One of several likely reasons is that the number of doctors leaving the workplace is increasing without enough new ones to replace them. A poll of more than 600 medical groups, released last year by the Medical Group Management Association, found that 40 percent reported they had a doctor leave or retire early — because of burnout.
And the shortfall of doctors is projected to only grow, especially for those in primary care. There, we may see a deficit of up to 48,000 doctors by 2034, the Association of American Medical Colleges says. “It’s very concerning for older adults,” says Terry Fulmer, president of the John A. Hartford Foundation in New York, which works to improve care for older adults. Many “need primary care to stay on top of any kind of chronic disease.”
But certain steps may help you get appointments when you need them or find a new doctor when the time comes.
How to get faster primary care
For a condition that’s annoying but not critical, first call your doctor or access your primary care physician’s online scheduling tool, if there is one, to see how quickly you can snag a spot. But that doesn’t always work, so try the following if you’re too sick to wait even a couple of days:
Put your name on a waiting list. Doctors’ offices often get last-minute cancellations. So book the appointment you’re offered but ask to be put on a waiting list. If you can be flexible about dates and times, tell the office staff so that they contact you with anything that opens up.
Be ready to act fast. Make sure you’re clear on how the practice fills appointments that open up at the last minute. For instance, will they phone you, text you or message you on the patient portal? “Usually, you don’t have much time before they move on to the next patient, especially if it’s a same-day or next-day cancellation,” Fulmer says.
See someone else in the practice. You can ask whether another physician there has a more open schedule. But if the office has a nurse practitioner or physician assistant, you may find that you can get an appointment with one of them pretty quickly. State laws vary, but generally, nurse practitioners and physician assistants can do many of the same things a doctor can, including diagnosing and managing a variety of medical conditions and writing prescriptions.
Plus, “their education often emphasizes patient-centered care, which means they may listen more,” says Peter Hollmann, a geriatrician and chief medical officer for Brown Medicine in Providence, R.I. Case in point: A 2021 review of 13 studies, published in the International Journal of Nursing Studies Advances, found the care given by NPs in primary care was equal to — and sometimes superior to — that of doctors.
Use your doctor’s network. The hospital or medical system your provider is affiliated with may help you find a same-day appointment with a different doctor (and practice). Check online, using the name of the facility and “same-day appointments.”
Get video care on demand. If you’d rather not leave home and cannot quickly get a telehealth visit with your doctor, ask university hospitals, medical centers, health insurers or telehealth companies to help you “meet” with another medical provider online. These are often same-day appointments. When we checked the Yale New Haven Health website, for example, it had available openings within the hour.
Try a convenient care clinic. You can go to a nearby urgent care clinic, a walk-in facility staffed by doctors and nurse practitioners. Another option is a convenient care clinic, which are walk-ins staffed by nurse practitioners and physician assistants. They’re often in chain pharmacies. Both types of facilities should send notes and recommendations to your primary care doctor after the visit, but it’s wise to confirm that they do.
How to see a specialist sooner
Can’t get an appointment with a new specialist as soon as you’d like? Book the first available opening and ask to be put on a waiting list. Consider these strategies, too:
Lean on your primary. Instead of struggling to book an appointment with a busy specialist on your own, ask your primary care provider for assistance, says R. Sean Morrison, chair of the Brookdale Department of Geriatrics and Palliative Medicine at Mount Sinai Hospital in New York. He or she can talk to the specialist’s office and explain why you should be seen in a timely way or determine whether another specialist who is more available may be just as appropriate.
Ask about an e-consult. In some cases, your primary care doctor may be able to discuss your health problem with the specialist. These doctor-to-doctor consultations are typically done online and may yield helpful information before your appointment or cancel the need for an in-person visit.
Check other locations. If the specialist you want to see has multiple offices, ask if there is more availability in one of the other places.
Call your health plan. If you’re having a hard time getting in to see a specialist (or any provider), contact your health plan’s member services department, says Michael Hochman, an internist in Los Angeles. “Health insurance companies have service-level standards, which includes the expectation that you can get in to see a specialist within 30 days if you need to,” he says. They may be able to help you find a different specialist your PCP is comfortable with who can see you sooner.
Use waiting time well. Ask your PCP if doing certain tests ahead of time might help the process move more quickly once you see a specialist. “If you do need to wait for a while, it’s ideal to get at least some of the work-up done before, so the specialist already has all that information in hand when they see you,” Morrison says.
How to find the right new doctor
If you’re looking for a new PCP — because the strategies here have not worked well enough, or your current doctor is leaving the profession or retiring — three steps can ease the way.
Cast a wide net. Ask your friends, family members and neighbors whom they go to and if they’d recommend them, Hochman says. Also, check with specialists you see and anyone you know who works in health care. Contact the practices that sound appealing.
Check availability. First, find out whether the doctor you’re interested in is taking new patients and accepts your insurance. (Using the name of a health-care professional or current patient may help if the doctor you decide on has a waiting list for new patients.) Then, in addition to considering how convenient the location is, the Department of Health and Human Services recommends inquiring about office hours (including nights and weekends), how long it typically takes to get appointments, whether virtual appointments are available and who can see you if your doctor is unavailable. You’ll also want to see whether the practice has nurse practitioners and physician assistants, and which hospital system the doctor is affiliated with.
Look for an age-friendly philosophy. That you want a doctor who is knowledgeable and respectful goes without saying, but as the years pass, it’s also wise to seek age-friendly care. This doesn’t always mean geriatricians; they are few and far between. The truth is, if you’re in relatively good health, you may not need a geriatrician, Hochman says. Instead, ask if the practice focuses on the 4Ms: what matters (your goals and priorities); medication safety and appropriateness; mentation (cognition and mood); and mobility (ways to keep you moving).
If you’re finding it hard to get into a new practice, you might even consider looking for a geriatric nurse practitioner or advanced practice registered nurse to serve as your PCP, Fulmer says. The 2021 review in the International Journal of Nursing Studies Advances found good evidence that nurse-based care — including geriatric care — improved overall patient care and outcomes.
Copyright 2023, Consumer Reports Inc.
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