So You Think There Are No Waits in the American Health Care System
The other day I was talking to a woman in the neighborhood and we got on the subject of national health care — or what she automatically dubbed “socialized medicine.” All those people in Europe, Canada, Australia — pretty much every other industrialized country in the world — are in trouble she said because she was certain they all had to wait unconscionably long times to get to see a primary care doc or specialist. Here, in the US, however, there are no waits. You’ve got coverage, you’ve got a doc, when you need him or her.
What planet, I wondered, does this woman — and so many other Americans like her — live on? No waits in the US? For whom, Warren Buffet (I’ll get to him on another posting). Bill Gates? People who can afford to pay $2000 to $25,000 for concierge care and instant access to their doctor? Well for the rest of us insured Americans, even well insured Americans, there are waits and very long ones at that. Let me give you a couple of examples.
A woman in her forties who develops type 1 diabetes. She was diagnosed by her PCP and he began to treat her. He prescribed a particular drug. Nonetheless, he recommended that she see a specialist. The ones she called could only see her in four to six months. Finally, a friend of the family pulled some strings and got her an appointment three weeks later. And it was a good thing because the PCP was prescribing the wrong med. If she had continued on this medication for the six months it would have taken –without string pulling — to see the specialist, could have really hurt her. Unfortunately, most people don’t have any strings to pull.
I do and it certainly didn’t help me a couple of years ago when I just felt really sick but didn’t know what was wrong. Thinking I maybe had a UTI, Urinary track infection, I called my PCP and tried to get in to see him. This was in October and the secretary said maybe he could fit me in in February. February? For a UTI? Couldn’t I just come in and give a urine sample. I had to fight for that. Without seeing him at all, they gave me an antibiotic, which didn’t help because five days later when I went to the ER in a hospital in Vermont, I had acute appendicitis which he would have been able to diagnosis by palpating my stomach in the right spot. But since my appendicitis, like many, didn’t present with lower right quadrant pain, and vomiting, who knew? I didn’t and therefore didn’t think to press on my right lower abdominal quadrant, which, it happens, was very tender indeed. I can’t tell you how much it cost me to have surgery in a tiny under-staffed hospital. The complications still plague me.
A recent article in the Boston Globe enumerated the problem. In Boston alone the waits for non-urgent appointments for surgeons, dermatologists, OB-GYNs, orthopedic surgeons has grown steadily longer. Try to get to see an OB and the average wait — and this is for people with good health insurance — is 70 days. As for primary care docs, well there aren’t enough of them, and it is almost impossible to get to see one. Here are the facts folks, we actually have fewer doctors per 1000 people than some countries with so-called socialized medicine. We have way fewer primary care doctors than most other countries and the shortage of primary care docs is getting truly catastrophic. If we had more and they could handle things before they became catastrophic, we wouldn’t need to see speicialists so often.
So please — check out other countries and their wait times before you bemoan the evils of so-called socialized medicine. Yes some do have long wait times. But in others, things are far better than here. Several years ago, I had a stomach infection and a colonoscopy to see what might be wrong. The nurse from the gastroenterologists office called me to tell me that they found a suspicious spot in my gut. Maybe, at age 57, I had Crohn’s disease, but then again maybe I didn’t. Freaked out by this I asked a bunch of questions, to which she answered, ” I don’t know, you’ll have to ask the doctor.’ To which I replied, so put me through to him. No, she said, you’ll have to wait — as in WAIT — for three weeks till your appointment with him. Needless to say, this was a potentially devastating diagnosis. Terrified I called a good friend who is a nurse in Australia. Yes, I woke her up in the middle of the night. She was horrified. “You mean the doctor didn’t tell you this in person?” she asked. “A nurse who couldn’t answer you questions told you this? You have to wait three weeks to talk to him?” She was incredulous. “That would never happen here. You’d be in his office the next day and he would give you the results and talk you through them.”