Even With Healthcare, We Can’t Always Get Doctors

george clooneyWhen I was at my last office job, the company changed its health insurance and our HR director met with each of us to walk us through the changes.

“So we need to choose a primary care provider from this list,” he told me.

“Okay,” I said, wondering if I was supposed to research them or call their offices or set up an initial physical or something.

“Let’s pick this one,” he said, choosing a name we both knew was random.

I never met that doctor. This is probably a good thing, because I’ve heard plenty of stories about long patient wait times to see PCPs, as well as PCPs who were so overloaded that they could not take on new patients. There is, as USA Today notes, a shortage of primary care physicians in America.

And also, as Slate recently reported, a shortage of Medicaid providers:

If you’re on Medicaid (in the states covered by the study) and you need to make a routine doctor’s appointment, there’s a 35 percent chance that the first number you call is for a provider that doesn’t currently exist.

“The study,” in this case, means the Department of Health and Human Services’ Access to Care: Provider Availability in Medicaid Managed Care. They contacted “a stratified random sample of 1,800 primary care providers and specialists,” and got some dismal results:

We found that slightly more than half of providers could not offer appointments to enrollees. Notably, 35 percent could not be found at the location listed by the plan, and another 8 percent were at the location but said that they were not participating in the plan. An additional 8 percent were not accepting new patients. Among the providers who offered appointments, the median wait time was 2 weeks. However, over a quarter had wait times of more than 1 month, and 10 percent had wait times longer than 2 months. Finally, primary care providers were less likely to offer an appointment than specialists; however, specialists tended to have longer wait times.

This is another disproportionate burden of poverty, of course. If you are on Medicaid, and you start calling a list of providers and find that, say, the first three numbers don’t work and the fourth number says “sorry, we’ve stopped participating,” and the fifth number says “we can make you an appointment in two months,” well—you can already see the time and hassle involved.

So I’m curious: how do you find your doctors? Do you choose names at random during your employer’s open enrollment period, or do you call offices, or have you been seeing one primary care provider for so long you can’t remember how the patient relationship started? Have you called doctors to have them say “we aren’t accepting new patients?”

I’ve found, in every city where I’ve lived, that my gynecologist is more than happy to also take care of my annual physical. My current gynecologist has also offered to provide references to specialists as necessary. So that’s a workaround that’s worked for me, at least for now. We’ll see what happens if my health needs change.



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