Tips on finding "doctor appointment space"?

italdesign

Level 2 Member
Nowadays when I need to see a (new) doctor, I'm usually told the soonest availability is... drum roll... in 4-6 months. After some back and forth with the receptionist I settle for presumably an unpopular doctor at a sooner time. Guys, this is harder than looking for SQ F Suites, and you end up settling for an angle flat on a weekday.

Is your experience similar? Any tips? Is there a platform that makes it easier to find doctor space (like an ExpertFlyer for doctor appointments)? I don't believe my facilities offer online appointment booking but I am looking into it....
 
Pick one good doctor and stay with him/her. The first appointment might take you 4 months but after that you'll be on his/her preferred list and can see the doctor in less than a week/10 days.
 

churnman

Level 2 Member
I've lost 2 great doctors thanks to all the nonsense created by Obamacare. They simply didn't want to deal with it anymore, all the crazy regulations, taking 3 times as long per patient just for records (like whether the farmer was hurt on 1" chicken wire or 2" chicken wire). Many of the great family doctors are retiring early. Just today, I found out an entire medical facility shut down where one of my doctors was at, now I have to get my records and find somewhere else. They said independently owned facilities are being pressured out due to new rules and insurance nonsense. Only hospital owned facilities will survive and then they will merge. Once enough merge and insurance companies merge we'll head to a one payer system since no one will want to be in this business any longer. This was orchestrated by the current administration lawyers and they knew what it would take to move toward that direction. Regardless of personality likes/dislikes, if people vote for Hillary they are voting for more of this. I'm independent, but will have to vote against her. What a nightmare this has caused.
 
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Maverick17

Level 2 Member
Just use all those miles to fly to **(insert country)** and see the private hospital doc within hours.

In reality there's no method I know of, unless you can sweet talk them to putting you on "standby", or keep calling every few days, for anyone who cancels or something. The squirrel is on the money as far as I know.

ETA: I've been in a lot of foreign hospitals for work in the past. Although general/family medicine they can be pretty good at the private places, I would not actually advocate for medical tourism. Especially not for anything with a specialist.
 
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italdesign

Level 2 Member
I can't speak for the family doctor, but the times I needed to see specialty doctors without referral, this has been the case.

I will say that the one time I was referred by a doctor, they were able to find me space quickly. Not sure if the referral helped.
 

haserfauld

Level 2 Member
Nowadays when I need to see a (new) doctor, I'm usually told the soonest availability is... drum roll... in 4-6 months. After some back and forth with the receptionist I settle for presumably an unpopular doctor at a sooner time. Guys, this is harder than looking for SQ F Suites, and you end up settling for an angle flat on a weekday.

Is your experience similar? Any tips? Is there a platform that makes it easier to find doctor space (like an ExpertFlyer for doctor appointments)? I don't believe my facilities offer online appointment booking but I am looking into it....
Look up concierge medicine. I work for one of the premier concierge medical companies in the nation. More and more people are going this route for this exact reason. Same day appointments, non-time-constrained visits, cell phone/e-mail directly to your doctor. Price can be steep, but we can barely keep up with demand (here in SoCal). I can't speak for other companies, and there are a lot of companies trying to capitalize on this niche that aren't really concierge practices, but worth looking into. Check out PersonalCare out of Irvine, CA.
 

Bury

Level 2 Member
We have appointments available with our doctors every day, if you're willing to consider care through a clinical trial!
 

MickiSue

Level 2 Member
Supporter
If you need a specialist, and you already have a primary, you can ask your primary doc for a referral. Years ago, I had an infection in my thyroid. My resting pulse was 104. My doctor's office called, and was told 2 months. My doctor himself called, asked to speak to the endocrinologist, and I got in the next week.

Same thing with any specialty. You WILL wait longer if you try to get in on your own.

As for bringing up politics...any doctor who deals with insurance companies--and that's what they're doing, not with regs, but with insurance company requirements--will complain about it. Clinics open. Clinics close. Obamacare has helped tens of millions of people to get insurance in the first place, and others to get it at a reasonable price, because the insurance companies can no longer put draconian limits on coverage, or charge terrible rates for those with actual medical histories.

I worked for insurance companies from 1989 to 2000. I know how badly they used to manipulate care and coverage, in order to allow their CEOs to continue to be among the highest paid CEOs in the state. I like this much better.
 

nickelfish1

Level 2 Member
I've honestly never had this issue. I call whatever Dr I want and I'm in within a max of two weeks. I called an orthopedist and got in the next day with the Dr who specialized in shoulders. That day did an x-ray and three days later was in the MRI machine. Granted there are probably 10 Dr's in there...but when I had a neck cramp I picked a name off a website (neck and spine Dr) not realizing he is a neurosurgeon and was in within four days. When I told him I had a crampy neck and thought I made the appt with the wrong Dr he said, "You're right. I'm a surgeon but I can still dx you and tell you who to go see." Turns out I have a herniated C3 -C4 so it was crampy for good reason!
 

italdesign

Level 2 Member
Look up concierge medicine. I work for one of the premier concierge medical companies in the nation. More and more people are going this route for this exact reason. Same day appointments, non-time-constrained visits, cell phone/e-mail directly to your doctor. Price can be steep, but we can barely keep up with demand (here in SoCal). I can't speak for other companies, and there are a lot of companies trying to capitalize on this niche that aren't really concierge practices, but worth looking into. Check out PersonalCare out of Irvine, CA.
Interesting. Do they take any insurance?
 

haserfauld

Level 2 Member
Interesting. Do they take any insurance?
PPO yes. Many also offer cash pay rates that, unless you routinely hit your deductible, can come out ahead. The healthcare space is such an absolute cluster these days, demand is skyrocketing. Note that the concierge access fees are not medical expenses, and cannot be billed through insurance. It's a slight simplification, but think of it as a health club membership. You pay a base monthly fee to have access to the health club, but other classes or services you get are outside that cost.

It's definitely not cheap, but people are flocking to these types of services. When people start realizing the amount of time wasted, headache involved, and overall lacking level of quality care they get in the mainstream system, the price seems much more reasonable (caveat being that the demographic we market to sees the annual access fees as 1% of their income).
 

churnman

Level 2 Member
My family is now cash payers for medical (using cc for points of course). We get better rates, end up far less in out of pocket costs compared to insurance, especially if counting the monthly premiums, and are receiving great care. Some doctors will give a cash-payer rate and we just pay up front for each visit, then get billed for any other services. I know some facilities now refusing all insurance and Medicare, but only take patients like us. They're able to keep rates low because they aren't forced to charge Medicare rates, but can go even lower. There are 3 large healthshare ministry programs that are exempt from the tax mandate and they have very low monthly rates. It's kind of like major medical used to be. Lowest monthly is $45/month and that exempts you from the 3% income tax mandate. Insurance companies are the main reason why medical care costs have risen so much in the last 40 years. I do get trip insurance for when we travel and we've used it for medical needs outside the U.S. It's amazing how much less medical costs are once you get outside the U.S. It really hurt that we lost a great independently owned medical facility just this week. They blamed the new law and it's objective to force out independents.
 

Laura

Level 2 Member
We have a PPO Plan with United HealthCare and we are offered TeleDoc. It is a phone # or an app you download, you can request to see a doctor (virtually), you can face time if needed, you talk to a doctor on the phone, describe your symptoms, a prescription is sent to your preferred pharmacy and there is no cost. Easier than going into a walk-in clinic or waiting days to see your doctor. I think many plans have something similar. Might be worth looking into...

With TeleDoc, my mom who is on MediCare and not with United can also use TeleDoc at no charge. Good for anyone living in the same household as you.
 

GettingReady

Level 2 Member
Interesting about the TeleDoc. Some of the health share ministries offer that too but I didn't know was available with PPO plans. So much for listening to heart and lung sounds, but a lot don't even bother with that anymore.
 

DanR

Level 2 Member
My family is now cash payers for medical (using cc for points of course). We get better rates, end up far less in out of pocket costs compared to insurance, especially if counting the monthly premiums, and are receiving great care. Some doctors will give a cash-payer rate and we just pay up front for each visit, then get billed for any other services. I know some facilities now refusing all insurance and Medicare, but only take patients like us. They're able to keep rates low because they aren't forced to charge Medicare rates, but can go even lower. There are 3 large healthshare ministry programs that are exempt from the tax mandate and they have very low monthly rates. It's kind of like major medical used to be. Lowest monthly is $45/month and that exempts you from the 3% income tax mandate. Insurance companies are the main reason why medical care costs have risen so much in the last 40 years. I do get trip insurance for when we travel and we've used it for medical needs outside the U.S. It's amazing how much less medical costs are once you get outside the U.S. It really hurt that we lost a great independently owned medical facility just this week. They blamed the new law and it's objective to force out independents.
Sounds all fine and dandy until you actually get sick. Then, you'll be in a world of hurt. Yes - you can get by with "sick" care cheaply without insurance (ie - get an infection, break a bone, get a cut, etc), but if you get diagnosed with cancer in February, what are you going to do? Odds are low, yes, but the results are catastrophic if you're unlucky. Nothing about "fixing" our health care system is as simple as you're trying to make it out to be. No doubt new payment reforms are making things difficult for independents, but payment reform is probably the key to getting a handle on our unsustainble rising costs. You're going to see more consolodation, for sure, because as risk is shifted from the insurance company to the provider, you're going to need the infrastructure and population size to take on that risk.
 

churnman

Level 2 Member
Sounds all fine and dandy until you actually get sick. Then, you'll be in a world of hurt. Yes - you can get by with "sick" care cheaply without insurance (ie - get an infection, break a bone, get a cut, etc), but if you get diagnosed with cancer in February, what are you going to do? Odds are low, yes, but the results are catastrophic if you're unlucky. Nothing about "fixing" our health care system is as simple as you're trying to make it out to be. No doubt new payment reforms are making things difficult for independents, but payment reform is probably the key to getting a handle on our unsustainble rising costs. You're going to see more consolodation, for sure, because as risk is shifted from the insurance company to the provider, you're going to need the infrastructure and population size to take on that risk.
That's why the healthshare programs are a viable option and much cheaper than insurance. Plans can handle up to one million in expense. It's great for things like what you're talking about, but not as good for little costs like doctor visits and rx for constant things. Have to see what is in your family's history and what you're at risk for before deciding if a healthshare program or regular insurance is best, along with out of pocket and premiums. Not one size fits all.
 

DanR

Level 2 Member
That's why the healthshare programs are a viable option and much cheaper than insurance. Plans can handle up to one million in expense. It's great for things like what you're talking about, but not as good for little costs like doctor visits and rx for constant things. Have to see what is in your family's history and what you're at risk for before deciding if a healthshare program or regular insurance is best, along with out of pocket and premiums. Not one size fits all.
The reason they are less expensive is the people signing up for it aren't sick. They are viable for healthy people. Insurance is all about spreading the risk among a large group of people. Sick people pay less than they use and healthy people pay more than they use. The exchange market is still too small and too sick to be viable today. A healthy person in the exchange is screwed by their premium. If employers stopped offering insurance in this country tomorrow and instead gave a stipend to individuals to go use on the exchange, premiums (on the exchange) would fall from where they are today, insurance companies wouldn't be losing their shirts on that line of business, and you'd likely see significantly increased competition in that space (rather than the exiting you're seeing today). That's one side. On the other side, how health care is paid for needs to continue to move toward paying for value/outcomes rather than paying fee for service. Yes - broken arms, colds, etc will probably always be paid fee for service - but chronic care management, where the real $$ are at needs to be different. Taking care of diabetes, heart disease, etc well across the country is what will lead to controlling costs.
 

MickiSue

Level 2 Member
Supporter
Seeing what's in your family history is an (gonna be blunt) ignorant way of choosing your healthcare coverage.

Women with no family history of breast cancer can develop it--in fact, the majority of newly DX'ed cases are women with no family history. Type 2 diabetes is epidemic these days, and was extremely rare in the past. The way that the ADA is choosing to "treat" it pretty much guarantees that it will get worse rather than better. Exposure to new and different infectious diseases can be devastating, and family history has zip to do with it.

Anyone can trip and fall, break a bone, rupture a ligament, suffer a concussion, get a scrape that gets infected.

The system of healthcare in the US sucks. But it sucks slightly less than it did during the 11 years that I worked in life and health insurance, because many of the tricks that the insurance industry used to avoid paying claims have been taken from them with the advent of the ADA.

Even if you never participate in your state health exchange, if you ever had a period of time when you were uninsured and you have ever been treated for a disease, you will benefit from the ADA and its elimination of the "preexisting condition" clause.
 

Sloebrake

Level 2 Member
Any tips? Is there a platform that makes it easier to find doctor space (like an ExpertFlyer for doctor appointments)?
Just an explanation/excuse - Almost every doctors clinic runs the same way. You're either an established patient and get ~15 minutes, or you're a new patient and get ~30-45 minutes. Since the reimbursement for 2-3 established patients is more than 1 new one, there's no reason for an established doctor to take on new patients.

You could also look into zocdoc - the uber for doctors. I haven't used it but it's been around for a few years and oozes "silicon valley disruption!!1!" polish and superficiality that so many crave.
 

italdesign

Level 2 Member
You could also look into zocdoc - the uber for doctors. I haven't used it but it's been around for a few years and oozes "silicon valley disruption!!1!" polish and superficiality that so many crave.
Nice. I do wonder what's the incentive for doctors to join. Are there actually good doctors who lack patients via traditional channels? Sure doesn't feel that way.
 

DanR

Level 2 Member
Several possible reasons: works to try and match patients with the type of doc they're looking for (language/culture preference, care style, rating, etc). For the orgs that use it, it allows another patient source to fill open appointment slots and importantly shifts scheduling resources away from existing staff. Even docs not accepting new patients have open appointment slots that can be filled with acute care type work - especially in the case where an appointment is cancelled on short notice. It would be incorrect to assume poor docs are using a service like this.
 

churnman

Level 2 Member
Found a doc near me that I can pay per visit for $35, no insurance. I've seen other doctors no longer accepting insurance or Medicare and only take cash. They're tired of the mess and have enough following they don't need it. It's interesting to see the fallout from the regulatory changes.
 

DanR

Level 2 Member
Regulatory changes lead to changes in practice. Fallout would be the politicized term. Change is change. Our health care system is undergoing major change right now and there will be good and bad that comes of it in individual circumstances. The old way wasn't working and it's way too early to know whether the shift that is underway will be net positive or net negative.
 

knick1959

Level 2 Member
The old way wasn't working and it's way too early to know whether the shift that is underway will be net positive or net negative.
Not for me. My employer has "adjusted" already and I'm paying way (way way) more to get way less. Massive net negative for me.
 

DanR

Level 2 Member
Not for me. My employer has "adjusted" already and I'm paying way (way way) more to get way less. Massive net negative for me.
see above where I say :) - there will be good and bad that comes of it in individual circumstances

It is highly unlikely your premium/benefits in an employer sponsor plan changed dramatically as a result of the ACA. The "costs" of the ACA to employers are minimal (dependents to age 26, free contraception, a few other small things). Lots of employers have used that messaging (and lots of employees have used the assumption in lieu of messaging) when discussing plan changes, but the reality is that health care costs are rising much faster than inflation and the only way many employers can continue to offer insurance to their employees at all is to shift more of the cost on to the employees while at the same time reducing benefits.

One of the biggest causes of recent premium increases comes from new Hepatitis C drugs. Amazing drugs, cure hepatitis c, but at a cost of 75-200k/treatment and there a millions of americans with hep c. If 10 people in your company were treated - that was an extra million $$ of expense for your employer.
 

knick1959

Level 2 Member
It is highly unlikely your premium/benefits in an employer sponsor plan changed dramatically as a result of the ACA.
Yet the timing is unarguable. "Unlikely" does make the case for me. I see dramatic, sudden changes timed perfectly to the implementation of ACA. The "affordable" part doesn't apply to me, and I wonder how many of the newly covered I am actually paying for myself, with all of the overhead that comes with it. Maybe bad timing ... but just bad in my book.

No need to debate it endlessly. I'm simply not a happy camper and its because of the cost. We now try to skip years for preventive / suggested visits to mitigate huge deductibles. This isn't "better" medical decision making, it's simply trying to avoid as much of the new reality as possible for the sake of our bottom line.
 

redbirdsj

Level 2 Member
We now try to skip years for preventive / suggested visits to mitigate huge deductibles. This isn't "better" medical decision making, it's simply trying to avoid as much of the new reality as possible for the sake of our bottom line.
No need to skip preventative visits! Those are free with qualified plans. I agree that timing and clustering tests and procedures into one year to the extent possible can help with deductible/OOP max management.

I view the ACA as fundamentally income redistribution. It's premised on the idea that the costs of the population's healthcare should be spread more evenly. Yes there are some features that are designed to reduce costs for the whole system (free preventative care, free contraceptives, etc.) but some argue those are counteracted by the fact that certain groups no longer have to fully internalize the costs of the health risks of their lifestyles (smokers, the obese, etc.).

Overall it's a shifting of the costs of the nation's healthcare from the sick to the healthy and the old to the young. I don't like it now because I'm young and healthy and don't get a subsidy. Maybe one day I will if I shift to a low-income lifestyle because the subsidies aren't means-tested (yet)! Ultimately my personal situation is of no importance in determining whether or not it's good policy.
 

knick1959

Level 2 Member
No need to skip preventative visits!
You're right, that wasn't accurate. We are reluctant to go in for even minor exception cases. My required twice-a-year visits to my age-old physician have been covered. Some very expensive prescriptions have not been, and these are creatively managed. Expiration dates are merely suggestions, right? :).
Ultimately my personal situation is of no importance in determining whether or not it's good policy.
This seems like an odd statement to me. But hey, you're welcome to pay my new-found extra. And, BTW, I'm neither young or perfectly healthy (although so far, so good). So the notion that it'll all get better with age may be incorrect. I'm still paying way more than I'm getting, and/or have gotten in the past.

I'll stop now. I was trying not to debate! Honest.
 

Bury

Level 2 Member
Health care costs are inarguably going up, but they were going up before ACA. I think ACA is part of the solution.

Sometimes I think everyone should self-insure, but then a bunch of people are going to go bankrupt in the hospital and/or die on the street. Seems like a net negative for a developed society like America.

I say this as a small business employer who will write about $60k in insurance premium checks this year.
 

MickiSue

Level 2 Member
Supporter
knick, when I was first added to Husband's coverage, we had copay of $25, a $200/person deductible, and no co-insurance (the 80/20 or 70/30 that many plans have. The deductible could be reimbursed, if you brought in receipts from the doctor to HR.

Well before the implementation of the ADA, the per person deductible went from 200 to 300 and then to 500. No more reimbursement for deductibles. Along with the $25 copay for anything other than well care, it went to 80/20 to an out of pocket max per person of $1000. (Meaning that until total allowable charges meet $4500, you will continue to pay, over and above the copay.)

Your company may claim that it's due to the ADA. But it's really due, in large part, to executive compensation at insurance companies. In 2014, the CEO of United Health Care, an MN based company, had total compensation of $107M.

He's had over $200M, so I suppose he blames the ADA for his drop in income, huh?

His predecessor's highest year's income was a little over $160M.

Now, UHC is cheap, compared to, say, Humana and Aetna. Their CEOs, for the same year, received over $600M and $400M, respectively.

Keep in mind that your premiums pay a big part of those salaries.

Still want to blame it on the ADA?

The biggest problem with the ADA is that it still uses insurance companies, and doesn't have tight enough controls over the premiums. We could learn a lot from Germany, where that's concerned.
 

churnman

Level 2 Member
All I know is my family is worse off now. I'm independent. I know of no one in my workplace or neighbors (Dem or Rep) that is happy with the new health law and so far they are voting against anyone who had anything to do with pushing this through. It didn't work for a lot of workers. The poor already were taken care of. And, insurance still doesn't have to cover pre-existing conditions for a year after you sign up (according to employers I've spoken to). So, you pay out a whole year of premiums for no care that you need and therefore you're paying for your present care (which isn't covered in the first year of "coverage") and insurance premiums for a year. That causes many with pre-existing conditions to not sign up and they're exempt from the mandate because of hardship (present medical bills and therefore can't afford the insurance). On top of that, the deductibles are so high ($5000 to $10000 per year per person) for the plans I've seen offered that some would be bankrupt just from that. So, they opt for no insurance. I think most of us agree there are things that need repealed and replaced.

Insurance companies caused a lot of the problems to begin with and had lobbyist in full force during the writing of the law that got shoved through Congress without hardly anyone seeing it, and certainly not the public. My doctor, who quit due to all this, was so angry at doctors he knew that left practice and their oath to work for the insurance companies years ago and making many millions of dollars, as MickiSue stated. He says they broke their oath.
 
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redbirdsj

Level 2 Member
No matter how healthy you are, you are putting yourself at a risk of ruin if you don't carry health insurance. Any significant health issue will bankrupt you.
 

MickiSue

Level 2 Member
Supporter
@churnman: employers are ignorant. It's not in their best interests to actually know the basic tenets of the ACA, because then they can blame their own choices that screw over their employees on the ACA, rather than A)rapacious insurance companies and B)their own greed.

IF you decide, outside of being a new hire or an open enrollment period to become insured, when you previously were not, yes, at that point, there may be limits placed on preexisting conditions. But during times that are considered open, no. And, of course the bulk of sign ups for health insurance are during either one's period as a new hire, or during open enrollment.

I can't speak for you, or your coworkers or neighbors. But I have observed that when one or two people in a group are vigorously opposing something, that most will either nod a little or murmur something that may or may not be taken as agreement. Politics and religion tend not to be comfortable subjects for most of us.


I don't know what state you live in, so I have no idea what plans are offered in your state. In mine, they range from high deductible plans, such as you mention, to those with lower ones, such as the BC/BS plan through Husband's employer with a $500 deductible.

Keep in mind, though, that deductible and out of pocket expense are two different things. The one is the amount of covered charges that you pay in full before the insurance company pays anything. The second is the total amount of covered charges you are expected to pay, once the insurance company begins to pay their share.

We've gotten far off the topic of "How do I get into a doctor's office in a reasonable time?"

That, too, has gotten worse. I mentioned above that I would have waited, VERY sick, for two months when I had a serious infection 12 years ago, had my doctor himself not intervened. I don't see that improving, frankly, no matter how the healthcare laws change.

The reality is that, absent extremely strict laws governing health insurance companies, they WILL screw their customers, just as banks will, absent strict laws governing them.

Issues exist with the ACA. But worse issues existed prior to its implementation. I don't have the answer. But "voting the bums out" is simply too easy, and, ultimately, ineffective an answer. The question, to my mind, is, "How do we improve on what we now have?" rather than "How do we dump it and start all over?"
 
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