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eridani

(51,907 posts)
Sun Jul 13, 2014, 07:18 AM Jul 2014

Long Waits for Doctors’ Appointments Have Become the Norm

http://www.nytimes.com/2014/07/06/sunday-review/long-waits-for-doctors-appointments-have-become-the-norm.html?hpw&action=click&pgtype=Homepage&version=HpHedThumbWell&module=well-region®ion=bottom-well&WT.nav=bottom-well&_r=0

One small consolation of our high-priced health care system — our $2.7 trillion collective medical bill — has been the notion that at least we get medical attention quickly.

Americans look down on national health systems like Canada’s and Britain’s because of their notorious waiting lists. In recent weeks, the Veterans Affairs hospitals have been pilloried for long patient wait times, with top officials losing their jobs.

Yet there is emerging evidence that lengthy waits to get a doctor’s appointment have become the norm in many parts of American medicine, particularly for general doctors but also for specialists. And that includes patients with private insurance as well as those with Medicaid or Medicare.

Merritt Hawkins, a physician staffing firm, found long waits last year when it polled five types of doctors’ offices about several types of nonemergency appointments including heart checkups, visits for knee pain and routine gynecologic exams. The waits varied greatly by market and specialty. For example, patients waited an average of 29 days nationally to see a dermatologist for a skin exam, 66 days to have a physical in Boston and 32 days for a heart evaluation by a cardiologist in Washington.

The Commonwealth Fund, a New York-based foundation that focuses on health care, compared wait times in the United States to those in 10 other countries last year. “We were smug and we had the impression that the United States had no wait times — but it turns out that’s not true,” said Robin Osborn, a researcher for the foundation. “It’s the primary care where we’re really behind, with many people waiting six days or more” to get an appointment when they were “sick or needed care.”

The study found that 26 percent of 2,002 American adults surveyed said they waited six days or more for appointments, better only than Canada (33 percent) and Norway (28 percent), and much worse than in other countries with national health systems like the Netherlands (14 percent) or Britain (16 percent). When it came to appointments with specialists, patients in Britain and Switzerland reported shorter waits than those in the United States, but the United States did rank better than the other eight countries.
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Long Waits for Doctors’ Appointments Have Become the Norm (Original Post) eridani Jul 2014 OP
Become? Erich Bloodaxe BSN Jul 2014 #1
The study was done last year. surrealAmerican Jul 2014 #2
Important point. Thank you! nt elias49 Jul 2014 #3
The right-wing was lying! Say it ain't so! stillwaiting Jul 2014 #5
Weird. I can usually get in to see my GP the next day. onehandle Jul 2014 #4
the Canadian wait times meme was always a big lie Doctor_J Jul 2014 #6
+1,000! I've got close Canadian family. The waiting line meme is BS. n/t RufusTFirefly Jul 2014 #26
When my daughter was a child, she woke up one day with a fever... KansDem Jul 2014 #7
Well, you are in Kansas and they seem to hate people WhiteTara Jul 2014 #9
Trouble is, since Arkansas didn't actually expand *Medicaid* but did the "private option" thing.... moriah Jul 2014 #30
Hubby and I now pay for the privilege of being able to get in to the primary doc. mnhtnbb Jul 2014 #8
eridani Diclotican Jul 2014 #10
I've been really lucky with this. noamnety Jul 2014 #11
America needs more doctors, not less patients IronLionZion Jul 2014 #12
Can't blame this on Obama .... Shoonra Jul 2014 #13
In 2007, my sister sat in a wheelchair for 6 months waiting for a knee replacement.. mountain grammy Jul 2014 #14
One month typically to see my doctor abelenkpe Jul 2014 #15
That's been my experience too aint_no_life_nowhere Jul 2014 #31
For me it depends on which doctor and severity of symptoms. NightWatcher Jul 2014 #16
We wait for ANY kind of physical exam in WI AllyCat Jul 2014 #17
Wow Cal Carpenter Jul 2014 #36
I could have mercuryblues Jul 2014 #18
Oh look, there's an app for that. proverbialwisdom Jul 2014 #19
You mean we can't have everything immediately ? Whatever will our "instantaneous gratification" Trust Buster Jul 2014 #20
If you are sick, you might need to get care immediately The Velveteen Ocelot Jul 2014 #29
So what do you do if you need an antibiotic or else the infection will get worse? davidn3600 Jul 2014 #33
We're talking about *health*, not ice cream cones. Cal Carpenter Jul 2014 #37
At least one component of this problem is an insufficient number of primary care providers. Aristus Jul 2014 #21
Does forcing people to buy private insurance help? Because we "fixed" healthcare, and no further Romulox Jul 2014 #22
Forty some years ago SheilaT Jul 2014 #23
I had to cancel my Dermatologist (been a regular patient for years) last December. Dustlawyer Jul 2014 #24
The practice that DH and I MissB Jul 2014 #25
My father had a medical practice. I worked there in the Seventies and Eighties. no_hypocrisy Jul 2014 #27
I noticed the article did not include France. My friend was visiting in 2013, broke her ankle. Thinkingabout Jul 2014 #28
I'd rather be in line that not be in line at all. nt conservaphobe Jul 2014 #32
Let's put that on a bumper sticker! woo me with science Jul 2014 #38
Go right ahead. No one is stopping you. nt conservaphobe Jul 2014 #39
My wait time is about 20 minutes. justgamma Jul 2014 #34
Kick for weekend visibility. area51 Jul 2014 #35
I had a suspicious lesion once spinbaby Jul 2014 #40

Erich Bloodaxe BSN

(14,733 posts)
1. Become?
Sun Jul 13, 2014, 07:31 AM
Jul 2014

When I was a kid, you could get in in a day or two. For the last decade or so, I've been lucky if I can get an appointment within two weeks. I hope they're not pulling out the RW 'Obamacare will cause us all to wait forever' crap. We were already waiting forever - we've got a shortage of doctors, especially lower paid types like GPs.

surrealAmerican

(11,332 posts)
2. The study was done last year.
Sun Jul 13, 2014, 07:43 AM
Jul 2014

This has nothing to do with Obamacare. The right-wing was lying when they insisted that Americans didn't wait as long as people in countries with national health care or national health insurance.

onehandle

(51,122 posts)
4. Weird. I can usually get in to see my GP the next day.
Sun Jul 13, 2014, 07:49 AM
Jul 2014

I've had two GPs in the last 20 years. One in the South and one in the Northeast.

Both of them can almost always see me the day after I call.

 

Doctor_J

(36,392 posts)
6. the Canadian wait times meme was always a big lie
Sun Jul 13, 2014, 08:11 AM
Jul 2014

That's just one more way that our system is worse than every other one on earth

KansDem

(28,498 posts)
7. When my daughter was a child, she woke up one day with a fever...
Sun Jul 13, 2014, 08:19 AM
Jul 2014

Around 102 degrees. We kept her home from school and called the doctor and were told they could get us in in three weeks!

I thought "WTF?!!" and went to urgent care. We also found another doctor.

But long-wait times for appointments has become the norm in my experience.

WhiteTara

(29,670 posts)
9. Well, you are in Kansas and they seem to hate people
Sun Jul 13, 2014, 08:42 AM
Jul 2014

in your state. Next door in Arkansas, I have called in the morning and gotten in the same afternoon. Right now I'm having some problems and my doc will be out of town for the next week. The nurse told me to chart stuff and to call in 4 days and if I'm still in the same place, she will get me in with another doc the same day.

Arkansas did go with expanded medicaid.

moriah

(8,311 posts)
30. Trouble is, since Arkansas didn't actually expand *Medicaid* but did the "private option" thing....
Sun Jul 13, 2014, 11:51 AM
Jul 2014

.... the people the insurance companies wouldn't take because they were too sick were added to an already overburdened Medicaid system with no actual improvements made to the infrastructure.

So my friend with fibromyalgia, degenerative disk disease, and a history of depression, despite no hospitalizations in over a decade, can't find a PCP in her county. None of the doctors on the state Medicaid website will take new adult patients in her county, she has to drive 50 miles to Pulaski County to see her doctor.

Still, here in Pulaski, it was a lot easier to find care even under Medicaid (until my disabiilty was approved I was also one of those who the insurance companies wouldn't underwrite), and 90% of people got to get Exchange-level insurance with 0% or 6% cost sharing.

mnhtnbb

(31,302 posts)
8. Hubby and I now pay for the privilege of being able to get in to the primary doc.
Sun Jul 13, 2014, 08:27 AM
Jul 2014

The primary I used to see left the 3 person practice--lured away to work for Big Pharma--
after he wouldn't adapt to the 'concierge' type practice the other 2 docs decided to create.
In other words, you pay an upfront fee--not covered by insurance--to belong to their pool
of patients and you are guaranteed to get in when you need it. Their yearly physicals are
2 hours!! with the doc. (I could always get in to see the day I called the guy who left, without
paying a concierge fee.)

I didn't like the concierge concept so I started calling around 2 years ago to see if I could
find another doc. No luck. Every time I followed up on a doc rec'd by a friend, I was told
the office was taking no new patients. So, I gave up and had hubby add me to the concierge
membership.

I have seen that doc exactly twice in the last year: once for a physical and one follow-up appt.
3 months later.

Diclotican

(5,095 posts)
10. eridani
Sun Jul 13, 2014, 08:46 AM
Jul 2014

eridani

Funny, I live in a country with universal Health care - and is able to call my doctor monday - and get an appointment the next day - or if he have a lot to do by the end of the same week - and he is to boot a rather good doctor who know my health history (it have been a complicated ride for me the last couple of years) and who is able to do the necessary test when it is needed....

For the moment I'm on a waiting list for a surgery - I got the papers about my surgery in May - and will be operated by the end of August - because the surgery are not life threatening - but hopefully will do a lot to fix a problem I have had a couple of years and who always end me in a hospital bed for time to time (a boring experience I would say - but I do have my trustworthy Ipad with me, and they have wifi in the hospital!) So I guess it is not bad to have universal health care after all..

And maybe at least as important - I would not getting expensive bill at the end of the hospital stay - and no extremely expensive co-pay to pay to the hospital either... Rather I would be able to walk out the hospital without any bill - and go to the bus stop, and ride the bus back home....

Diclotican

 

noamnety

(20,234 posts)
11. I've been really lucky with this.
Sun Jul 13, 2014, 09:21 AM
Jul 2014

Earlier this week I set out for a bike ride. Along the way, I noticed a weird sharp edge/hole on one of my teeth.

My dentist is on the route I was biking, so I stopped in to see if I could get an appointment. They called back to see if he had a minute, he said yeah, he wanted to see what was up and at least then he'd know how long of an appointment I needed. Next thing you know, I'm in the chair, bike gloves still on, helmet on the floor, and he's filling it with composite.

We finished up, and I continued on the rest of my bike ride.

Time between "I should see the dentist" and sitting in his chair - about 15 minutes, most of which was my biking the rest of the way to his office.

IronLionZion

(45,163 posts)
12. America needs more doctors, not less patients
Sun Jul 13, 2014, 09:22 AM
Jul 2014

Sounds like there should be ample career opportunities


conservatives want less patients by keeping people out.

Shoonra

(513 posts)
13. Can't blame this on Obama ....
Sun Jul 13, 2014, 09:39 AM
Jul 2014

I had to wait weeks for a doctor's appointment years before Obama held his first elective office. I had to wait hours in some dreary waiting room with old furniture and older magazines under Dubya (and under Reagan and under Nixon and in between). This is not something that can be blamed on Obama or ACA.

But before ACA a whole lot of people couldn't even make doctor's appointments, or their waiting room was the packed lobby of a hospital emergency ward.

mountain grammy

(26,553 posts)
14. In 2007, my sister sat in a wheelchair for 6 months waiting for a knee replacement..
Sun Jul 13, 2014, 09:40 AM
Jul 2014

fully paid for by insurance and worker's comp. A friend who can't move her arms after an injection procedure to relieve nerve pain, was told she had to wait 8 weeks to see a neurologist.
The only people who have the "best medical care in the world" are the rich and they like it that way. The rest of us are expendable.. what the hell, there's too many of us anyway.

abelenkpe

(9,933 posts)
15. One month typically to see my doctor
Sun Jul 13, 2014, 09:43 AM
Jul 2014

If I'm really sick they'll usually get me in within the week to see the nurse. It's been that way for years so it isn't Obamacare. I'm in LA...in the city. It has to do with a lack of general practitioners. And almost everyone needing to go to a general practitioner to get a referral before they can go to a specialist.

aint_no_life_nowhere

(21,925 posts)
31. That's been my experience too
Sun Jul 13, 2014, 11:59 AM
Jul 2014

Three to four weeks wait time here in California. A lot of offices are so swamped they aren't taking new patients.

NightWatcher

(39,343 posts)
16. For me it depends on which doctor and severity of symptoms.
Sun Jul 13, 2014, 09:44 AM
Jul 2014

If I call my GP and I've got a sore throat and 102 degree fever, I can usually pop in the next day for a few minutes and a script for meds.

If I call a specialist for something that is not as immediate, the wait becomes a little longer. If I need to schedule a test at Mayo, see ya in a month or two.

You shouldn't count a wait to see a specialist along side the wait to see a GP for something run of the mill, like the flu.

AllyCat

(15,987 posts)
17. We wait for ANY kind of physical exam in WI
Sun Jul 13, 2014, 09:53 AM
Jul 2014

Typically a month. Yet an infection or fever we get in the same day with a larger copayment. And at my well-woman check that was supposed to be free under ACA, I was charged a separate code for additional treatment . Huh? Oh yeah, I had the gall to ask questions so they charged me for an extended visit.

Cal Carpenter

(4,959 posts)
36. Wow
Sun Jul 13, 2014, 01:58 PM
Jul 2014

"...my well-woman check that was supposed to be free under ACA, I was charged a separate code for additional treatment..."

I'm curious, did your doctor indicate during the appointment that the questions/extra time would result in additional charges?

Regardless, I find it troublesome that you got an extra charge for a wellness exam. Everyone should be given enough time to address their health concerns -- otherwise how are we to tell if we are well? Particularly folks who have been uninsured for awhile until getting ACA coverage and may have a lot of small concerns about this or that.... damn... I'm sorry to hear that.

mercuryblues

(14,464 posts)
18. I could have
Sun Jul 13, 2014, 10:14 AM
Jul 2014

told them that, for free.

Over a year ago I was feeling very sick. I called the DR for an emergency appt. While waiting for the appt I spent 4 days in the hospital and a long weekend at the beach recuperating. So my appt. for not feeling well turned into a follow up after discharge.

The tuly sad part is, if I was seen the day I called and given the Rx I needed I could have avoided the hospital stay completely.

proverbialwisdom

(4,959 posts)
19. Oh look, there's an app for that.
Sun Jul 13, 2014, 10:21 AM
Jul 2014
http://www.latimes.com/business/la-fi-healthcare-watch-20140713-story.html

Convenience, fixed prices boost demand for doctor visits via Web, text

By LISA ZAMOSKY
July 13, 2014

Mary Castaneda had a sinus infection that just wouldn't go away, and she was feeling awful. She knew she needed to see a doctor, but her timing was off.

"It was after-hours so I couldn't get in to see my doctor," says the 35-year-old Mission Viejo real estate agent.

She'd recently heard about a new service that would quickly connect her with a doctor by video via her smartphone, and she decided to give it a shot.

She downloaded the app and after just a few minutes was connected with a board-certified doctor. Fifteen minutes later, she had a prescription to ease her symptoms and a list of tips from the doctor about how to fight off future infections.

<>
 

Trust Buster

(7,299 posts)
20. You mean we can't have everything immediately ? Whatever will our "instantaneous gratification"
Sun Jul 13, 2014, 10:23 AM
Jul 2014

Culture to do ?

The Velveteen Ocelot

(115,070 posts)
29. If you are sick, you might need to get care immediately
Sun Jul 13, 2014, 11:48 AM
Jul 2014

or it could get worse. Or you could die. It's not a matter of wanting "instant gratification," FFS. And anyhow, that wasn't the point of this thread. The point is that the wingers brag that we have a better health care system than countries with universal coverage because everyone can always see a doctor right away. Turns out that isn't true.

 

davidn3600

(6,342 posts)
33. So what do you do if you need an antibiotic or else the infection will get worse?
Sun Jul 13, 2014, 12:03 PM
Jul 2014

Bacterial infections don't hold off until you get to the doctor.

Aristus

(65,985 posts)
21. At least one component of this problem is an insufficient number of primary care providers.
Sun Jul 13, 2014, 10:28 AM
Jul 2014

When a doctor graduates from medical school, he or she often has anywhere from $100,000-200,000 in student loans to pay back.

The fastest way to pay them back is to specialize (gastroenterology, urology, etc.) so you can bill for expensive procedures.

One solution (which the US will never adopt, by the way) is to send medical students to school on the tax-payers dime. When they graduate, they will be obligated to practice as primary care providers for a certain set number of years as a way of paying back their schooling costs.

They do this in a number of European countries, which is why it will never happen here. The right-wing has successfully conflated 'European' with 'socialist' even though most of them are very successful capitalist economies.

Romulox

(25,960 posts)
22. Does forcing people to buy private insurance help? Because we "fixed" healthcare, and no further
Sun Jul 13, 2014, 10:30 AM
Jul 2014

changes are expected...

 

SheilaT

(23,156 posts)
23. Forty some years ago
Sun Jul 13, 2014, 10:42 AM
Jul 2014

many doctors in Northern Virginia were not taking new patients. So this is not an entirely new problem.

I'm waiting several weeks for an appointment with my doctor, but it's for a yearly check-up and not something urgent, so it's fine by me. I suspect that if it were something that needed to be looked at right away it would be different.

Dustlawyer

(10,489 posts)
24. I had to cancel my Dermatologist (been a regular patient for years) last December.
Sun Jul 13, 2014, 11:02 AM
Jul 2014

I just went last week to the rescheduled date appointment.

I am severely allergic to Poison Ivy and 12 years ago I caught it. I had to go to the ER and get the shot. It kept coming back a week after the shot and I kept going to emergency clinics until they didn't want to give anymore shots. It gets in my blood stream. When I realized that what used to work wasn't going to work anymore I tried to make my 1st ever appointment with a Dermatologist. I called several and the quickest was 3 months, the rest were longer up to 6 months! I finally just showed up at an office and refused to leave. While walking by the front desk they told the doctor about me refusing to leave. She came out to tell me she was full and saw the extent of my problem, it was going down my throat and shutting my eyes and covered most of my body she took me right in. At that time the Cortizone cream I use since that visit was prescription only. She grudgingly gave me one more shot and and jar of the cream which allowed me to finally get rid of it for good.

The myth of American Exceptionalism, whether it is medicine or just about any other damn thing is just that, a myth. When you dig down like here you find that we really aren't better than other countries anymore in any of the good categories. Another example I have seen first hand recently is from the BP oil spill. The government and industry continue to tout that seafood sold in America, whether caught by our fishermen or imported, is the safest in the world. Want to know how we achieve such safe seafood? FDA inspectors smell it! Laboratory test are too expensive (they say). LSU tested some Gulf Shrimp caught off of Louisiana that had been passed by FDA inspectors. The shrimp had over 1,000 times the allowable levels of hydrocarbons! Before you freak on Gulf seafood, understand that now well over 90% of the seafood purchased in the states is imported, mainly from Asia where their rivers are way more polluted than ours. As long as you don't eat it more than 2-3 times a month, the experts say you would be ok (for whatever that is worth)!

MissB

(15,799 posts)
25. The practice that DH and I
Sun Jul 13, 2014, 11:13 AM
Jul 2014

(and our kids) go to has varying wait times depending on what you need.

I schedule my annual gynecological exam six months out, but if I have any issues then my primary care dr works me in that day or the next.

Dh's primary care dr is the same. Ditto for the pediatrician. Even outside the practice, I've found that wait times aren't that bad in town, maybe because there are so many hospitals and dr offices here.

The dermatologist is the only one in that practice with shockingly long wait times. Unless you are on accutane, in which case you have scheduling priority it seems.

no_hypocrisy

(45,627 posts)
27. My father had a medical practice. I worked there in the Seventies and Eighties.
Sun Jul 13, 2014, 11:36 AM
Jul 2014

His waiting room was always full, usually geriatric patients.

And they'd wait. One hour. Two hours.

They'd squirm while waiting, but they'd never leave or find a new doctor.

Because back in the day, my father would spend a good hour with you even if you had a 15 minute appointment. He'd take a full medical history. Asked about your marriage, your kids, your family. Did you engage in sports and/or recreation. Did you have a pet. Did you smoke and/or drink? How much? What kind of health did your parents have? How was your job? What did you eat for the past three days? And so on.

My father came out of the tradition that you couldn't treat a patient unless you KNEW a patient and no two were alike. He didn't whip out a prescription pad and hustle you out. Not only was he judicious with the meds, he gave out medication samples he got from the drug reps.

So when you were waiting in the waiting room, you reckoned that you would get your hour when it was your turn to see Dad.

That's the difference with today's medicine.

Thinkingabout

(30,058 posts)
28. I noticed the article did not include France. My friend was visiting in 2013, broke her ankle.
Sun Jul 13, 2014, 11:41 AM
Jul 2014

Within 3 hours of walking into a medical facility, she had xrays, saw a doctor who referred her to orthopedic specialist, had a cast placed and walked out with crutches. Also, had a visiting nurse that afternoon and everyday until she left France to give her anti clotting injections. Best of all, at a cost of $36. Before returning to the US we attempted to get a prescription for a wheelchair, could not do this, had to rent one out of pocket. Saw her primary doctor the next day and it took 12 days before she was able to get a referral to see a orthopedic specialist. What a crock of crap, BTW, she is on Medicare.

justgamma

(3,660 posts)
34. My wait time is about 20 minutes.
Sun Jul 13, 2014, 12:08 PM
Jul 2014

You don't make an appointment, you just walk in and tell them which Dr. you want to see.

My husband's Dr. takes a week to get an appointment and you have about 1 1/2 hr. wait after you get there.

area51

(11,851 posts)
35. Kick for weekend visibility.
Sun Jul 13, 2014, 01:18 PM
Jul 2014

We need more doctors and we need to start subsidizing their education costs. Also need more residency slots. Are there any doctors reading this thread who'd like to comment?

spinbaby

(15,073 posts)
40. I had a suspicious lesion once
Sun Jul 13, 2014, 03:27 PM
Jul 2014

A little bump that persistently bled and itched and wouldn't heal. After some weeks, I went to my GP who referred me to a dermatologist. The first appointment I could get with a dermatologist was in eight months, so I removed the bump myself with nail clippers because it was damn annoying. Hasn't come back.

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