Changing Primary Doctors

[MoochNNoodles]

Has anyone here (especially in the US) tried to change primary doctors recently?  Oh. My. Goodness! 

When I was pregnant with my oldest (who is almost 6) we moved about a half hour away from our old house; where all our doctors were.  Since I'm home with my kids and I don't have many babysitter options I have to take my kids with me to the doctors.  So basically; I haven't gone unless I've been sick.  That's been twice.  In 6 years.  I actually need to allow 45 minutes just to get to an appointment and get in to their office (in a large building on an upper level).  So you see; one appointment can waste half of my day.  That's hard when your lugging babies or little kids along.  

So I've had a long cold and I traveled recently.  Both those things mess with my ears.  Yesterday I woke up with a new, loud ring in my right ear.  It didn't go away.  I dozed off on the couch and when I woke up with was even louder.  I only got a few hours of sleep and when I woke up this morning it was loud again and I couldn't go back to sleep.  So that lit a fire under me for finding a new doctor.  I called the group I had been considering (good reviews on the doctors care as well as appointment wait times and it's just 10 minutes from my home!!).  They have 1 doctor accepting new patients.  She is booking into MARCH!!!!  I figured I would have to wait a month or maybe 6 weeks (standard when I worked for a few specialists).  But 5 months!?!  She actually warned me that if I wait too long; they'll be into April's schedule.  That's fine for a well visit; but I'm not sure what that means for any sick needs that might come.  Or what is going on with my ear at the moment.  (i didn't mention my ear situation.)

So I don't know what to do.  I've put it off so long already.  Can/should I wait 5 months?  I'm not sure if I can or should go to a walk in clinic; since I'm pretty sure I need follow up care to whatever they might be able to do.  It doesn't feel infected.  They may just say I need to get a doctor/ENT.  There are basically 2 other groups I looked at.  One is a single doctor practice and thats really not what I'm looking for.  The other; I sat on hold for a while before hanging up before I even got to talk to anyone.  That's not a good sign.

It's been almost 2 years since I saw anyone at my old doctors.  I really do want someone closer.  We have a doctor shortage in this area; that doesn't help.  Why is this such a hassle? I should probably add that my old doctor actually left that practice so I'm assigned to a different doctor there now; but I've never seen that doc.  I saw the PA last time because I thought I had an ear infection. 

  What a frustrating day!

 

[mollyblue]

I moved 9 years ago... I have been searching for a doctor ever since.  It is a nightmare.  Yes, I am in the US.  My old doctor had a speciality.. that was delivering babies... but he treated boys, girls, he was my mom's doctor, my kids doctor, my doctor, I had a cyst one time under my arm, he cut it out right in his office.  you need blood work, right there in his office, an xray, you guessed it, right there in his office.  I figured moving to a bigger city medical care would have to be better, right, I mean the competition alone ought to keep everyone on the up and up.  My general practioner only wants to keep a file for me, anything that goes wrong, she wants to refer me to a specialist.  The specialist only wants to treat their one thing... When I was diagnosed with diabetes, it was discovered at a health screening I HAD to have to get insurance through my work.  The Nurse here referred me to my general practioner.  My general practioner charged me for an appointment to refer me to a endocrinologist  (I am supposed to get one free checkup per year, but she wouldn't code that visit as a check up because I would not let her do a pap.   It took  me 3 months to get into the specialist, who then wanted to refer me to a dietician, a heart specialist, and back to my general practioner... Heaven forbid if I should actually get sick. IMO, a specialist ought to be able to talk to me about my diet... I don't see any reason to see a specialist to read a lab report that my nurse practioner could already tell me, and google could already tell, and my general practioner could already tell me, I have high blood sugar... After waiting 3 months for my initial appointment, my followup appointment was rescheduled TWICE because the doctor was going to be out of the office on the days THEY scheduled it for.  So a 6 month delay for a maintenance drug.  No wonder health care is so unaffordable.

 

[MoochNNoodles]

Goodness gracious thats a lot of running around.  I've worked in medical offices; so I kind of get what goes on behind the scenes.  But in both offices I worked in; our wait wasn't 5 months.  DH just got home and said there is a practice about 20 minutes from here that also does walk ins.  I'm going to look them up.  I guess I wouldn't mind the wait so much if this ear wasn't giving me a new and annoying symptom.  I told DH I'm going to by an Otoscope at Walmart.  They aren't very expensive and it'll at least give me an idea of whether or not I need to resort to a walk in, see if the old doctors place will get me in or wait it out.  It's not fool proof; but it's a start.

If I were back home I'd have my choice of medical professionals in the family to consult.  I'd get an answer a snap. 

 

[denice]

There is definitely a shortage of PCPs which is reaching a critical point.  There are very few in this area that are taking new patients, it actually was beginning to be an issue when I moved here 20 years ago and it is really bad now.  I actually go to a family care clinic at the Care Point run by the OSU medical school.  A lot of people have told me that they would never go there because they had heard horror stories about them.  These are lifelong residents who have been going to the same practice most of if not all of their lives.  I am sure those practices have not been taking new patients for quite some time.

Medicine has become so advanced which has led to patients being referred to specialists for a lot of things that they  didn't used to be referred for.  Fear of lawsuits keep doctors working strictly within the limits of their specialty.

I waited 8 months for my  last physical.  Of course there is a huge downside for physicians with physicals, reimbursements are very low for them.  Most physicians only set aside a few hours a week for them because they are a financial loser for the practice.

 

[Winchester]

I've been lucky. While my office has had problems keeping a doctor (I've had at least seven different doctors in the same office in the past 15 years or so), I hardly ever have problems getting an appt. In fact, there are times when I can call first thing in the morning and, if it's necessary, they'll see me that same afternoon. The last time I called in (just a couple weeks ago), I had to wait a week for a regular appt for a BP check and some bloodwork and I think that's the longest I've waited in a long, long time. That's for a regular doctor.

My GYN, however, requires an appt at least a good month in advance. And to see an orthopedist, well we're talking a good 6-8 weeks most of the time. So you wait for almost two months for your appointment and you get to actually see the doctor for........what, 5 minutes? It's frustrating.

There is a walk-in clinic not too far from here. One of my GFs had to go there one time for an ear issue; she said it wasn't that bad at all. 

Mooch, you need to see somebody about that ear. Sounds like it needs to be checked-out.

 

[artiemom]

MoochNNoodles, It sounds as if you should be seen soon. You may have an ear infection which needs antibiotics. I would not wait when it comes to ears. You could always go the the Emergency Room, but be prepared to waste about 7 hours.. Yes, that is how long it takes around here for non-emergent cases. 

I guess living near Boston does have it's advantages.  I have been with my doctr (PCP) for over 25 years. I was one of her first patients. Over the years, she will periodically close her own practice. She has about 6 doctors in the group. She keeps some openings in her caseload for emergencies. If she is not available, then one of the other doctors will see you, or the nurse practitioner.

When I need a full physical, I have to book months in advance. 

When I see my endocrinologist, my appointment is a year in advance. I spend about 15 minutes with her! 

For a dermatlogist, I had to wait 6 weeks for an initial appointment; and that was for a possible skin cancer. My friend who sees the same doctor, has to wait 2 months for a full check up. 

Is there a walk in clinic somewhere so you can at least have someone look at you? They will bill your insurance company. Some hospitals have a clinic devoted to non-emergency walk ins.

Once you have an established physician it is easier. I do not know what I would do if I had to change doctors and groups. 

Mooch and Denice, I guess we all know what the issues with medical care are. 

I am fortunate in the fact that my own PCP tries to deal with things herself, before sending her patients to a specialist. 

My dad's PCP felt the opposite. It was a hassle taking him to so many different specialists. He had a lot of issues. The communication between doctors was almost nill. At one point, the specialist would prescribe a cetain medication, but to get refills , you had to contact his PCP !!!! 

The specialist felt the PCP should be monitoring his care, handling all his scripts, being like the team leader. The PCP felt the specialists should be there for refills and such. 

it was an ongoing nightmare! I was pulling my hair out. 

When my dad's PCP changed to a concierge practice; we could not afford the fees so my dad had to change PCP's.

We finally decided on a doctor who was closer to home, and was highly recommended by his cardiologist. While this doctor was very smart, we did not have a good experience.  That was a mistake! While the drive was much shorter, the wait time was not. We actually waited hours in the waiting room. He was too busy! And the office was a mess. Most of the appointments were sent to a nurse practitioner. My dad hated that. He wanted a doctor. I felt the same way. 

Yes, those appointments took all day. The travel time was literally 15 minutes, but to get my dad in and out of the car, to the office, and waisting for the doctor would take a big chunk of the day. it was exhausting. 

Mooch, I know what you mean about it taking all day. 

I honestly feel that the days of having a quick, in and  out doctors appointment are gone and never to return. Even if you find someone closer to home, it does not mean a short visit. 

Doctors have to overbook, because of the low re-imbursements form insurance companies. Things have changed for the worst. They cannot allot as much time as they had in the past to devote to appropriate care. They are rushed. They have to make a quota. It is the insurance companies running things. If the group is affiliated with a hospital, then sometimes it is worse. The hospital dictates how many patients they are to see in a given day. yes, physicians do get fired. I have seen it myself. 

I worked my entire life in the medical field. I have seen so many changes; and not for the better of either patients or workers. it is bad. the entire system is messed up. 

It is so frustrating...Wait until you have to deal with the insurance company. I am still fighting with mine; all due to a major mistake of my prior employer. I canceled my COBRA coverage as of 12/31/14. The company handling the cobra contacted the prior employer to cancel the insurance. I did not find out until July 1, when my current insurance was cancelled due to a secondary insurance. Yup, my prior employer never cancelled my policy!! Yet I have documentation that the company handle the COBRA told them to do it!! 

After many fights with my former employer, demanding that this insurance be cancelled, I finally got the situation partially resolved. My former employer's excuse was that the person who was supposed to cancel my insurance is no longer working there. He left before he cancelled it... My response: who cares? fix it....one phone call...bureaucracy. And this from ma major Boston teaching Hospital..

I now have coverage with the correct company from July 1. I was re-instated. However, the insurance company revoked all payments from January to July. 

I have gotten bill for thousands of dollars because of this mess.. I was never billed for the COBRA coverage. My former employer was paying it. Now that they cancelled it. They are both saying they are not responsible for any medical bills. It is a nightmare. 

They say it has to go to "boards" to review and ti takes up to 3 months.. the physicians are demanding payment. I do not have the money to do so...

I think I finally got this situation  straightened  out...after spending over 20 hours on the phone with many people. I have a file full of documents regarding this. 

It has been a nightmare! None of it has been my fault. I did everything I was supposed to do. I never tried to be shady. It is incredible how much power the insurance companies hold. 

You really do not realize it until it happens to you..or you see all the i ineptitude's which go on behind the scenes. 

 I swear things have gotten so messed up with the entire system. Medical care is now managed as a 'big' business and not to 'help' people. For crying out loud, when the main requirements for any type of medical technical job is; "good customer service/customer relations skills", instead of looking at technical skills, you know the system is doomed. Employees are constantly reminded and given classes on 'customer service"......not technical skills, but customer service. It is disgusting. 

ok--off my soapbox  

 

[MoochNNoodles]

My ear is a lot better; that new ring is gone.  They are still on the loud side though.  If it keeps up I may have to try a walk in place.  I used one when I broke my toe.  The wait was much better than the ER.  The hospital here does have some walk in clinics too.  I'm just not sure what my insurance will think of using them for a sick visit.  I'll have a higher copay probably.  

The problem really is that I'm not truly established anywhere at the moment.  I went in and filled out the paperwork to become a new patient and I was given basically a packet of information.  They seem to have a good system in place for their established patients.  Part of the reason I wanted a group like theirs is how the single practice doctors have more limited hours and resources for those sick visits.  My kids pediatrician is a single doctor practice.  She is closed Wednesdays and Friday afternoons.  I like that my kids have a good relationship with her; but it's frustrating if they get sick.  Another practice nearby covers for her; so its not like they are without care; but they know her.  

Most doctors are scheduling several weeks in advance. My dentist its 4 months if you need to reschedule last minute. But emergencies they will get you in ASAP.  The dermatologist that DH and I see is several months out as well.  They got me in in 6 weeks when my OBGYN wanted me to have some moles checked out because they were growing fast during my pregnancy.  I think we literally have 3 dermatologists offices in our area.  And one was shut down for some violations a few months ago!  My kids dentist is about 4 months out for new visits.  We always schedule things at our last visits so that helps.  When i was working in the Neurologists office it was usually a 4-6 week wait for appointments. But if another doctor called to talk to the Neurologist about a patient; we'd get them in soon.  But it was up to the doctor to say where in his schedule he wanted the appointment.  His appointment slots were 15 minutes for established patients and 30 for new.  I guess it just depends on what the doctor has reserved for what sort of visits.  I think they try to balance things out; but there is only so much you can do.  

 

[denice]

The longer visits for new patients make sense.  New patients are coded differently and the reimbursement is higher.  When I was younger and didn't get routine physicals I rarely went to the doctor.  Even though I wasn't a new patient they got to bill for me as a new patient because it had been at least three years since my last visit.  I am just not one to go the doctor that much.  I think the last 'sick appointment I went in for was well over 10 years ago when I had Bell's Palsy.  I initially went to an urgent care because I know starting the steroids quickly is key.  The urgent care doctor gave me a prescription for pred but still wanted me to see my regular doctor which I did.

 

[misty8723]

I would think it would be a good idea to tell the new doctor's office what is going on and maybe they can find an appointment a lot sooner than five months.  I know my doctor saves a few slots for people calling who are actually sick - but that may be for established patients only. 

 

[LTS3]

 
My ear is a lot better; that new ring is gone.  They are still on the loud side though.  If it keeps up I may have to try a walk in place.  I used one when I broke my toe.  The wait was much better than the ER.  The hospital here does have some walk in clinics too.  I'm just not sure what my insurance will think of using them for a sick visit.  I'll have a higher copay probably.  

I don't know what insurance you have or the coverage but with my insurance, a walk in clinic is covered and there is a co-pay depending if the clinic is "in network" or "out of network". I use an "in network" clinic so the co-pay slighly higher than the co-pay for a PCP visit. "Out of network" co-pay is much higher. I've gone to the urgent care clinic for a raging sore throat and ear infection on a weekend.

 

[catlover73]

I have had luck using practices that do both urgent and primary care.  I have a great physician now even though she is single practice.  Because she does both primary and urgent care it is easy to make appointments. I get migraines which sometimes require injections to relieve the pain and nausea and I can call the office and they will find a way to fit me in.  I found this practice when I got a bad migraine one day at work and the doctor I was using at the time suddenly had no openings even though they also did walk-in care.  I was so sick that my boss actually had one of my co-workers drive me to the doctor and allowed her to stay on the clock to do so. This doctor took care of me immediately even though I was a new patient and just walked in with out even calling first. Her office staff actually called me a cab to get home and allowed me to stay in the room they treated me in for over an hour so I could be comfortable until the cab arrived.  They even instructed the driver to call them when he got close so they could give me time to get ready to leave.  I have been using this doctor now for over a year and she is is awesome.  My hubby started using her too. I have other medical issues that can flare up with no warning and this doctor makes sure his patients can get in to see her when they need to.  Once you are an established patient all visits are billed as regular office visits even if you have to walk in without an appointment.  I have never waited longer than 30 minutes to see  this doctor and neither has my hubby.

My hubby had picked me up from work one day when he had an appointment scheduled for a follow-up from an illness and I was just going to wait in the car.  He was supposed to be the last appointment that night.  I had a medical issue that was causing me pain but we were both off the next day so I was going to just make an appointment for then.  My hubby knew I was in a pain and mentioned it to the doctor at the end of his appointment.  She told him to tell me to come in.  She took care of me right away even though she had to work late to take care of me.

My previous doctor was part of a multi-doctor practice that also did urgent care.  I quit using them when they told me they had nothing available when I needed to come in for a bad migraine.  They had treated me for this issue and knew that this happened.  I did not like suddenly getting blown off.  Also this practice felt the need to wait until November and bill you for an entire year of appointments. I got fed up with the lack of organization.  My hubby also used to use this facility and ditched them when they got blood work results showing he was diabetic and did not even bother to call him.  He found out he was diabetic when his Cardiologist mentioned it to him during a check-up. He got a copy of the test results and I told him to go see my doctor.  She checked his blood sugar and put him on medication right away.  She also scheduled him for a new round of blood work quickly.  She was really angry that the previous doctor would treat any patient like that.

 

[MoochNNoodles]

 
I don't know what insurance you have or the coverage but with my insurance, a walk in clinic is covered and there is a co-pay depending if the clinic is "in network" or "out of network". I use an "in network" clinic so the co-pay slighly higher than the co-pay for a PCP visit. "Out of network" co-pay is much higher. I've gone to the urgent care clinic for a raging sore throat and ear infection on a weekend.

I don't honestly remember what copay I paid when I used the walk-in for my broken toe.  They were the only place I have ever visited that looked at my insurance card and said 'Oh; I know all about this one!"  My insurance is covered through DH's union; so even though it's part of one of the big companies, it takes some know-how to bill it.  I only came across one other person with it when I was working in the medical offices.  

 
I have had luck using practices that do both urgent and primary care.  I have a great physician now even though she is single practice.  Because she does both primary and urgent care it is easy to make appointments. I get migraines which sometimes require injections to relieve the pain and nausea and I can call the office and they will find a way to fit me in.  I found this practice when I got a bad migraine one day at work and the doctor I was using at the time suddenly had no openings even though they also did walk-in care.  I was so sick that my boss actually had one of my co-workers drive me to the doctor and allowed her to stay on the clock to do so. This doctor took care of me immediately even though I was a new patient and just walked in with out even calling first. Her office staff actually called me a cab to get home and allowed me to stay in the room they treated me in for over an hour so I could be comfortable until the cab arrived.  They even instructed the driver to call them when he got close so they could give me time to get ready to leave.  I have been using this doctor now for over a year and she is is awesome.  My hubby started using her too. I have other medical issues that can flare up with no warning and this doctor makes sure his patients can get in to see her when they need to.  Once you are an established patient all visits are billed as regular office visits even if you have to walk in without an appointment.  I have never waited longer than 30 minutes to see  this doctor and neither has my hubby.

My hubby had picked me up from work one day when he had an appointment scheduled for a follow-up from an illness and I was just going to wait in the car.  He was supposed to be the last appointment that night.  I had a medical issue that was causing me pain but we were both off the next day so I was going to just make an appointment for then.  My hubby knew I was in a pain and mentioned it to the doctor at the end of his appointment.  She told him to tell me to come in.  She took care of me right away even though she had to work late to take care of me.

My previous doctor was part of a multi-doctor practice that also did urgent care.  I quit using them when they told me they had nothing available when I needed to come in for a bad migraine.  They had treated me for this issue and knew that this happened.  I did not like suddenly getting blown off.  Also this practice felt the need to wait until November and bill you for an entire year of appointments. I got fed up with the lack of organization.  My hubby also used to use this facility and ditched them when they got blood work results showing he was diabetic and did not even bother to call him.  He found out he was diabetic when his Cardiologist mentioned it to him during a check-up. He got a copy of the test results and I told him to go see my doctor.  She checked his blood sugar and put him on medication right away.  She also scheduled him for a new round of blood work quickly.  She was really angry that the previous doctor would treat any patient like that.

That sounds like a really nice doctor and facility!  There is one physician in the area who is also taking walk ins. But how do I say this nicely...he looks like a total creep.  And the reviews for the clinic (wait times, cleanliness, etc) were poor.  I suppose it would work in a pinch.  But honestly in this area with a doctor shortage, if you have time for walk ins; I'm not sure that is a good sign either.  It used to be a typical practice.  Its about half the distance as my old doctor.  There are other walk in clinics I can try too.  The one that I used when I broke my toe is across the street from my old doctor; but that wasn't an issue because I had dropped my kids off to my mother's house; which is only 10 minutes or so from there.  The new practice I filled out the paperwork for says they do their best to get you in the same day. They have a few Physicians Assistants and Nurse Practitioners in the group. They also offer walk-in sick visits on Saturday mornings.  DH would probably switch to this clinic if a male doctor were accepting new patients.  His old doctor moved so he does need one also.  

I need to look into these new hospital sponsored walk-in places.  The others are 20 and 30 minutes away.  I know my BFF used the one near her house for her family when she was going through chemo and had to be very careful about her family bringing germs home.  We have different insurance companies.  My insurance is decent and once I get things to go through; they are good about paying.  I believe its one of the hospital walk-ins that does the yearly physicals for DH's employer.  I had stitches put in my finger after a work accident at one of them about 15 years ago and I recall people there with paperwork being filled out.

My ears are feeling much better tonight.  I'm just a tad congested.  So hopefully the cold is gone and my ears have settled down for a good long while.  

 

 

[stewball]

I am so glad I don't live in America.

 

[AbbysMom]

Late to the thread. I was going ot make the suggestion to make the way far out appt because you can always cancel it.

Do you have a CVS with a Minute Clinic in it nearby? I've been once or twice to them and they charge the same copay as the doctor's office whereas for me, most walk-ins at a hospital will charge the ER copay.

 

[MoochNNoodles]

I just checked and we don't have one.  I thought we might; but it's just the vaccinations you can get at the pharmacy here.  That looks like a good option and they even list the out of pocket cost for the services.  

 

[mollyblue]

I don't like our CVS here.  I took my son once because he has really bad allergies and I liked the care, except for she used the oxygen thing you put on your finger and didn't tell us there would be a separate charge for that - but live and learn.  I took him back 6 months later and they wouldn't see him because they had already treated him for that and said it was chronic so we  needed to see a PCP - which we didn't have.  We found a doctor that has a walk in clinic with limited weekend and evening hours, and I took him there, and thats how we ended up with our PCP.  Its convenient, but even on the doctor side, they don't really treat anything... they just want to give referrals to specialist.  When I was diagnosed with diabetes, she referred me to an endocrinologist and gave her such high praise and made it seem like they worked together a lot, but when I went to the endo, she didn't even know who my doctor was.