This Is Ridiculous

[ladysprite]

There is something deeply, fundamentally, enragingly wrong with our medical system.

I admit, I hate going to the doctor, and I will postpone it as long as humanly possible; usually longer than is safe or rational. But a large part of that comes from the fact that, on the rare occasions that I get up the guts and activation energy to go, it turns out that I can't get an appointment anywhere for love or money.

This is the second time I've tried to get an appointment with a dermatologist, mostly because I've finally hit the 'actually worried' stage about the funny-looking mole on my back. It's tiny, but it has every single hallmark of being something dangerous. Unfortunately, the soonest any of the local doctors can see me is the end of September.

This is better than last time I tried, though, for another problem - when out of four different clinics, not a one could get me in in less than two months. That time, I just gave up and didn't go at all. And, to be completely honest, that's what I think I'm going to do right now. By the time I get in anywhere, if it's malignant it'll be metastasized beyond treatability - and if it's benign, I will have wasted a lot of time and frustration for nothing. So honestly, there's absolutely no point in going. Screw it.

And this is all triply frustrating in the face of my day job, where people call at 10am, demand an appointment before 2pm the same day, pitch a screaming fit at the receptionist if we can't do it, make me cancel my lunch break to see them for their "emergency" (usually either vaccines or a problem that's been going on for at least 3 weeks), and then ultimately fail to show up, deciding that they didn't feel like coming after all.

Right now, I hate the world. MD's most of all.

Comments

[tafkad.livejournal.com]

If you are truly concerned, you have every right to invoke the word 'emergency.'

[ladysprite.livejournal.com]

I did. That *was* their emergency offering.

[z-gryphon.livejournal.com]

Well, worst comes to worst, you do know quite a few doctors who could probably whip off a small skin growth without difficulty. That sounds facetious of me, but it really isn't meant that way. You'd probably need to do followup with People Doctors afterward in order to straighten out the paperwork, particularly if it ended up being something that requires further treatment, but at least you'd know in short order.

[citabria]

I'm amazed that you're facing those delays while living so close to Boston. One of the things I really liked about living near/working in NYC was that I rarely needed to wait more than 2 weeks for an appointment -- even with a doctor I'd never seen before. Usually, if I did need to wait more than 2 weeks, it was because my schedule was difficult to schedule around. The only exception was my gynecologist -- I'm used to up to 6-month waits, except in an emergency.

It seems to me that, for a mole, it's worth it to schedule the appointment. You can tell them that you're concerned and that you'd be interested in coming in sooner if someone cancels -- people always do. A visit to a dermatologist is rarely considered an emergency, unless you're directly referred by your doctor, and even then there's usually a wait -- I doubt that Ds hold open as many "emergency appointments" as other specialists do. So, even though I understand your frustration, I'd suggest breathing deeply, calling back, and scheduling the appointment. Just to be safe.

[mindways]

In my experience, it varies drastically by office. Some doctors around here are scheduling 8 months out, some 3-4 days out.

(By type of appointment, too - I have to schedule ~3 months in advance with my PCP's office for my yearly physical, but can generally get an appointment in 1-3 days to check out an acute problem.)

[pale-chartreuse.livejournal.com]

I've had suspicious moles removed at my regular md's office without a problem. They're going to send it to a lab for diagnosis in either case. The "do I need to see a specialist" part of this, is part of the annoyance. You can let your regular dr. make that call, if it's needed.

[ladysprite.livejournal.com]

That'd be assuming I have a regular MD.

My one experience with dealing with a PCP was so ragingly unpleasant that I fired them and haven't been back. I just go to specialists as needed....

[pale-chartreuse.livejournal.com]

True enough. If you have a Gyn/Ob, it still could be a possibility though. I've had great dr.s and fired some as well. Right now I'm making do with an ok large practice, so that at least I can get seen by someone.

[mindways]

Gods, I hate that.

I've had good luck getting appointments in 7-10 days with Dr. Taub, a dermatologist in Medford Center... but I'm extremely flexible as to when I can go in, so YMMV.

*hugs*

[ladysprite.livejournal.com]

Just got off the phone with his office. Apparently he's on vacation for the next two weeks, and the first opening he has at all is in the third week of September. :(

[mindways]

*headdesk* Ah, well. One of the problems with a single-provider practice...

(Though from the list in your next post, it sounds like he clocked up better than most, which is sad given the circumstances.)

[filkertom.livejournal.com]

No advice, just support and hugs.

[dagibbs.livejournal.com]

*hugs*

Yeah, I tend to hate the delays, and the fact that even if I have an appointment with a Dr, it will NEVER actually occur when I make the appointment, and that I'll always have to waste time in the waiting room.

[ladysprite.livejournal.com]

I can deal with the waiting-room delays; I understand that. When you're forced to book every 15 minutes, you're bound to run behind - stuff never goes as quickly or smoothly as it's supposed to.

It's just the lead-in that grates on me. I've been calling around for an hour now, and most places are booking in late October right now. One place was booking in March, and when I said it was an emergency, offered me a fit-in in January.

[dagibbs.livejournal.com]

If stuff never goes as quickly, then you should know that, and not book people in.

I find it a statement that my time is far less important than the Dr's time. I am expected to be there on time, and then wait an hour or two for a 15-minute appointment.

Lead-in -- that doesn't grate nearly as much. Hopefully it means someone is trying to manage their load. Of course, they don't need to be impolite to you about it.

[wcg.livejournal.com]

I have no experience of using these folks, but they might be worth checking out.

[leanne-opaskar.livejournal.com]

Wow. I'm shocked that it takes so long to see a doctor. O_O Usually if I need to see someone, I'm slotted in within the next three days, specialist or no!

Is Boston just woefully short on doctors or something?

*hugs and much sympathy*

[leanne-opaskar.livejournal.com]

On further thought -- have you considered crossing state lines and attempting to get treatment elsewhere? Might be easier.

[quietann.livejournal.com]

Alas, most insurance has a pretty strict list of doctors a person can see... but looking in New Hampshire might be a good idea.

From what I have heard, the further one gets from Boston, the easier it is to get an appointment. We have a severe shortage of primary care doctors around here. There are more specialists but even they book out months in advance. However -- for something that needs multiple visits, and for emergencies, once you get in for that first visit and establish a relationship, getting more visits in a timely manner is *much* easier.

[leanne-opaskar.livejournal.com]

*nodsnods*

I understand about the whole insurance thing, but it sounds like ladysprite isn't using it because of the hassle with her PCP? For a procedure which sounds pretty simple (like this), I would think it would not be too expensive to pay out of pocket?

I am really sorry to hear that there is a shortage of doctors in the area. /: Not good. My sympathies!

[starcat-jewel.livejournal.com]

If you're worried that it might be malignant, don't just give up. For one thing, skin cancers are generally slow-growing; 3 weeks isn't going to make a huge difference, and that's what you said you could get with Dr. Taub.

I would not want to see what happened to maenad because of doctor negligence happen to you because you decided to give up trying.

[glinda-w.livejournal.com]

Seconded.

[meranthi.livejournal.com]

Ugh. We just had that problem with our daughter. She got a black eye in May and it's still tender. Got in to see the pediatrician just fine, but he wanted a second opinion. This was in early August. First appt? Mid-Sept. For something the doctor wanted checked out immediately.

Yeah. So very very very very wrong.

[joannahurley.livejournal.com]

Contrasting the "service" provided by human docs with that provide by vet docs shows that something is seriously wrong on the human side.

Do you have walk in clinics? Do they do something like this? That's what I do instead of a primary. I mean, I go to a primary, but just for checkups and to make him write a prescription. Generally I ignore him the rest of the time because I am Not Impressed.

[felis-sidus.livejournal.com]

By the time I get in anywhere, if it's malignant it'll be metastasized beyond treatability - and if it's benign, I will have wasted a lot of time and frustration for nothing.

There are at least two other possibilities:
1) It's a pre-cancerous lesion and can be successfully removed any time in the near future, but could become dangerous in the far future. Which makes three weeks to a month just fine as far as timing goes.

2)It's a slow-growing cancer which can be treated completely successfully within the near future, but shouldn't be left indefinitely. This also makes three weeks to a month just fine.

If you're really worried, go to a hospital walk-in center. Tell them you don't have a primary care doctor and are very worried about the changes in the mole. They may or may not remove it on the spot, but they at least will let you know how urgent, or not, removing it is.

Situations like this are why it's worth the effort to find a regular doctor. Yes, it's not likely that the first doctor you try will suit you, or even that the first few will suit you. Doctors are humans too, with their own personalities as well as skills and interests. It's not realistic to paint them all with the same brush, and that's a good thing because the doctor who's perfect for you might not work out for someone else at all, and might drive yet another person straight up the wall.

It's worth the effort to keep looking. It took me many years to find my first primary care doctor. I had initial appointments with at least six different gynecologists when I decided to change my GYN specialist. In both cases I ended up with doctors with whom I shared wonderful working relationships and mutual respect, as I do with my current physician.

What I usually suggest to people who are looking for a new primary care doctor is to start a list of things that are important to you in a doctor. Keep it handy and edit it as often as ideas occur to you. When you think it's a pretty good description of what you need, share it with friends, and ask if they know of a doctor who comes close. When you get a recommendation that seems worth looking into, schedule a routine inital visit. It will probably be two to three months into the future, at least. It's going to be a longer-than-usual appointment, as first visits always are, and most practices only have a small number of spots each week for this kind of visit.

Some people recommend telling the doctor outright that you're conducting a search for a new doctor, and may or may not continue to see him/her. I say play that by ear. Sometimes it works better just to go through the visit as though you're going to be a permanent patient. If you have any concerns about the interaction, though, bring them up as they happen. How the doctor responds will tell you a lot about how it would be to work with that person on other issues. When it comes time to leave, if you aren't sure you want to return, just don't make another appointment. If asked to do so, just say you'll get back to them.

If you decide not to return, and if you feel comfortable doing it, writing the doctor a letter explaining briefly and as nicely as possible why you aren't going to schedule a follow-up can be helpful to the doctor. Often, people just disappear after seeing a doctor, leaving the doctor wondering what went wrong. And they do wonder, and care, about that.

When you have your first visit with the next potential doctor, it's not necessary to include doctors you've seen only once in your list of prior physicians unless they turned up something the new doctor needs to know.

This may seem like a lot of trouble to go to, and it is. But having a doctor who knows you and with whom you're comfortable saying anything at all is important enough to make the effort.

Good luck with the mole. Please don't cancel that appointment!