I dont understand why it takes so long to see one’s doctor!

[Ginevra]

What is the *point* of having a primary care physician if it is impossible to see that physician for any reason except a well-care appointment secured months and months in advance? I haven’t laid eyes on my actual, literal physician in several years; he’s like The Great and Powerful Oz. Now dh is trying to make an appointment because he has a very concerning lump on his neck. If he wants to see our actual, literal physician, guess when that could happen? December. What in the actual heck? By saying, “ok, I’ll take any medically certified, breathing person affiliated with this group in this location,” his soonest appointment is end of August. So now he’s trying to see if any of their other locations has any medically certified, breathing people who could possibly see him before, I don’t know, he dies of thyroid cancer or something. 

I’m very unhappy about this right now, as well as, obviously, concerned about dh. Why is this the reality? Is it a shortage of doctors? Is it just that there’s so many people with health problems? Should we all just make appointments every half-year for a well visit on the off chance there will be some concern that’s cropped up by then? 

(I have also been ignoring the fact that I need a primary care physician for ds19 because he can’t see his pediatrician anymore, but I hit a dead end when all four people I called were not accepting new patients. So I just kind of back-burnered it, though it still needs to be done.) 

Also, P.S., if it is this difficult in the DC Metropolitan region, which has outstanding health care, how hard is it in, I don’t know, Iowa? 

[EmilyGF]

You need to call in for a sick appointment. And you need to call in every day at 7 am. My PCP then funnels me into the urgent care part of the clinic and I either get a same day or next day appointment, a scolding for not seeing the PCP for so long, and then a scheduled follow up appointment. Last time I complained about the long waits and they "found" an appointment much earlier.

Yeah, it is lousy. The same thing with the pediatrician.

[SKL]

Under any plan I've had for at least the past 15 years, I would call a certain number and tell them what the issue is, and they do a sort of triage and get me or my kid in fast if it sounds concerning.

In your case, find that number (either with your insurance / HMO or your practice), tell them your dh has a growing lump and cancer runs in his family (if anyone related to him ever had cancer), and most likely they will see him pretty quickly.

You could also go to urgent care if your co-pay / deductible isn't horrible.  (Or even if it is, depending on the circumstances.)

[Guest]

16 minutes ago, happysmileylady said:

Generally here (in Ohio) we don't have much problem getting in to see the regular doc when there's a problem.  

Could it be an issue with your particular insurance an a lack of places that take it?

I doubt it, since it is CareFirst, which is huge. 

[Guest]

8 minutes ago, SKL said:

Under any plan I've had for at least the past 15 years, I would call a certain number and tell them what the issue is, and they do a sort of triage and get me or my kid in fast if it sounds concerning.

In your case, find that number (either with your insurance / HMO or your practice), tell them your dh has a growing lump and cancer runs in his family (if anyone related to him ever had cancer), and most likely they will see him pretty quickly.

You could also go to urgent care if your co-pay / deductible isn't horrible.  (Or even if it is, depending on the circumstances.)

I did actually suggest he could go to urgent care, even though this doesn’t really fit the definition. At least it would get the ball rolling with MRIs or whatever needs to happen. 

[Pawz4me]

Our primary care practice has "after hours walk in" from 4:00 to 8:15 in the evenings and on Saturdays from 8:00 until 12:30. You don't need an appointment, as far as I can tell the office visit charge is the same as during normal business hours (our co-pay is the same), and it's the same providers (the PAs and NPs rotate schedules). So that's what we'd do in your DH's shoes. Their staff is composed of several PAs, NPs and one doctor. We see a PA for routine care. From what I've heard it can take months to get an appointment with the doc. But due to the walk in hours it's really easy to see a PA or NP. 

Edited July 17, 2019 by Pawz4me

[HS Mom in NC]

Yes, there are shortages.  Here's an example posted today at Drudge Report: https://napavalleyregister.com/news/local/california-doesn-t-have-enough-doctors-to-recruit-them-the/article_de24ccce-16b2-50e9-a1f0-44f1263c029b.html

[Carol in Cal.]

It’s awful everywhere I know of except a little pocket in eastern Washington state.  I know an elderly couple whose PCP went boutique and decided to find someone else.  It took them three years to get someone else to take them.  And this is in the supposedly overserved SF Bay Area.  So many doctors are flooding out of the market right now.  Pharmacists, too.

[Jean in Newcastle]

I haven't found this to be a problem but I am in a major metropolitan area.  I really do think that it depends on the place. 

[Arcadia]

18 minutes ago, Quill said:

I did actually suggest he could go to urgent care, even though this doesn’t really fit the definition. At least it would get the ball rolling with MRIs or whatever needs to happen. 

 

We go to urgent care and pay the same amount as we would if we see a PCP (or my obgyn). My husband and I don’t have a PCP anyway while our kids have a pediatrician but that was what we were told to do for anything other than scheduled appointments. So we have been seen in urgent care for strep, HFMD, etc and have not bothered choosing a PCP. 

I am going to look for an allergist and pulmonologist before bothering with choosing a PCP since I would be going urgent care anyway for anything other than scheduled annual checkups.

[scholastica]

We’ve been lucky to get into a practice with a walk-in option. They have two nurse practitioners who see patients there all day long. Sometimes there’s a wait, though. If I need to see my actual doc, it can be 2-4 weeks. I can, however, send a message through the patient portal if I know for sure what’s going on. I do make a point to do an annual visit so she knows who I am and that I’m intelligent enough to know my own body.

Yes, there is a shortage of docs, especially primary care. This is mainly because it no longer pays as well, and there are a lot more people with insurance coverage now. It’s an unintended side effect of Obamacare. I’m glad more people have access, but we need more physicians to handle the load.

[Jaybee]

I am so with you.  Where we lived before, I was always able to get in to see our PCP in a reasonable amount of time. Where we live now, any medical care takes forever to get in, especially if you need a new patient appointment. I don't care a lot for our PCP here, but I'm hesitant to try to get set up with someone new.

ETA: Last time I was sick, miserable with some kind of respiratory thing, I decided just to show up at the office and see if they could work me in. It worked, and I was in within about 15 minutes--less than if I had actually had an appointment. I'm sure that wouldn't always be effective, but I decided to risk it.

Edited July 17, 2019 by Jaybee

[J-rap]

That's frustrating.  At our local clinic, we've almost always been able to see our doctor for something important within a few days.  Generally I think doctors here leave some open times for that.  If that's not possible, the primary doctor is still notified about the situation so they're aware of what's going on.  Maybe our clinic is unusual, or maybe it has to do with it being a small town.

In any event, we're moving to a large metro area next week so we'll see if that changes! 

[catz]

I just today made an appointment for well visit and vax for my son (so not a sick visit) and had no problem getting in the week of Aug 5.  We can see doctor same day for sick visit and our clinic has evening and weekend urgent care.  We have not had this problem at all. We live urban in a major metro.  

I know certain and further flung areas can be very short on doctor staffing and there are medical deserts out there.  It's a huge issue.  

That is ridiculous for a clear problem that should be seen immediately.  I'm sorry.  I would consider ER or urgent care if you had to wait over a month.  

Edited July 17, 2019 by FuzzyCatz

[Selkie]

1 hour ago, Quill said:

Also, P.S., if it is this difficult in the DC Metropolitan region, which has outstanding health care, how hard is it in, I don’t know, Iowa? 

I live near Iowa and some of our doctors are located there, and we never experience long waits. For a lump on the neck, we would probably be seen that same day or the next.

Re. a doctor shortage, I personally know of a few doctors who retired early or changed professions because they found Obamacare to be such a hassle. One of them was our much-loved family doctor - I'm still sad over that! And I have also heard several doctors say that they would not recommend it as a career at this point in time.

I hope your dh gets an appointment soon and that it turns out okay.

[itsheresomewhere]

Urgent Care here does physicals, work physicals daily along with sick/need care now.  So many regular doctors here have gone to that ridiculous VIP care crap ( 1500-2000 a year that gives you a one guaranteed appointment with the physician and up to 2-3 guaranteed sick appointments.  You still have to pay your co-pay on top of this.) that the urgent care saw a need. 

Edited July 17, 2019 by itsheresomewhere

[Jean in Newcastle]

I wonder if it makes a difference that my pcp is an internal med. doctor?  I don't see as many GPs around here. 

[stephanier.1765]

I'm right there with you. It is impossible to get an appointment with my doctor. They don't schedule ahead. It's simply one month at a time and those appointments open sometime in the last week of the previous month. But which day that might be isn't set in stone. It's whenever the staff in charge of that get around to it.

Just last week, I needed to see my doctor because I can't get my prescription renewed without him actually setting eyes on me. Of course there is nothing available but they did have a doctor who had come in to help relieve the backlog. Oh my word! He gave me the third degree about my medication. Said he would never prescribe it for me because fibromyalgia is in the mind and I needed to see a psychologist instead. Then he started throwing out the names of different medications I should try instead. Been there, done that. Does he think my doctor hasn't tried everything under the sun and that this medication isn't what keeps me functioning? I wanted to scream. He told me I was putting him in a rough spot. Because he doesn't want to say yes, but that he can't say no. He finally got the damn paperwork and I filled out my portion and then did a urine test. He better well of done his part or there will be hell to pay. I am not pleased that I was treated as a drug seeker when I have been on this medication for years and never, not once, abused it. He even asked me if I was getting from a pain management doctor as well. AAAARRRRRRGGGGGGGHHHHH!

[vonfirmath]

I have never had a problem getting in to my doctor within a couple of days with a specific problem request. (And same day when it is a true sick appointment). it generally takes a month to 6 weeks to get in for a well appointment.  (our insurance is United Healthcare)

 

Have you tried moving to a different office?

Edited July 17, 2019 by vonfirmath

[Arcadia]

1 hour ago, Carol in Cal. said:

  I know an elderly couple whose PCP went boutique and decided to find someone else.  It took them three years to get someone else to take them.  And this is in the supposedly overserved SF Bay Area.  

 

I was immediately assigned an obgyn by PAMF last year as they say I don’t need a PCP if I have an obgyn (previous obgyn is private practice and has since retired). I did have a two month wait for my well women appointment.

I was immediately assigned an oncologist surgeon and an oncologist when we switch to Stanford Healthcare. My appointments were within two hour of just walking in.

What we realized after having different employee health plans over the years is that our current employee health plan is considered one of the better ones by providers and my husband’s employer is well regarded by the healthcare providers. Basically the healthcare providers know they have a high chance of being paid on time and will have less issues with billing. They won’t as happy when my husband’s employee health plan was with Aetna or United Healthcare.

Edited July 17, 2019 by Arcadia
Funny autocorrect

[cintinative]

My husband's doctor is like this for well checks but not for issues of concern (sick visits).  Mine is usually pretty good about seeing me within a couple of days if I call. With my recent fall, I got in the same day but had to see a different provider.   Now, as far as specialists go, yes, the wait can be months unless our GPs intervene and request we are seen earlier. Recently this happened to my husband. He had a CT report saying potential metastatic disease and the liver doctor couldn't get him in sooner than two months. Um, no. The GP was able to recommend someone else who could see him in a month. Even that seemed like forever. (It ended up not being cancer when all was done). 

I think you have been given some good advice up thread regarding calling every day, expressing your concern, etc.  Sometimes there are cancellations and they can fit you in. I hope it works out for you.

 

 

[cintinative]

5 minutes ago, Arcadia said:

They won’t as happy when my husband’s employee health plan was with Aetna or United Healthcare.

 

This is interesting to me because that is our current and past provider, and we have had issues getting specialist appointments. 

[Guest]

20 minutes ago, itsheresomewhere said:

Urgent Care here does physicals, work physicals daily along with sick/need care now.  So many regular doctors here have gone to that ridiculous VIP care crap ( 1500-2000 a year that gives you a one guaranteed appointment with the physician and up to 2-3 guaranteed sick appointments.  You still have to pay your co-pay on top of this.) that the urgent care saw a need. 

That is awful! Elitist medical care. Blah! 

[Guest]

17 minutes ago, vonfirmath said:

I have never had a problem getting in to my doctor within a couple of days with a specific problem request. (And same day when it is a true sick appointment). it generally takes a month to 6 weeks to get in for a well appointment.

 

Have you tried moving to a different office?

No way...based on how difficult it was trying (and failing) to find a doctor for my son, I would not want to be medically “homeless” now, too. 

[vonfirmath]

Just now, Quill said:

No way...based on how difficult it was trying (and failing) to find a doctor for my son, I would not want to be medically “homeless” now, too. 

 

I wonder if the problem then is insufficient doctors for the population there.

 

[Guest]

Update: he managed to get an appointment for August 1st. 

I think part of the problem may have been in the information he conveyed and the way he said it. He just said he needs a physical, hasn’t been to the dr. in years, and has “some concerns”. He’s an under-reactor when it comes to medical things. I told him he should say something like @SKL said above. He’s the opposite of a hypochondriac. 

[purpleowl]

Just now, Quill said:

Update: he managed to get an appointment for August 1st. 

I think part of the problem may have been in the information he conveyed and the way he said it. He just said he needs a physical, hasn’t been to the dr. in years, and has “some concerns”. He’s an under-reactor when it comes to medical things. I told him he should say something like @SKL said above. He’s the opposite of a hypochondriac. 

With the "hasn't been to the dr. in years" - some friends of mine were surprised to learn that they were no longer considered existing patients of their doctor because neither of them had been seen in some amount of time (I think 3 years). Their dr was family practice and so they'd been at the office plenty of times with their kids, but they themselves had fallen off the existing patients list. So they were told that they'd need new patient appointments before they could be seen for other issues. I wonder if there was a similar issue here?

Whatever the case, I'm glad he managed to get an earlier appointment!

[Guest]

8 minutes ago, purpleowl said:

With the "hasn't been to the dr. in years" - some friends of mine were surprised to learn that they were no longer considered existing patients of their doctor because neither of them had been seen in some amount of time (I think 3 years). Their dr was family practice and so they'd been at the office plenty of times with their kids, but they themselves had fallen off the existing patients list. So they were told that they'd need new patient appointments before they could be seen for other issues. I wonder if there was a similar issue here?

Whatever the case, I'm glad he managed to get an earlier appointment!

Yes, that happened two days ago when he first called. They said he would have to re-apply as a new patient. 

[Laura Corin]

I can normally get an appointment with a named doctor within a week, any available doctor normally within a few days, and any doctor for something urgent on the same day if I call early (Scotland). I'm glad he got an appointment. I don't think we get offloaded for being too well here - you only get delisted for antisocial behaviour.

Edited July 17, 2019 by Laura Corin

[Miss Tick]

If it's been a while since his last period he could mention that signs indicate he might be pregnant? That usually gets you in pretty quickly...

In college I had a weird lump and the phone person was completely uninterested in getting me an appointment less that 8 weeks out. So I took it and started asking about cancer and how that works and if 8 weeks would make a difference in something that had shown up in less than 2 weeks, and then she found an appointment for the next week and we parted amicably. Super eye-roll. 

Glad your dh got something sooner. Funny that he is an "under reacter". Is there an official term for anti-hypochondriac?

[Carrie12345]

I sometimes have trouble getting well-care appointments that aren’t WAY out, but sick appointments are pretty quick here. We’ve had a huge increase in medical buildings over the past few years.  We’re about 2 hours outside of major cities and drive 30-45 minutes for regular doctors (which is considered local by our standards.)

[Pawz4me]

I suspect some, if not most, of the difficulty with getting in to see a specific primary care doctor/PA/NP quickly is due to profit. From a profit standpoint it probably doesn't make sense to reserve a block of time every single day for Provider A to see his or her sick/urgent need patients. If that block of time doesn't get filled it represents a lot of lost earnings. Better to fill all the slots ahead of time with well visit appointments and shuffle sick/urgent need patients into walk in after hours or urgent care settings, where those providers are likely to stay consistently busy, too. But that's just a guess.

[Guest]

33 minutes ago, SusanC said:

If it's been a while since his last period he could mention that signs indicate he might be pregnant? That usually gets you in pretty quickly...

In college I had a weird lump and the phone person was completely uninterested in getting me an appointment less that 8 weeks out. So I took it and started asking about cancer and how that works and if 8 weeks would make a difference in something that had shown up in less than 2 weeks, and then she found an appointment for the next week and we parted amicably. Super eye-roll. 

Glad your dh got something sooner. Funny that he is an "under reacter". Is there an official term for anti-hypochondriac?

I was wondering that, too. First, I was thinking about how “hypo-“ and “hyper-“ are opposites, so maybe it would be, like, “hyperchondria.” But it’s hypo that means “under,” so, no, that wouldn’t work. But, apparently, Google tells me, the word hypochondria has to do with “under the abdomen” and is based on the old alchemy-style medical beliefs. So - no; I guess there isn’t really a word for being a non-hypochondriac in the extreme other direction. But there should be! 

[Sherry in OH]

Our primary care physician is part of a network of physicians with multiple offices.  The physicians rotate through the various clinic sites.   We haven't had any difficultly getting in to see a physician but except for annual physicals, have always accepted appointments with the first available physician.  If we only wanted to be seen by our primary care doctor, we would have to wait for him to be at our local clinic and have open slots in the schedule.  That might mean a wait of two to three weeks, not months.  The office staff won't even schedule appointments more than two months out.    For sick care, the triage nurse has sometimes told us to go to urgent care imediately rather than wait for an appointment.   

[mathnerd]

Call and ask them if they have an afterhours-walk-in location near you. You can find that info on their website as well. Another thing that I do to get immediate attention is to call the doctor's office (PCP, not the front desk of the health group) and leave a message for the care team about your issues. Either the nurse or the assistant calls me back in an hour and asks me what the details of my issue are and then they schedule an appointment which is actually a blocked out time slot that the doctor has reserved for such cases. So, if your husband called his PCP's office and told them that he has a lump that needs to be evaluated immediately, they would respond better. Also, my medical health group now offers direct messaging with the doctor's office staff as well as emailing the doctor directly. I have found that very effective as well. Most big health groups offer that feature now. 

[GoodGrief]

Military healthcare here, and it's a few weeks to see my primary for a non-urgent problem in our location. Even urgent can be a couple days, which leads people to go to ER for things that aren't truly emergencies. Then if you need referral to a specialist, it's several more weeks.

My daughter has private insurance as well through her college and was able to get an appointment within a day when some urgent symptoms developed (involuntary movement in three limbs. However, they really had nothing to offer for the problem, which obviously required a neurologist. Calling directly to the neurologist resulted in being offered an appointment two months out.The clinic pulled some strings and got her in within days. Now she needs a movement disorder specialist. Again calling directly got us offers of appointments in November at the earliest. Even with the neurologist intervening, we are still waiting until September (This was from back in early June. I called several specialists, and wait times were similar for all of them. High population, urban area.)

I don't have a solution, but there does appear to be a shortage. And when your insurance limits who you can see, it's worse.

 

[Frances]

9 hours ago, Homeschool Mom in AZ said:

Yes, there are shortages.  Here's an example posted today at Drudge Report: https://napavalleyregister.com/news/local/california-doesn-t-have-enough-doctors-to-recruit-them-the/article_de24ccce-16b2-50e9-a1f0-44f1263c029b.html

It’s very sad that we don’t do a better job of investing in our young people in this country. We have an abundance of qualified people who want to pursue medical careers, but many (and in the case of medical school, the majority) are turned away due to a lack of training spots. Instead, we rely on people trained in other countries to make up the difference and still have shortages due to insufficient residency slots and burnout.

We rank close to last among developed countries for the number of physicians we train here relative to population.

https://data.oecd.org/chart/4JWk

[Joker]

I always hear of these stories but I've never experienced them. Not in FL, CA, TX, IA, or IN. I can get a sick appointment same day most of the time but sometimes it happens within 48 hours instead. A new patient appointment is different and usually takes several months unless I find a doctor new to the practice. Specialist appointments often take longer for a check in/up but I haven't waited more than 3 months for those either. Currently, we are actually surrounded by hospitals and doctor's offices. They are everywhere so it seems to be super easy to find one when needed. 

[TravelingChris]

Dh and I do have concierge care.  We get a physical each year as part of  the package but the real advantage is we get to see our doctor usually the same day or next day even if it is not an acute illness.  I have also called him several times on vacation and had him either advise me or do a prescription for me that I could pick up locally.  We do not have any limit to how many times we see him (like the 3 or 3 mentioned above).  For me as a super consumer of medical stuff (I have so many chronic illnesses) and for me to feel comfortable that my dh is at least being seen once a year, it is totally worth it.  We use our FSA to partially fund it (and it would totally fund it if we weren't also using the FSA for optical and dental expenses too).

[Wheres Toto]

I just made an appointment for a yearly physical and it's in November.   My gyn and pediatrician also make yearly physical appointments a few months out.  But I've never had trouble getting in the same day for sick visits with any of them.    I've been with the same pediatrician for 25 years and the same gyn office (with a slightly different shuffling of doctors coming and going) for 32 years.   

Around here we have urgent cares popping up on every corner.  It seems like a lot of people use the urgent cares for sick visits and physicals and only see a regular doctor practice when they need a specialist. 

[Just Kate]

What a cruddy situation! And I’m glad your dh is getting in to see his doctor a bit earlier. I experienced the exact same situation last spring. I noticed a lump on the side of my neck while driving home from a work appointment out of town. Next morning, I got up and called my primary doctor - he couldn’t see me but another doctor in the practice was available. This doctor took my concerns very seriously and I was scheduled for a CT scan within days. Unfortunately, the CT showed some additional swollen lymph nodes in my chest, which prompted a visit to an ENT for a biopsy, another CT, and a scheduled PET scan (which I ended up cancelling). This all happened very quickly (and I live in a rural state).

It ended up that there was nothing wrong with me and we don’t know for sure why I had all of those swollen lymph nodes (neck and chest). Looking back, we may have been a bit too aggressive with the way it was handled, but I had known other people who live around me with similar situations who weren’t diagnosed correctly and that made me nervous. I was scared to not take things seriously. 

I wish the best for your husband. Based on my extensive research at the time, chances are, it is nothing and he will be just fine. But I do think it is important to have a doctor look at it to just make sure. 

[vonfirmath]

16 hours ago, Sherry in OH said:

Our primary care physician is part of a network of physicians with multiple offices.  The physicians rotate through the various clinic sites.   We haven't had any difficultly getting in to see a physician but except for annual physicals, have always accepted appointments with the first available physician.  If we only wanted to be seen by our primary care doctor, we would have to wait for him to be at our local clinic and have open slots in the schedule.  That might mean a wait of two to three weeks, not months.  The office staff won't even schedule appointments more than two months out.    For sick care, the triage nurse has sometimes told us to go to urgent care imediately rather than wait for an appointment.   

 

This is my office. And yes when I go in with an emergent issue I don't always get "my doctor" -- I don't care. I take who is available.

[Farrar]

Several things... First, my understanding is that the shortage is not so much doctors overall, but primary care. And that part of the reason is that you can't make as much in primary care. My friend who is a primary care and palliative care doc says that in many countries with single payer healthcare they pay primary care docs the most on the scale. Specialists don't end up sinking money into becoming specialists like they can here, but they also don't profit from it - they have to want to be specialists. Because to keep your system running, you need more primary care docs than anything else.

Second, CareFirst sucks. I have a lot of words about CareFirst that I can't post on this board. They're evil. It's gotten better because they resolved a lot of their payment disputes, but for awhile they were holding practically every practice hostage around here. They're the biggest provider around us and they were engaged in such a shakedown that a ton of practices and hospital and urgent care chains had to ditch them for awhile.

Finally, how far are you willing to drive? Because One Medical is worth the $. And possibly the drive.

[Serenade]

18 hours ago, Arcadia said:

 

We go to urgent care and pay the same amount as we would if we see a PCP (or my obgyn). My husband and I don’t have a PCP anyway while our kids have a pediatrician but that was what we were told to do for anything other than scheduled appointments. So we have been seen in urgent care for strep, HFMD, etc and have not bothered choosing a PCP. 

 

 

I think this is the new model for primary care.  

[QueenCat]

That would drive me nuts. I can get in the same day if I'm sick. It might be a P.A. appt, but I'm seen. If P.A. sees that it's serious, the doctor comes in the room. 

[Guest]

4 hours ago, Farrar said:

Several things... First, my understanding is that the shortage is not so much doctors overall, but primary care. And that part of the reason is that you can't make as much in primary care. My friend who is a primary care and palliative care doc says that in many countries with single payer healthcare they pay primary care docs the most on the scale. Specialists don't end up sinking money into becoming specialists like they can here, but they also don't profit from it - they have to want to be specialists. Because to keep your system running, you need more primary care docs than anything else.

Second, CareFirst sucks. I have a lot of words about CareFirst that I can't post on this board. They're evil. It's gotten better because they resolved a lot of their payment disputes, but for awhile they were holding practically every practice hostage around here. They're the biggest provider around us and they were engaged in such a shakedown that a ton of practices and hospital and urgent care chains had to ditch them for awhile.

Finally, how far are you willing to drive? Because One Medical is worth the $. And possibly the drive.

When/if something serious developes, I’m willing to drive pretty far for great care. But I would be reluctant to head to the city for a regular visit. What is One Medical? 

[Jean in Newcastle]

6 hours ago, TravelingChris said:

Dh and I do have concierge care.  We get a physical each year as part of  the package but the real advantage is we get to see our doctor usually the same day or next day even if it is not an acute illness.  I have also called him several times on vacation and had him either advise me or do a prescription for me that I could pick up locally.  We do not have any limit to how many times we see him (like the 3 or 3 mentioned above).  For me as a super consumer of medical stuff (I have so many chronic illnesses) and for me to feel comfortable that my dh is at least being seen once a year, it is totally worth it.  We use our FSA to partially fund it (and it would totally fund it if we weren't also using the FSA for optical and dental expenses too).

Fortunately, this is exactly what I get from my non-concierge primary care doctor.  Specialists can be a bit harder to get into initially, but once I am established as a patient, I haven't had difficulties getting into seeing them quickly as well. 

[Farrar]

20 hours ago, Quill said:

When/if something serious developes, I’m willing to drive pretty far for great care. But I would be reluctant to head to the city for a regular visit. What is One Medical? 

One Medical is a concierge care chain. They have them in several cities, including DC. You pay a fee yearly on top of the regular visit fees, though those are in line with other places and covered by your insurance with your regular co-pay, etc. Though, it's also affordable and transparent enough to go out of pocket for just regular check up type visits. You can pretty much always get in to your specific primary care person in a week. You can always get someone at one of the locations within a day. They spend actual time with you. I've never felt taken so seriously by a doctor that wasn't my kids' pediatrician. Everyone I know who uses them feels the same.

I know of other concierge care places in northern Virginia, but there may be some in Maryland as well that I just am not aware of. In general, I used to be dismissive about concierge care, but now I think if you don't want to be told some of the idiotic things I've been told over the years by doctors, that it's the only way to get anyone to actually listen to you. 

[happypamama]

Our PCP is a family doc and sees all six kiddos plus myself. She only works three days a week, so for urgent visits (or for like the baby's three day checkup), we never see her, but we can generally get a followup or well visit with her in a reasonable time frame. She saw me a few months postpartum after N and wanted to see me again in a month and made sure the office made it happen for me. But we can see one of her partners or the NP/PA for urgent visits, or I usually just use urgent care because more convenient hours, and if I'm not going to see our regular doc anyway, I don't really care who it is that we see for an ear infection or the like. The UCs around here are all the same hospital system as our primary anyway, so the records are all there. 

 

Pediatric specialists, though. Oh boy. Talk about a wait!

[hepatica]

On 7/18/2019 at 9:36 AM, Serenade said:

 

I think this is the new model for primary care.  

I had an interesting conversation with an urgent care physician about this very thing. About a month ago I was having lyme symptoms. I have had lyme a couple times before (live in CT) and so I am acutely aware of the symptoms. I was headed out on a backpacking trip in a couple days so I decided to try just going to urgent care (I had a primary care physician for years but she left the practice to set up her own private concierge type practice so I don't currently have a designated PCP, although I guess I am still considered a patient of the practice). Anyway, the urgent care doctor kept insisting that I should really see my PCP for these types of things because he was just an emergency physician. I explained to him that the truth of the matter was that even when I did have a PCP, I only ever saw her for yearly physicals. All three times I had seen a doctor for lyme in the past it had been whomever in the practice was available that day (which of course was never my PCP), and that the care he gave me was indistinguishable from the care I received from doctors in the practice. I could get timely sick appointments, just never with my PCP. I eventually came to the conclusion that there is not much use for a PCP unless you have an ongoing health problem for which you are making regular follow-up appointments (ie, appointments that are scheduled weeks or months in advance). If you are like me and only see the doctor for a yearly physical and the very occasional thing like lyme, then you are going in blind anyway. 

IME, the only solution to this is to avoid doctors in big multi-physician practices. But of course doctors like these big shops because they don't have to worry about billing etc. My kids have seen a pediatrician in her own private practice, by herself, and they have had exactly the kind of care medical professionals seem to be alluding to when they tell you to get a PCP. We schedule routine physicals far in advance, but she does same day or next day sick/injury visits and of course they always see her, so we have a 15 year history with the same doctor. She knows me, she knows our family, she knows our lifestyle and just generally she treats us all with respect. She also knows how insurance and billing work, so she is able to warn us ahead of time about which things might not be covered, or how to get around various insurance requirements. She is generally more knowledgeable about insurance than doctors in large practices, which is also a huge benefit. Anyway, I fear this type of care is quickly disappearing....