I love about my job is that it is hard to get many of patients to a specialist, and many are exceedingly unwilling. Not only to I get to look things up, I get to call the specialists via a Med-Con service and move ahead with what we can do, given the situation. Makes for a much more interesting practice.

[DianeW88]

Her scope was done there. Her consult was at Cottonwood Pediatric Gastroenterology, which both her pedi and her allergist recommended/referred us to.

 

Oh, wow, that's a long time. I'm in Davis county. Maybe that makes a difference. Of course, if your specialist is good....they're worth the wait.