Shortage of Physicians?

[Zippo]

A bit of a rant here:

I don't know what it's like where you live but here in the Bellingham, Washington area there seems to be a real shortage of physicians. Perhaps that shortage may be coupled with an increase in need for physicians due to Covid and an aging population - I don't know. I do know that I made an appointment for October 25th with "my" physician to get cortisone shots in my wrists. I've been going to him for 6 or 7 years but the last couple have been a problem. I got an email from their office on Tuesday that my appointment would need to be postponed because the doctor had decided to take a vacation during that week. I was somewhat upset that I had to wait 8 weeks (give or take a few days) to get the initial appointment, that I'd been living with the pain in my wrists (and it is affecting my golf!), that they would schedule an appointment during his vacation in the first place, and that I would need to wait an additional week until he returned. I called the office (you wait on hold for anywhere from 15 minutes to 35 minutes waiting for the receptionist to pick up the phone) and explained, as nicely as I could, that I was in pain and that I needed those shots and if he couldn't do it was there anyone else in the office that could give them to me. She said she didn't know but that she would call me back.

While I waited for the call I got on the computer and searched for physicians in my area. I called a couple of fairly large (for our area) family care networks and the local hospital care network to see if I could find any other doctors accepting new patients. Turns out that, if I was pregnant, I wouldn't have much of a problem - but I could not find another MD accepting new patients. There are some PA-C medical professionals available but they would not be able to perform the type of procedure I needed, and it would be January before I could see them. And, as an old guy, there is much that I might need that I would not be able to get from such folk. What I was hoping to get was a physician with whom I could build a relationship, who I could call and make an appointment with in a reasonable (a couple of weeks?), and who could provide my medical care for the remaining amount of time I might need it. No luck.

The doc's office called me back today and made me a new appointment for the middle of next week (yaaay!) for me to see the doc as, apparently, he's the only one in that office able to inject cortisone into my wrists.

My wife and I believe we've entered the age of McMedicine. Unlike the loss of the "party line" telephone, I don't think that's such a good thing. So, I'm curious, do you also have trouble getting a doctor's appointment? Is it just a local thing? Maybe I've been blacklisted?

[saevel25]

Could be the area you live in. 

In NE Ohio, being that I am near Cleveland and other large population centers. There are a lot of doctors in the area. Now, a specialist, was a month out. For my primary physician, which is a place that has like 4 doctors, I can get an appointment 3-7 days out if I do not care which doctor I see. 

[Big Lex]

Very similar here, in NJ. I am a doctor; I don't do primary care, but I can tell you I am busier now, in my late 50s, than I have been at any previous time in my career. When we try to hire new doctors, it is very difficult to find qualified candidates. It extends to nurses, physician assistants, medical technicians/technologists, clerical staff, billing, everything. We turnaround large resection specimens now on average probably 5-7 days. Four years ago, the turnaround was about 2-3 days. It's insane, and I have no idea why it's happening. My colleagues in other specialties say the same thing. And so do my friends in the building trades, in banking, sales, everthing. 

[Vinsk]

You can have that done at an urgent care. At least the urgent cares I’ve worked at. 

[Zippo]

41 minutes ago, Vinsk said:

You can have that done at an urgent care. At least the urgent cares I’ve worked at. 

Thanks, @Vinsk. That was going to be my next call if the doc's office hadn't called back. I guess my issue with urgent care is that there is really no way to build a long term, two-way, trust relationship with urgent care doctors. I had seen and visited my previous primary care physician for more than 20 years before he retired. If I had pain, for example, I could go see him for relief and he knew me well enough to know that I wasn't simply drug seeking. But it seems like those sorts of physician-patient relationships are no longer available with McMedicine.

Is there are physician shortage in your area? Do you find yourself busier than ever and less able to get to know and spend time with a single patient than previously?

[Vinsk]

3 hours ago, Zippo said:

Is there are physician shortage in your area? Do you find yourself busier than ever and less able to get to know and spend time with a single patient than previously?

There’s a shortage for primary care just about everywhere. At urgent care we don’t generally manage chronic issues. However, if I have a patient that has an acute on chronic issue like yours, I see them. This includes things like:

Joint injection, diverticulitis flares, MS flares, ingrown nails, migraines…..

[GolfLug]

I will second the urgent care recommendation. You might get seen and treated by a PA but the job gets done. 

[Zippo]

Thanks, folks. I'll give Urgent Care a try next time. Right now, I'm looking forward to getting this done on Wednesday. It's been a long wait.

[Timbro]

On 10/14/2022 at 5:49 AM, Zippo said:

A bit of a rant here:

I don't know what it's like where you live but here in the Bellingham, Washington area there seems to be a real shortage of physicians. Perhaps that shortage may be coupled with an increase in need for physicians due to Covid and an aging population - I don't know. I do know that I made an appointment for October 25th with "my" physician to get cortisone shots in my wrists. I've been going to him for 6 or 7 years but the last couple have been a problem. I got an email from their office on Tuesday that my appointment would need to be postponed because the doctor had decided to take a vacation during that week. I was somewhat upset that I had to wait 8 weeks (give or take a few days) to get the initial appointment, that I'd been living with the pain in my wrists (and it is affecting my golf!), that they would schedule an appointment during his vacation in the first place, and that I would need to wait an additional week until he returned. I called the office (you wait on hold for anywhere from 15 minutes to 35 minutes waiting for the receptionist to pick up the phone) and explained, as nicely as I could, that I was in pain and that I needed those shots and if he couldn't do it was there anyone else in the office that could give them to me. She said she didn't know but that she would call me back.

While I waited for the call I got on the computer and searched for physicians in my area. I called a couple of fairly large (for our area) family care networks and the local hospital care network to see if I could find any other doctors accepting new patients. Turns out that, if I was pregnant, I wouldn't have much of a problem - but I could not find another MD accepting new patients. There are some PA-C medical professionals available but they would not be able to perform the type of procedure I needed, and it would be January before I could see them. And, as an old guy, there is much that I might need that I would not be able to get from such folk. What I was hoping to get was a physician with whom I could build a relationship, who I could call and make an appointment with in a reasonable (a couple of weeks?), and who could provide my medical care for the remaining amount of time I might need it. No luck.

The doc's office called me back today and made me a new appointment for the middle of next week (yaaay!) for me to see the doc as, apparently, he's the only one in that office able to inject cortisone into my wrists.

My wife and I believe we've entered the age of McMedicine. Unlike the loss of the "party line" telephone, I don't think that's such a good thing. So, I'm curious, do you also have trouble getting a doctor's appointment? Is it just a local thing? Maybe I've been blacklisted?

As far as I know, physicians are getting more scarce due to how stressful and demanding it is(on top of costing a fortune to get education), on top of that many people who get educated and trained leave after few years due to burnout. Top it up with increasing amount of patients constantly and you have some really huge deficit of specialists per amount of patients.

[Zippo]

5 hours ago, Timbro said:

As far as I know, physicians are getting more scarce due to how stressful and demanding it is(on top of costing a fortune to get education), on top of that many people who get educated and trained leave after few years due to burnout. Top it up with increasing amount of patients constantly and you have some really huge deficit of specialists per amount of patients.

I think you've got it. Plus, my doc said, they're coming out of school $400,000 in debt. And, even though this is one of the best places in the world to llive, housing prices here in the Bellingham area are too high for them to buy homes.

He did both of my wrists and they are already well on the road to improvement so that's good. They've got another physician starting in January plus some more PA-C  types so hopefully it'll get better here.

[Big Lex]

This is going to sound geezer-like, which I guess it is, a little, but medicine ain't what it used to be, as it were. It's much more complicated in my specialty, and I'm sure this is true for all specialties. A cancer case which came as a single specimen and was completed by reviewing 12 slides when I was a resident in 1993 (with @Missouri Swede) now comes as 8 separate specimens, requires 30-40 slides, along with additional special stains, and molecular genetic testing, and an expanded, more detailed report...all in the background of greatly expanded "compliance" requirements etc. etc. None of this speeds us up, obviously. Throw a little pandemic labor shortage and cash crunch on all this and you've got a lot of frustration on everyone's hands. I'm sure this is not just medicine...

So with all this, we can have the same number of doctors per patient, but suddenly it's a shortage, because there is more to do. 

[GolfLug]

1 hour ago, Big Lex said:

This is going to sound geezer-like, which I guess it is, a little, but medicine ain't what it used to be, as it were. It's much more complicated in my specialty, and I'm sure this is true for all specialties. A cancer case which came as a single specimen and was completed by reviewing 12 slides when I was a resident in 1993 (with @Missouri Swede) now comes as 8 separate specimens, requires 30-40 slides, along with additional special stains, and molecular genetic testing, and an expanded, more detailed report...all in the background of greatly expanded "compliance" requirements etc. etc. None of this speeds us up, obviously. Throw a little pandemic labor shortage and cash crunch on all this and you've got a lot of frustration on everyone's hands. I'm sure this is not just medicine...

So with all this, we can have the same number of doctors per patient, but suddenly it's a shortage, because there is more to do. 

This makes sense. And exactly why it is fine for many routine illnesses to be handled by PAs and Nurse practitioners. More cost effective as well all around.

[colin007]

The looming/existing teacher shortage is equally terrifying

[woodzie264]

A bit late to the party but as a PA in orthopedics, I do joint injections all day.  In your case, your doc should teach your PA how do it and problem solved. But I get your point. 
 

The following is my personal experience and is just a brief synopsis of the conversations I’ve had with docs, peers, and other providers who I know leaving medicine. As  @Big Lex said, medicine ain’t what it used to be. 
 

I have seen several surgeons I know personally leave medicine via early retirement or chance fields because of the increased government involvement/requirements and while reimbursement steadily drops, malpractice costs inversely climb.
 

While I imagine most providers don’t go into medicine for the money, the headaches are getting bigger each year, the requirements to reach reimbursement criteria steadily gets more layered with red tape while the reimbursement, once criteria is met, steadily falls. On top of that, malpractice insurance costs and related liability risks steadily climb…so the guys who have the smarts and ambition to do something different are leaving medicine or going to all cash practices (I’m sure you guys are seeing those pop up). When they (docs and providers) have other opportunities to provide better lives for their families and their futures via alternative means with inherently less headache and liability, they will go elsewhere. 
 

As long as those three things continue, quality and access to health care will steadily decline. 

[dennyjones]

Two years ago my primary retired without telling his patients.  It was a real challenge getting a new doctor.  Most recommended were not accepting new patients.  I asked my surgeon for recommendations and am currently looking.  It's not easy.