How does your doctor "doctor"?

[SKL]

All this talk about labs ... I assume these are for known or suspected conditions?  I've never had blood work done unless it was to confirm / rule out a specific concern.

We've had some done at LabCorp, ordered by our chiropractor, and I started wondering, can we just order our own if we are curious?  Would that save time and money?  It's something I might look into, but does anyone else do that?

[Pawz4me]

39 minutes ago, SKL said:

All this talk about labs ... I assume these are for known or suspected conditions?  I've never had blood work done unless it was to confirm / rule out a specific concern.

 

I've had basic blood work (CBC and metabolic panel) done routinely since I was in my mid-30's or so, long before I developed any serious health issues. It's needed to check for common things like cholesterol, anemia, blood glucose (diabetes), etc. 

[TravelingChris]

7 hours ago, vonfirmath said:

I get my blood pressure checked at every dentist appointment

 

Not at my dentist.  But he is the best dentist I have ever had,  Very honest-  the last dentist I had in this city claimed that I and my 2 daughters needed many cavities filled and when we went to him, we didn't, super caring, and just really fantastic.

[kbutton]

3 hours ago, Jean in Newcastle said:

Re labs. My doctor sets up labs before my visit. In the case of regular monitoring lab work he puts it in the computer to be scheduled for the next appointment while I am finishing up my current appointment. For new issues I contact him on MyChart, tell him what I am scheduling an appointment for (ie symptoms) and ask if he could schedule any general labs that would be helpful to him so that I can get them done prior. It’s always worked well. Of course he may order more labs after he sees those results and examines me but we have the general screening ones out of the way. 

The only providers here that do that are out of network providers who aren't in network with anyone anymore because they are tired of the system. 

I can't even MyChart my kids' pediatrician. They have their own portal, but it's super restrictive what they do messages for. I can't get the front office to talk to the pediatrician that might be ten feet away to ask if we can come with labs already run because DH knows what's likely wrong and the ER screwed it all up. 

5 hours ago, Pawz4me said:

I think this must be regional or an issue with your provider. It's not uncommon here to have blood work done prior to a visit. My previous PCP was fine with me coming in a few days before a visit to have blood work done. Or I could do it after meeting with him. He left it up to the patient. DH always has blood work done before seeing his oncologist. And in any event--it would be an easy policy to change if the will was there to cut down on in person medical visits and overall costs.

Not here.

It's also super uncommon to have bloodwork done in office. You usually have to go to an outpatient lab. The few that have labs on site or draw the on site send to a lab that's not considered as reliable for some things.

My parents live somewhere very different (including different state) and they have a lot of the same gatekeeping. It's not quite as bad, but it's close. They have quite good healthcare for a rural area, but they don't have an excess of providers, and their doctors are constantly booked. You can't just walk in and see someone for a sick visit without being an established patient unless maybe you are traveling, and then only if the doctor is super nice, not busy, etc. (so you could probably see someone for an urgent GYN appointment, but a family doctor will not have room). They don't have urgent care nearby, so it would be an ER visit even during daytime hours.

 

[heartlikealion]

I’ve never had BP checked at the dentist. But I have been to dentists and orthodontists that do a lot of in house stuff. Instead of the hospital, dd got emergency stitches at a specific pediatric dentist. When I went to my orthodontist they had a room to make molds for the mouth on site (like for mouth guards, retainers etc). 

I have access to my chart with my primary care doctor but I haven’t used the message area much. I messaged them before to confirm my BP.

[Corraleno]

6 hours ago, skimomma said:

This seems simple enough on paper.  I would say I am about as well-equipped as one can get in the US for keeping on top of my health care.  I have insurance, I have time, I am healthy,  I am educated, I speak English as a first language, I am not poor, I have my own transportation, and I am comfortable making phone calls and advocating for myself.  And yet, this still does not happen.  I live in an area in which HWCs of all levels turn over at an alarming rate.  I cannot even count how many doctors have simply been gone within a year after I have been established as a "new patient."  Some have handed me off to another provider (with or without notifying me), while others are simply gone when I call to make an appointment.  I have never had any sort of doctor-patient relationship (as an adult) where the doctor actually recognizes me at any point and no continuous records of medical care or lab results. The longest continuous doctor-patient relationship I have ever had as an adult was three years.  More than once, by the time one former provider warehouse finds my records to send to the next, the next is already gone.  It is exhausting.  I still try.  I have a new doctor now that has "stuck" for 18 months now.  I have had one physical with her and have managed to go in for an issue once in that time.  But I have no illusions that she will be the next time I call.  Repeat all of this for dh and dd.  Thanks goodness (so far, anyway) none of us have any medical issues.  And I imagine the situation only gets worse if you eliminate one or all of the well-equipped advantages I have.

OTOH, I have seen the same dentist every 6 months like clockwork for the last 25 years.  So I know *how* to do it if the landscape allowed it.

I can also say, since I have had many PCPs over the years, that some do all of the things the OP would like to see happen and others barely even break a 5 minute dialog during a physical.  I find that my personal experience aligns with the evidence that a traditional physical is a waste of time.  But as others have stated, I have to get one to establish myself as a patient in order to be seen for other issues.  Sometimes I know I need a new doctor and schedule a physical.  Other times an issue arises, I learn my doctor has ghosted me, then schedule a physical with a new provider with the real intent of getting my issue resolved.  Often this means going twice.  Once as a "new patient physical" and then again for the issue.  I find myself scheming to try to slip my issue in during the physical just to save time (and money), but most times, they are on to me and immediately tell me I must schedule a follow up appointment.   No one has time for this.

 

 

This mirrors my experience exactly. I have had ONE doctor in my entire life for more than 18 months, and that was only for 3 years. It seems like every time I need to actually see a doctor about something, I discover that the last doctor I saw is now gone so I have to get "established" with a new doc, and there's only 1 or 2 docs at the practice who are even accepting new patients, which requires a physical, and the earliest appointment for a physical is 4-6 months away. So I book the mandatory appointment for several months later, and then go to Urgent Care for the immediate issue. Then when the appointment finally comes around, the "physical" consists mostly of answering a million medical history questions that I've already answered with every previous doc, and those answers are already in their files.

And on the off chance that the get-established appointment actually coincides with the need to discuss a specific medical issue, I can't actually do that, because a "new patient physical" and a "sick visit" are two entirely different things, so I need to make a separate appointment to discuss whatever the issue is. Other than getting labs ordered (after arguing with the doc about why I want those specific labs done), the visit is completely useless, since I can't ask questions about any new or non-chronic issues and they already have the answers to all their questions in their files — but they can bill insurance $450 for it, which I assume is the whole point of requiring "physicals" to "get established" with a new doc every time the previous one leaves.

Navigating the American medical system, even for healthy, well-educated, well-insured people who are good at advocating for themselves, is just beyond Kafkaesque — and the most enraging part is that this seems to be purposely baked into our for-profit system, where all the extra visits and expense are seen as a feature not a bug.

[wathe]

Here patients are attached to a doctor, not to a "practice" - (I assume that means some sort of turnkey healthcare conglomerate/company?).  This is true for both primary and specialty care.  

Many docs will band together to share office overhead/staffing/on-call/after-hours care, but the individual patient is attached to a particular MD.  The local funding model supports that.  Continuity of primary care here is actually pretty good.  (while also true that some areas have doctor shortages, in which case, all bets are off)

I had childhood family physician.  During university days, I used the campus clinic for episodic care, but childhood FP was still FP of record and would have been involved if anything complex had come up.  Transitioned to adult life in new far away town, switched to a new FP, husband to the same.  Kids were born in to the same doc's practice.  She retired and practice was hand over to my "new" FP, about 8 years ago.  So, at age 50, have had 3 different FP's.  This is typical for many (most?) Ontarians (who aren't in areas with MD shortages - that's a big caveat)

Adding that DH, whose care needs are more complex than mine,  also has long-term doctor-patient relationships with his various specialists. 

Edited August 23, 2022 by wathe

[Laura Corin]

3 minutes ago, wathe said:

Here patients are attached to a doctor, not to a "practice" - (I assume that means some sort of turnkey healthcare conglomerate/company?).  This is true for both primary and specialty care.  

Many docs will band together to share office overhead/staffing/on-call/after-hours care, but the individual patient is attached to a particular MD.  The local funding model supports that.  Continuity of primary care here is actually pretty good.  (while also true that some areas have doctor shortages, in which case, all bets are off)

I had childhood family physician.  During university days, I used the campus clinic for episodic care, but childhood FP was still FP of record and would have been involved if anything complex had come up.  Transitioned to adult life in new far away town, switched to a new FP, husband to the same.  Kids were born in to the same doc's practice.  She retired and practice was hand over to my "new" FP, about 8 years ago.  So, at age 50, have had 3 different FP's.  This is typical for many (most?) Canadians (who aren't in areas with MD shortages - that's a big caveat)

Adding that DH, whose care needs are more complex than mine,  also has long-term doctor-patient relationships with his various specialists. 

A practice in the UK is a single doctor or a group/partnership. So usually between one and five doctors and associated health care workers. I can choose to see any of them but I have a favourite whom I almost always see. I've been seeing him for over ten years.

[Jean in Newcastle]

47 minutes ago, wathe said:

Here patients are attached to a doctor, not to a "practice" - (I assume that means some sort of turnkey healthcare conglomerate/company?).  This is true for both primary and specialty care.  

Many docs will band together to share office overhead/staffing/on-call/after-hours care, but the individual patient is attached to a particular MD.  The local funding model supports that.  Continuity of primary care here is actually pretty good.  (while also true that some areas have doctor shortages, in which case, all bets are off)

I had childhood family physician.  During university days, I used the campus clinic for episodic care, but childhood FP was still FP of record and would have been involved if anything complex had come up.  Transitioned to adult life in new far away town, switched to a new FP, husband to the same.  Kids were born in to the same doc's practice.  She retired and practice was hand over to my "new" FP, about 8 years ago.  So, at age 50, have had 3 different FP's.  This is typical for many (most?) Ontarians (who aren't in areas with MD shortages - that's a big caveat)

Adding that DH, whose care needs are more complex than mine,  also has long-term doctor-patient relationships with his various specialists. 

This is my experience in the US. But obviously many others have vastly different experiences from mine. 

[TravelingChris]

9 hours ago, skimomma said:

This seems simple enough on paper.  I would say I am about as well-equipped as one can get in the US for keeping on top of my health care.  I have insurance, I have time, I am healthy,  I am educated, I speak English as a first language, I am not poor, I have my own transportation, and I am comfortable making phone calls and advocating for myself.  And yet, this still does not happen.  I live in an area in which HWCs of all levels turn over at an alarming rate.  I cannot even count how many doctors have simply been gone within a year after I have been established as a "new patient."  Some have handed me off to another provider (with or without notifying me), while others are simply gone when I call to make an appointment.  I have never had any sort of doctor-patient relationship (as an adult) where the doctor actually recognizes me at any point and no continuous records of medical care or lab results. The longest continuous doctor-patient relationship I have ever had as an adult was three years.  More than once, by the time one former provider warehouse finds my records to send to the next, the next is already gone.  It is exhausting.  I still try.  I have a new doctor now that has "stuck" for 18 months now.  I have had one physical with her and have managed to go in for an issue once in that time.  But I have no illusions that she will be the next time I call.  Repeat all of this for dh and dd.  Thanks goodness (so far, anyway) none of us have any medical issues.  And I imagine the situation only gets worse if you eliminate one or all of the well-equipped advantages I have.

OTOH, I have seen the same dentist every 6 months like clockwork for the last 25 years.  So I know *how* to do it if the landscape allowed it.

I can also say, since I have had many PCPs over the years, that some do all of the things the OP would like to see happen and others barely even break a 5 minute dialog during a physical.  I find that my personal experience aligns with the evidence that a traditional physical is a waste of time.  But as others have stated, I have to get one to establish myself as a patient in order to be seen for other issues.  Sometimes I know I need a new doctor and schedule a physical.  Other times an issue arises, I learn my doctor has ghosted me, then schedule a physical with a new provider with the real intent of getting my issue resolved.  Often this means going twice.  Once as a "new patient physical" and then again for the issue.  I find myself scheming to try to slip my issue in during the physical just to save time (and money), but most times, they are on to me and immediately tell me I must schedule a follow up appointment.   No one has time for this.

 

 

That is why I pay extra for the concierge service.  It lets doctors have less patients and actually have time to care for the patients they have.  I am not rushed at allergist, rheumatologist, pulmonologist, psychiatrist, retinal specialist, ophthalmologist, ENT, infectious disease doctor, wound care doctor, or any other specialist I have seen recently. And I do not particularly care whether my practitioner is in my insurance or not.  My health comes first. I come in with list, usually and hopefully.  

[TravelingChris]

7 hours ago, Pawz4me said:

I think this must be regional or an issue with your provider. It's not uncommon here to have blood work done prior to a visit. My previous PCP was fine with me coming in a few days before a visit to have blood work done. Or I could do it after meeting with him. He left it up to the patient. DH always has blood work done before seeing his oncologist. And in any event--it would be an easy policy to change if the will was there to cut down on in person medical visits and overall costs.

For our annual visit, we always get the testing done before the actual visit so that the doctor can look over the results and talk to you about them.  A nurse does the eye exam, ekg, checking blood flow by measuring both in arms and legs, and takes blood and tells us to pee in cup too.  

[Pawz4me]

1 hour ago, wathe said:

Here patients are attached to a doctor, not to a "practice" - (I assume that means some sort of turnkey healthcare conglomerate/company?).  This is true for both primary and specialty care.

The primary care practice I use has one MD and several physician assistants. I see a PA, she serves as my primary care provider and I see her for all routine appointments. But if I were sick and she didn't have any openings that day then I'd be given the option of seeing someone else in the same practice who could see me sooner. So most people here in my area identify with their primary provider but also with the practice. The same is true for specialists.

[TravelingChris]

4 hours ago, SKL said:

All this talk about labs ... I assume these are for known or suspected conditions?  I've never had blood work done unless it was to confirm / rule out a specific concern.

We've had some done at LabCorp, ordered by our chiropractor, and I started wondering, can we just order our own if we are curious?  Would that save time and money?  It's something I might look into, but does anyone else do that?

THis is the lab that 8 different doctors in 4 different states warned me to never, ever use because they are notoriously unreliable.  

[Jean in Newcastle]

6 minutes ago, TravelingChris said:

That is why I pay extra for the concierge service.  It lets doctors have less patients and actually have time to care for the patients they have.  I am not rushed at allergist, rheumatologist, pulmonologist, psychiatrist, retinal specialist, ophthalmologist, ENT, infectious disease doctor, wound care doctor, or any other specialist I have seen recently. And I do not particularly care whether my practitioner is in my insurance or not.  My health comes first. I come in with list, usually and hopefully.  

I get all that with my non- concierge doctors. But I honestly don’t recognize what others are describing. It’s like they are describing a different country!  I am very careful in choosing and “interviewing “ my doctors but it looks like others don’t have choices that I have. 

[TravelingChris]

8 hours ago, Jean in Newcastle said:

Yea, I was referring to those people who actually have a choice but it does appear to be regional. I even had established care with a low cost medical clinic for those who don’t have the advantages you mentioned. 

So did I.  Before I had my concierge doctor, I got stung by a wasp in the nose on a weekend.  Because both my mother and my youngest are allergic to wasps, bees, etc, and this was my first sting,  I knew I had to get to an urgent care.  I went to one, and they refused to see me and told me to go to ER.  I didn't want to and called and found an urgent care/family practice Indian physician practice that would see me.  He treated me very well.  He also has treated my son very well when he has had problems like tick bites with ring, etc.  He was not expensive at all. Cheaper than the worthless, fancier-looking urgent care that I went to and the physician misdiagnosed my cellulitis as something else.

[heartlikealion]

7 hours ago, Corraleno said:

This mirrors my experience exactly. I have had ONE doctor in my entire life for more than 18 months, and that was only for 3 years. It seems like every time I need to actually see a doctor about something, I discover that the last doctor I saw is now gone so I have to get "established" with a new doc, and there's only 1 or 2 docs at the practice who are even accepting new patients, which requires a physical, and the earliest appointment for a physical is 4-6 months away. So I book the mandatory appointment for several months later, and then go to Urgent Care for the immediate issue. Then when the appointment finally comes around, the "physical" consists mostly of answering a million medical history questions that I've already answered with every previous doc, and those answers are already in their files.

And on the off chance that the get-established appointment actually coincides with the need to discuss a specific medical issue, I can't actually do that, because a "new patient physical" and a "sick visit" are two entirely different things, so I need to make a separate appointment to discuss whatever the issue is. Other than getting labs ordered (after arguing with the doc about why I want those specific labs done), the visit is completely useless, since I can't ask questions about any new or non-chronic issues and they already have the answers to all their questions in their files — but they can bill insurance $450 for it, which I assume is the whole point of requiring "physicals" to "get established" with a new doc every time the previous one leaves.

Navigating the American medical system, even for healthy, well-educated, well-insured people who are good at advocating for themselves, is just beyond Kafkaesque — and the most enraging part is that this seems to be purposely baked into our for-profit system, where all the extra visits and expense are seen as a feature not a bug.

That’s so frustrating. If I did have an issue at a wellness visit I most certainly would bring it up. What’s the worst they can do? Say I won’t look at that, come back. But they might look at whatever it is. 

[heartlikealion]

My ds had a freak accident last week and got stitches at the ER. They were poorly done and/or removed too soon. I’m so upset about this. I left a voicemail with the ER today but no one bothered to return my call. My son was instructed to have them removed and xh took him in yesterday. His face looks terrible and now he’s having to wear butterfly bandages. His pediatrician doesn’t remove stitches and the removal was part of the hospital fee so that’s why he was just taken back there. 

I have such little faith in my local hospital. There’s one small hospital even closer but we never heard good things about it. On a couple occasions we drove even further to the Children’s hospital. It’s just crappy when there’s an emergency and you don’t want to add wait time. 

[SKL]

8 hours ago, wathe said:

Here patients are attached to a doctor, not to a "practice" - (I assume that means some sort of turnkey healthcare conglomerate/company?).  This is true for both primary and specialty care. 

I don't know about percentages, but where I live, over time, more and more small MD practices have become part of one of the 3 or 4 large practices in the area.  These large practices are basically very reputable hospital systems that also offer comprehensive healthcare services.

Theoretically I am supposed to have a PCP, but the dude they assigned me to 5 years ago moved away, and I haven't been back for general care since.  I was able to schedule a mammogram and a colonoscopy in the system without a PCP.  If I ever do need a PCP again, I guess I'll just have them assign one to me like last time.  Probably someone I'll see 1 time if that.

[skimomma]

14 hours ago, TravelingChris said:

That is why I pay extra for the concierge service.  It lets doctors have less patients and actually have time to care for the patients they have.  I am not rushed at allergist, rheumatologist, pulmonologist, psychiatrist, retinal specialist, ophthalmologist, ENT, infectious disease doctor, wound care doctor, or any other specialist I have seen recently. And I do not particularly care whether my practitioner is in my insurance or not.  My health comes first. I come in with list, usually and hopefully.  

This is literally not an option for large swaths of the US.  It is not in my area.  It is not even within a 4 hour radius of my area.  There are also no allergists even within a 2 hour drive.  And I know that is not at all unique.  The medical landscape is starkly different in rural vs. urban areas.  For reference, I had to drive two hours for each of dd's orthodontist appointments.  The demand is here but the supply of practitioners willing to come (and stay) in many rural areas is low.  We recently did get a (one, single) orthodontist to establish here after I was past those years.  She is fully booked so some people are still driving two hours for care.  Before she came, there were jokes about pooling our money and sending someone to school with he understanding they would promise to work here.....like that town in Maine and the plumber.

[skimomma]

8 hours ago, heartlikealion said:

That’s so frustrating. If I did have an issue at a wellness visit I most certainly would bring it up. What’s the worst they can do? Say I won’t look at that, come back. But they might look at whatever it is. 

Yep.  That's what they say.  "You will have to make a separate appointment for that."  This is why I sometimes practice ways to slip in the issue during a wellness/new-patient appointment.  It is not even to save money.  It is to save time, which often means saving suffering and/or worsening of a problem.  By the time I get a wellness visit to establish myself as a new patient (can be weeks or even months) then have to wait another weeks or months to get the follow up appointment, the problem has to be really REALLY big for me to even bother.  We don't have urgent care here and walk-in clinics are only for very very basic issues.  So this leaves the only other option of going to the ER, which many people do.  I have never had a problem so dire that I had to go that way, but I have contemplated it.

My current doctor, who has stuck for 18 months so is now vying for my personal record, required TWO appointments to get a physical.  I had to make a "new patient intake" appointment prior to the "physical."  The physical (at least once every two years) is required by my workplace insurance.  If I don't get it, I pay more per month for coverage.  So multiply it by THREE as everyone in my family had to do the same thing.  Six appointments.  This provider, like all in our area, is part of one of two hospital groups.  I have seen other PCPs within her "group."  But I still have to start over and answer the same questions and get the same baseline labs, and and and.  I can SEE my chart in the portal so I assume she can as well?  But that is not how it seems to work.  My dh and I were strategizing that when this one disappears, which is statistically certain to happen, we should find three different PCPs so we can stagger the hassle.

[Corraleno]

7 hours ago, Jean in Newcastle said:

I get all that with my non- concierge doctors. But I honestly don’t recognize what others are describing. It’s like they are describing a different country!  I am very careful in choosing and “interviewing “ my doctors but it looks like others don’t have choices that I have. 

Many people's choices are constrained by the insurance they have, so they first have to find a list of in-network docs, and then they have to find one of the rare ones that is accepting new patients. It's difficult to "shop around" for a doctor when they all require a physical/wellness visit as a condition of taking you on as a patient, but insurance only covers one such visit per year. And patients don't really have any control over how long a doctor stays with a practice; I'd still have the wonderful doc I started with when I first moved here if she hadn't left after three years. I'm in an urban area and generally the only docs taking new patients here are newly-minted and/or new to the area, and those also tend to have higher turnover. So it's a vicious cycle unless you happen to luck into a great doc who is in network AND accepting new patients AND willing to settle in the area and stay with the practice long term (AND you don't have to switch insurance due to a job loss or change).

[TravelingChris]

2 hours ago, skimomma said:

This is literally not an option for large swaths of the US.  It is not in my area.  It is not even within a 4 hour radius of my area.  There are also no allergists even within a 2 hour drive.  And I know that is not at all unique.  The medical landscape is starkly different in rural vs. urban areas.  For reference, I had to drive two hours for each of dd's orthodontist appointments.  The demand is here but the supply of practitioners willing to come (and stay) in many rural areas is low.  We recently did get a (one, single) orthodontist to establish here after I was past those years.  She is fully booked so some people are still driving two hours for care.  Before she came, there were jokes about pooling our money and sending someone to school with he understanding they would promise to work here.....like that town in Maine and the plumber.

Yes, I know.  And even though I am in the biggest city now in my state, we don't have enough good specialists in a few different areas.  I have to go 2 to 2.5 hours away to Nashville to see my rheumatologist.  And I think there may be a good rheumatologist or 2 in town, but they are in the same practice with the 2 that we fired-one was mine and the other was my daughter's.  Both were not good ones at all.  And I think you can't go from seeing one to going to be a patient of one of their partners in the practice. So tomorrow, we will have a four to five hour rt.

And I know that rural, and especially rural in the West and in some of the Northern areas of the US, means very inadequate health care. Which is why someone like me cannot live in those areas and I am so extremely happy that dh got a job in this city, rather than one area where he could have gotten a job that is in the West and not a big city and health care is probably not available locally as well as it is here.

[historically accurate]

11 hours ago, skimomma said:

Yep.  That's what they say.  "You will have to make a separate appointment for that."  This is why I sometimes practice ways to slip in the issue during a wellness/new-patient appointment.  It is not even to save money.  It is to save time, which often means saving suffering and/or worsening of a problem.  By the time I get a wellness visit to establish myself as a new patient (can be weeks or even months) then have to wait another weeks or months to get the follow up appointment, the problem has to be really REALLY big for me to even bother.  We don't have urgent care here and walk-in clinics are only for very very basic issues.  So this leaves the only other option of going to the ER, which many people do.  I have never had a problem so dire that I had to go that way, but I have contemplated it.

My current doctor, who has stuck for 18 months so is now vying for my personal record, required TWO appointments to get a physical.  I had to make a "new patient intake" appointment prior to the "physical."  The physical (at least once every two years) is required by my workplace insurance.  If I don't get it, I pay more per month for coverage.  So multiply it by THREE as everyone in my family had to do the same thing.  Six appointments.  This provider, like all in our area, is part of one of two hospital groups.  I have seen other PCPs within her "group."  But I still have to start over and answer the same questions and get the same baseline labs, and and and.  I can SEE my chart in the portal so I assume she can as well?  But that is not how it seems to work.  My dh and I were strategizing that when this one disappears, which is statistically certain to happen, we should find three different PCPs so we can stagger the hassle.

I have a visit with a new doctor to become a patient coming up. When I say coming up, it's at the end of January. That's the quickest I can get in. This is in an area that has 3 large medical groups in the city. 

I had the same doctor from ages 15-40. Then he retired, since then, about 8 years, I have had 4 doctors, and I haven't had any PCP since 2018 (I saw her once and she left for a different city in 2019).