Waiting Times

Robert Farley wrestles with the horrors of socialized medicine:

So, after a year of trying to make my cholesterol problem go away by ignoring it, I decide to finally get my prescription of Zetia refilled. I call up the clinic to ask about a refill, and get told that I have to go and see the doctor again. This isn't terribly surprising to me, so I go ahead and schedule an appointment. Unfortunately, the first appointment available is in two months. Fine; I just hope that I don't have a heart attack between now and then.

Oh. Wait. That happened right here in the United States of America. Waiting for appointments -- can you imagine? The horror, the horror.

Comments

? You don't take a prescription for a year and then expect immediate attention ?

When you made the appointment what did you say you wanted?

Third question. How do you know your cholesterol problem didn't go away when you ignored it?

Posted by K | July 13, 2007 12:36 AM

Ahh, argument by anecdote. I take cholesterol medicine, and I can get an appointment with my doctor in minutes. I just made one for tomorrow 15 hours ago.

Posted by James Robertson | July 13, 2007 12:42 AM

While relying on anecdotes to argue is indeed fallacious, they're useful in illustrating abstract truths.

Posted by Eric | July 13, 2007 1:25 AM

The big problem with this debate is it's completely dominated by anecdote, from both sides. But not without reason. It seems to me the complexity of the issue is so overwhelming and so removed from average folks, even from doctors themselves, that anecdote is the only information many people have.

Posted by shecky | July 13, 2007 1:28 AM

It's traditional in America for doctors to not charge for telephone calls, so they have an incentive to insist upon office visits, which are charged, but which are less efficient in many situations for both patient and doctor. I believe lawyers charge for phone calls, so they are more willing to give advice over the phone.

Posted by Steve Sailer | July 13, 2007 1:45 AM

If anyone tries to get into a specialist as a first time patient a two month wait is nothing. Unless its dire, you have a long wait since they usually have only one day a week set aside for new patients.

Posted by Rob | July 13, 2007 1:51 AM

I suspect most doctors would be reluctant to prescribe a drug over the phone for a patient who hasn't been seen in a year, for what seems like obvious reasons to me. Since Farley's cholesterol hasn't gotten under control after a year of using one medication, perhaps a reevaluation is called for, as refilling a possibly ineffective medication would be pointless or even dangerous.

Of course, all this is beside the point and may have nothing to do with difficulty actually scheduling an appointment.

Posted by shecky | July 13, 2007 3:05 AM

I'm a proponent of nationalize healthcare but, please, can there be a rule that increases one's financial liability if they do stupid things like this guy does?

If you ignore a life threatening condition, you're going to get sick. You're probably going to die. I don't have a problem sharing the burden of health care costs. I have a problem with paying for other people's outright stupidity.

Posted by Thomas | July 13, 2007 5:52 AM

in the Gilliard thread, which is ostensibly closed.

MY, call yr sysadmin...

Posted by Doug spots comment spam | July 13, 2007 5:58 AM

True ancedote...Moved to chicago land from pittsburgh. Time for my yearly gyn exam/pap/mammo. Found 5 PPO mds within 10 miles of my home. The first 2 I called were not taking new patients. The third 4 month wait for appt. Fourth, 3 mo wait...took that one and never called the fifth. Went to appt and got referral for mammo...when I called to schedule there was a 6 wk wait. The md did not do blood work but gave me a referral for the lab work...1 week wait to have blood drawn. Really.

Posted by jerri | July 13, 2007 8:28 AM

The argument isn't by anecdote. It's a rebuttal to the arguments against single payer which use similar anecdotes. It's implicitly noting that their arguments by anecdote (all the long waits) are invalid.

Posted by Jeffrey Davis | July 13, 2007 9:40 AM

Waiting? So what else is new, and why is that such a big problem?

Of course some people find the easy way around it by clogging up the emergency rooms with common cold symptoms. Honest to God--and I know you don't want to hear another anecdote--I spent three hours in an ER with my neighbor at 2:00 a.m because she had constipation pains.

Posted by susan | July 13, 2007 9:42 AM

Since we are engaging in anecdote here about waiting times, let me add a couple.

At the moment, I have no health insurance (my girlfriend is working on the paperwork to get me covered by her company as a domestic partner). One one occasion this year when I had a respiratory infection, I went to a walk-in clinic nearby. Waiting time was a little less than an hour, and the cost was about $80, but I got free sample meds, so I saved about $30 on prescriptions.

Another time I needed to see a specialist, when I got a scary-looking rash after using the whirlpool at a gym. I called a couple of local dermatologists, one of whom only worked a few days per week, and the other who was booked until the following Monday (this was on a Friday). I pressed the receptionist a little and she suggested calling back in a couple of hours to see if there were cancellations. Called back, there was one, and I got seen that day. Cost of the office visit was about $130, I think, but again I got the prescription meds free (samples).

BTW, Steve Sailer makes a good point about physicians and phone calls. I've had some physicians refill a prescription after a phone consult, but this does cut into their revenue model so usually they ask for you to come in to the office.

Posted by Fred | July 13, 2007 9:42 AM

The presence of long waiting times seems to suggest that the market isn't working as efficiently as it could. The solution is not a nationalized program, but rather to free up the market. One way to do this, it seems to me, is to reduce the impediments to becoming a doctor. In order to do that we need to reduce the influence of the AMA who understandably only concerned about their current members and would resist large numbers of new doctors. There is a shortage of med schools in the US, and the AMA is one large reason why. my 2 cents.

Posted by Nick | July 13, 2007 11:42 AM

The problem here is with the moron who stopped taking his medicine for a year, thinks cholesterol is going to kill him in two months, and that if he could only take it for the next two months he'll be ok.

Not having cholesterol medication for 2 months after stupidly no taking it for the previous 12 is hardly the same as having to wait in pain for 2 years for a new hip.

Posted by Dave | July 13, 2007 12:45 PM

Represcribing medication without seeing the patient would be neglient at best. Doing the Rx after a phone call likewise.

Physicians can refill over the phone for on-going patients who have been seen recently for maintenace drugs (e.g., maintenance doses of thyroid replacement).

In most communtities (not all) there are young FPs taking patients, a few phone calls could lead to an earlier appointment.

In many communities it is difficult to find an Ob-gyn, often because of the malpractice crunch on OB services. Establish a relationship with an FP who can then speed up a referral (also, some FPs still do routine gyn exams, expecially in rural areas).

Posted by save_the_rustbelt | July 13, 2007 3:26 PM

Nick is hilarious! Yes, we need the people who couldn't get in to medical school to become doctors!! That'll solve all of this, not eliminating pointless middlemen (insurance companies). Free up that market, Nick! If that happens, the medical community may finally be able to enjoy the high level of esteem people have for lawyers...

Posted by Father Figure | July 15, 2007 1:03 AM

1. Robert Farley, the writer of this squib, is a 33 year old professor at the University of Kentucky. I assume his "clinic" was at the university. The MDs there, as I do, have teaching and research responsibilities which tend to limit the time in clinic. If he felt that pressed to see someone, I would imagine that he could have seen any number of private MDs in his area.
2. If Farley thinks that his cholesterol will improve by ignoring it, he's a fool.
3. If he thinks that government-run health insurance will improve his waiting times, his access, or his hypercholesterolemia, he's an even bigger fool.

Posted by orthodoc | July 17, 2007 7:11 PM