For most of us, finding the right doctor is a moot point. We already have one we're relatively satisfied with, and knows our medical history. So, we fortunate souls can skip the initial consultation preparedness speech, and move directly on to our problems.
Why is it that once you're in, you can never get in? Or, get an appointment, that is without what seems like an act of Congress? Now, not all doctor's operate this way, but enough do to warrant further investigation.
What is the problem? The problem is that with the capitation HMO and PPO plans of insurance, most doctors are squeezed into a Physician's Group. Each step further down the ladder away from the insurance company your doctor is, well the fewer direct dealing they have with the actual insurance company. Therefore, your monthly premium gets hacked up into bits for each rung on that ladder: Step one - the insurance company; Step two - the Administrative costs; Step three - the Physician's Group; and steps four, five and six are juggled between the Doctor, the laboratory, and radiological groups. That's a mighty thin slice of the pie left to your Doctor. Plus, there are incentives to all to save money by restricting (denying) care. So, to make up for this thinning paycheck, the Doctor's do what any good business person does. Take on more clients (patients). On average, most Doctors see only 25-30% of the actual total patients that are assigned to their practice. Even that percentage is high volume, averaging 75-150 patients per week or more. It becomes somewhat like visiting Disneyland during the height of summer, Saturday afternoon. Chances are you'll be in for a lot of waiting. Same principles apply to getting that appointment. The more patients they have to see within only so many office hours, tends to strangle both the amount of time allotted for each patient, and the number of openings for future visits gets pushed further and further apart.
If you don't regularly see your Doctor, chances are excellent that when you call to schedule that appointment, they won't have any times available for 6-8 weeks, if you're lucky. Need to schedule on a certain day or between specific hours, add another 2-3 weeks onto your wait. It's a fact of our health care industry - fewer Doctors, being paid less per patient, to do twice the paperwork on top of treating numerous new ailments, illnesses, plus all those new drugs being pimped to you via television.
While you're waiting for that 6-8 weeks or more to pass, here are a few excerpts from my previous blog regarding the initial appointment, that may be helpful:
1. Ask if you need to complete any forms. If so, have them mailed, faxed, or go pick them up. Then you can fill them out and return them before the 6-8 weeks.
2. Ask if you should have any tests done. Usually the Doctor will want to assess your condition before any tests, but it can't hurt to ask. It may be that you're due to have blood work done or a mammogram, EKG, etc. This way you can be doing something productive while waiting for the appointment.
3. Always ask to be called if there is an opening &/or cancellation before your scheduled appointment. You never know when someone may be hospitalized or change their mind or have a conflicting schedule. Don't be afraid to ask, it happens more than you realize, but if you don't let them know you'd be willing to accept an alternate appointment time, then they assume you're content with the one you have.
4. Be prepared with a brief synopsis of your health ailments since last seen, anything new, including medications, emergency room or urgent care visits, etc. Also, include a list of questions you'd like to discuss with the Doctor.
5. Bring any recent lab work results, x-rays, etc., with you. If you are unable to hand carry these items, make a note as to the date and place any tests &/or x-rays, etc., were performed, so they can get the results efficiently.
6. Review your notes and make a plan. Most Doctors are so overwhelmed they have little time for each patient. Have a plan ready - the most important information relayed early, along with the most important questions. It may feel as thought you've entered a race against time while trying to jam everything into the conversation with your Doctor. That's why making those lists, notes, and having a plan of attach are so vital. Now, I don't recommend pouncing on the Doctor like some hyena, but try not to waste any time hemming and hawing about why you're there. Be direct, clear and concise. State your case. Ask your questions. But do allow the Doctor the courtesy to speak now and again. They may even want to see your list and reorder items to what they consider most important. So try to write as clearly as possible. Remember you only have a short amount of time to convey your health concerns and questions to a busy Doctor - you don't want to stumble over poor hand writing.
7. Take notes. Listen to what your Doctor is saying. After all, you've waited all this time for their advice, so listen up and write down the important points. It something isn't clear, ask for clarification. It's very important you fully understand your Doctors' actions, whether that's sending you for tests or to another Doctor or Specialist. Ask why and what they hope to accomplish with these actions and if you need to relay any information or do anything further.
8. Follow-up. If you're being treated in any manner - medications, tests, or referrals, always follow up with the Primary Care Physician.
9. Make the follow up appointment today. Don't wait to call in, ask when to follow up and make an appointment to do so today.
The truth is, Doctor's need to hold back some appointment times to see returning patients who need to be seen on a timely basis. For medication refills that are restricted, or cast or stitches that need timely attention, etc., They don't put you off just to piss you off, it's just part of they necessary plan in seeing patients in the order of medical urgency. Remember that when you call to make the appointment. Sometimes the key is to what you relay to the scheduling clerk, and how serious sounding it seems. Who knows, it could shorten your wait time down to 2-4 weeks or even less.
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