Recently, a friend mentioned that her sister had just moved to Boston and was looking for a doctor. He asked for a recommendation.

Let me contact my friend. He is on the faculty at Harvard Medical School and at MIT. I bet he will know the best doctors.”

Just like old times, right? When you need medical care, you ask a local doctor you trust.

His answer? “Big problem.”

There are no PCPs (primary care physicians) taking new patients at either MGH (Massachusetts General Hospital) or BWH (Boston Women’s Hospital). It is virtually impossible for someone to choose his internist anymore. Everyone’s practice is closed. You can go to a practice where a junior person will be building up a panel. Those practices are either institution-based (e.g., Health Care Associates at BIDMC, Beth Israel Deacon Medical Center) or private groups. Can she afford a Concierge practice?

He concluded with, “I need one myself.”

 

Physicians not accepting patients

I advise friends and family to avoid doctors when possible. I never thought avoidance would be enforced en masse from the physician side.

Many people believe only uninsured people have difficulty seeing physicians. Earlier this year, a Maryland boy died of a brain abscess from an infected tooth. His mother tried to get dental care but nope, no room at the inn.

Twelve-year-old Deamonte Driver died of a toothache Sunday.

A routine, $80 tooth extraction might have saved him if

  • his mother had been insured,
  • his family had not lost its Medicaid,
  • Medicaid dentists weren’t so hard to find, and
  • his mother hadn’t been focused on getting a dentist for his brother, who had six rotted teeth.

As the proverb goes,

For want of a nail, the shoe was lost.

For want of a shoe, the horse was lost.

For want of a horse, the rider was lost.

For want of a rider, the battle was lost.

For want of a battle, the kingdom was lost.

And all for the want of a horseshoe nail.

For want of a dentist, a young boy’s life was lost. Not your problem, you think. This is an aberration. Read on.

 

A national health plan and its unavailable doctors

A national health plan assigned a primary care physician to a friend living in Maryland and a partner in a District of Columbia law practice. She called to make an appointment.

I’m sorry. The doctor is not accepting new patients.”

She started calling the available physicians on the health plan’s website.

One by one, she heard “I’m sorry. The doctor is not accepting new patients.”

She called the health plan.

I cannot find a physician who is taking new patients. Can you recommend someone?

To find a doctor for you, we would have to call each one, just as you have to do.”

Isn’t finding a doctor one way health plans justify the 30% overhead they cost the system? If that is not enough incentive, many states have laws requiring health plans to have available primary care doctors and to give these names to their members.

Maryland’s statutes read

2) A carrier shall notify each enrollee at the time of initial enrollment and renewal about how to obtain the following information on the Internet and in printed form:

(i) a list of providers on the carrier’s provider panel; and

(ii) information on providers that are no longer accepting new patients.

(3) (i) Information provided in printed form under paragraphs (1) and (2) of this subsection shall be updated at least once a year.

(ii) Subject to subsection (n) of this section, information provided on the Internet under paragraphs (1) and (2) of this subsection shall be updated at least once every 15 days.

What happened, well-known National Health Plan?

What happened, Maryland?

Margaret Cary, MD, MBA, MPH
Maggi is a family doctor and leadership coach who engages her audiences in highly interactive presentations. Maggi is a doctor’s doctor with a physician’s mind and a friend’s heart. As an executive coach, she blends a scientist’s thinking with empathy. She is a constant learner and serial focuser with a lifelong passion for sharing what she’s learned. She is an inspirational motivator, occasional humorist, and excellent listener and storyteller. She translates the latest research in leadership development into her coaching process and into entertaining and highly interactive presentations. She is an author, trainer, facilitator, and teacher (Georgetown University School of Medicine). Her authenticity and ability to communicate and connect emotionally with her audience through storytelling—combined with just enough humor—result in rave reviews and standing ovations. She embodies a warm, sincere approach in sharing lessons learned as she guides you in creating your own Leadership Expedition. Email Dr. Cary at drcary@thecarygroupglobal.com to learn more.

2 COMMENTS

  1. There would be enough providers in Boston if they practiced medicine like the rest of the country but according to the Dartmouth Atlas and others providers there see patients far too often with little impact on the quality of their care. Providers never have open hours in their schedule so they have learned to fill it up with the highest paying patients – those with high end insurance polices that pay a premium for the Harvard name.

  2. Mea culpa. As my Harvard source gently told me, BWH = Brigham and Women’s Hospital and BIDMC = Beth Israel Deaconess Hospital. What can I say? I’m only a country doctor.

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