All good Docs quit

All the good Docs in town have quit practicing. Are you seeing this in your area? What is this about?

Seeing some bum makes everything worse, not better. I’m comfortable seeing a primary care who can simply write prescriptions, but I’m a little confused about this market reshuffling and the implications.

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COVID brought teleheath into the mainstream.

My insurance (CIGNA) is advertising it as part of one’s overall health plan.

I haven’t seen my current endo IRL ever—it’s been all video visits for 2 years and I’m not even 2 miles from her office.

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I feel like a LOT of people have been retiring lately too - I work in a hospital and we’ve had a rush of retirements over the past 2 years, partly due to Covid and partly due to pension plan issues. It seems like a lot of docs in my area (heavily saturated with physicians) are older and I’m worried about what will happen when they are all retired.

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We have a huge shortage of doctors. It’s costly to live here and they really don’t pay that great. We have federal fill in doctors because of our shortage. A bunch of doctors quit or left and the people that lost their doctors were even told to go to urgent care for a while for their basic needs.

We don’t have an endo on our island but we used to have one that “visited” once a month. The DE here used to handle most standard diabetics for care. But with covid the endo switched to video visits as a safer alternative. She likes it as she doesn’t really need to see people in person and she isn’t trying to fly back and forth. It’s worked fine with me and she has always been good about responding quickly to any med request or question by e-mail.

I heard our medical group is pressuring doctors to go back to in person visits more. My hubby prefers in person visits for his doctor while I prefer video visits unless for some reason it needs to be in person. I like the option of video visits and me having to do routine visits with a few doctors makes it easier.

But yea, more and more of a shortage. I heard that is going to worsen.

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I lost my long time Rheumatologist this year. I just feel awful about it. He was one of the great ones.

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A lot of my doctors retired, well some anyway. One of them had already gone to one of those big conglomerations and it was almost impossible to get a proper prescription filled or get in contact with him and then he retired and didn’t even tell anybody- my longtime dermatologist.

I’ve been trying now for over a month to try to get them to prescribe the right steroid foam for me for my eczema which is now severe at flare ups, and that’s the only thing I’m allowed to use that treats it all. I saw someone who was not a true doctor but the next step down told her what I needed and still they keep calling in the wrong thing, what a bunch of idiots. You can’t call the office and directly anymore, only on very rare occasions, you get shuffled off to a call center which sounds like it may be in Russia, lol.

So I have tons of tubes of the cream which are useless to me because they irritate me. Another thing that happened was my other steroid ointment, they called in like 25 tubes of it, lol, so at least I can say I’m not gonna have to order it for another year and a half at least. They should start doing that with everything that lasts a long time and then you only pay one co-pay.

I have not gone to anybody except my endo and my cardiologist and finally my eye doc recently and my hematologist because I’m now on a blood thinner full-time again. I have not seen my GP since I had Covid and that was on video appointments, but I guess I’m going to have to go back there at some point- everyone there are such idiots, I’m really dreading it. I stopped trying to get vaccinations there now- I just go to the pharmacy because every time I made an appointment there when I come in they told me they didn’t have the vaccine because they gave it to someone else. I still have to get my flu shot but it took me a while to recover from my last Covid booster since I always have a reaction to every vaccination and I’m just delaying it because I’m masking when I’m teaching anyway and I’m halftime in teaching online now again thank Goodness. It takes me a month to recover from the flu shot. Plus I have to get another pneumonia vaccine and shingrix.

If you get one good doctor I guess you should be happy, that just seems that is what is happening lately. My brothers new go doctor is a crook- he was refusing to RX prescriptions for more than 30 days and he was trying to make him come in for an appointment each time. I kept calling the office and told them can you please rx 90 days like everybody else does and they kept saying they did it but they never did. Then finally my brother called them and got them to call in to the mail order pharmacy by some miracle.

Then they were sending him bills for an appointment when he didn’t even go in there, he just called up to get a prescription refilled. And they told him he was not going to have to pay that because the doctor supposedly wasn’t selected as his gp, although he was. Well I finally looked up the doctor online when he received another bill for like $500 again and it turned out his doctor was in a fraudulent enterprise with a pharmacy in Kentucky I think and instead of losing his license or being charged he had to pay $125,000 fine. The legal document was published online.

It turned out though that the bill was actually for his cardiologist who he saw only once after he got out of the hospital, he has afib now… they sent him to a collection agency and I don’t even remember getting any other bill for that. The first letter stated that he was going to be sent to a collection agency if they didn’t hear from him on the day that was already passed lol. Fortunately when he called the office they were very apologetic and they were going to try and take care of it. Let’s see what happens.

Very sadly there have always been a lot of fraudulent people. In medicine. And they need to get the hell out of it…I have never met so many vile, disgusting people in my life as during the murder of my father during that last month. They are a disgrace to the profession. It is not that time like when my uncle was a doctor, but even then there were a lot of negligent things happening which were covered up which he tried to report on one occasion. He saved someone’s life who almost died due to the negligence of a higher up doctor, his hospital superiors wouldn’t let him report it because they said it would ruin his career.

My cardiologist office I could never get anybody on the phone there, literally you have to wait for 20 minutes or longer, sometimes and a woman I spoke to once told me it was because everybody keeps quitting there, that’s why. Then they don’t charge me my co-pay when I’m there and I have to call them and keep sending in checks, that they never get, it is such a hassle. My father was going there too before he died and it was the same thing, there were a couple of times when he was too weak for me to get him there, he was wheelchair-bound and an invalid at that point due to covid, and I couldn’t even get ahold of anybody to tell them to cancel the appointment, so ridiculous.

There’s a lot more that I could say which is even worse than what I have written here but it would take a novel. If anybody hasn’t realized this yet this is all a sign of the collapse of the society, which began in serious a few years back.

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I want you to exercise caution if anybody suggests remote cardiac monitoring. I want your people to request to see the data collected, just to be on the safe side. They ought to know: 1.) The data exists; 2.) The Doc has actually looked at the data and not just sent you a bill for service; and, 3.) Long runs of concerning rhythm were actually detected.

Just like in diabetes, it’s best if patients get access to data. If patients are prohibited from viewing the data produced by their body, that might be cause for concern.

I tend to have a decent rapport with my doctors, or doctors in general, and from what I’ve read and heard, doctors are suffering from burnout, they are overworked, with too many patients and not enough time. One anesthesiologist told me, while looking for agreement from my gastroenterologist, that he wouldn’t do it again [become a doctor].

Doctors went into the profession with expectations, and things have changed, with fewer in private practice, hence suffering under the scheduling of hospitals or systems. Caring doctors, like pediatricians, GPS, and internists, as opposed to surgeons, are underpaid and overworked. Some might have been traumatized by the horrors of COVID, others feel that the profession they chose is no longer the one they are in.

My most recent visit to an internist had me listening sympathetically to my primary as he was telling me that many of his med school colleagues are retiring early - to him that is 65 - and for him, a driver was that there was not enough time to see all the people that needed him. The conversation was a bit longer than I can describe, with some back and forth as to the why’s, but I could see his eyes watering a bit. There was pain behind them.

On the other hand, my old endocrinologist was still going strong, but in his case, he was mentoring other doctors, and not as responsible for care. Another doctor of mine signed a 10-year lease - he’s 70 - but he is in a private practice with less stress; he is a podiatrist. Plus, as I’ve discussed with him, he has no idea what to do with his free time, other than golf.

Last thought, but my next door neighbor is a radiologist, middle-aged, and normally quiet and low-key, but he was ecstatic when I talked with him, and as I found out, he was retiring. He was absolutely gleeful. He planned a lot of traveling.

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My GP has his own practice. He is 67 and he just had a new center built for his practice. The center will have room for two physicians, a kitchen where staff will teach patients how to make heathy meals, a massage therapist, a pickle ball court, and a space for lectures. He wants to teach people how to have healthier lifestyles.

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My endo recently turned 65 and I asked her after she has been treating me for about 30 years if she is ready to retire as doctors are also retiring everywhere around here. Her kids are grown up and I thought she may be ready to take some leisure time. She said no, that her husband is an engineer in the gig economy and does not always have long term steady contracts. She says that she has no intentions of retiring.

Then I realized how lucky I am as my lipidemiologist in the same practice is 78 years old and when I asked him earlier this year when he planned to retire, he told me that he enjoys his work and will continue to work as long as he is physically and mentally able.

Maybe there is something in our local water that keeps these people sane, eager, and working??? :thinking: My father, an international scientist retired at 90.

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I think a young doctor is the best bet, he or she will hang around a little longer and hopefully outlive you.

My entire life has been a revolving door for doctors who are always moving or switching fields or hospitals or insurers.

It’s big for docs to do the concierge thing no so they don’t have to deal with insurance companies as much and can spend more time. It’s expensive though.

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i am with you

This is a huge problem in my area as private practices are really hard to find since the big hospital conglomerations either put them out of business or almost put them out of business but offer to buy the practice and give the doc the job. The latter is what usually happens. The problem then is that all the doctors who had good service now work for people that just want to churn as many patients through as quickly as possible.

I experienced this change first hand when I was a bit younger. I had seen the same doctor since I was a kid (still do actually) and he worked in a private practice owned by some other doctors who started the office. Eventually they got older and ready to retire so they sold the practice to the local hospital system which owned most doc offices already (they are a “non profit”, though they have no issue at all charging patients absolutely ridiculous amounts of money). The change was very noticeable. Wait times were longer, the office service was poor, and you’d be lucky if you had 10 mins with the doctor. My doctor had enough of it and left the practice. He went to another office that is owned by another giant hospital system, and they were much better, but still some of the same big business issues. Recently he moved from there back to the other company but in a different office. My guess is that he was offered something very generous for him to leave the other. The new place is even worse than the old one I mentioned before, especially when it comes to communication and refills.

The big conglomerates never offer any way to actually talk to your doc on the phone, and though they say “you can send a message to your doc on the patient portal” they never look at or respond to those, and I guarantee it is probably not even the doctor that looks at it but their assistant or another office worker. It is so hard to get prescriptions refilled properly, and it isn’t the doctor that actually does them, it is their assistant. One of my meds was prescribed as 2 per day, but the last 2 times I went to pick it up they had been sent the wrong per day amount (it is a script that needs a refill every time), but the right number of pills. They would only fill for 1/day because that was the instructions and the insurance wouldn’t cover any more because of it, and they couldn’t give me more anyway because of the dosage. They sent in requests a few times and I called and “left a message with the doctor’s assistant” because that is the most that I could actually do. Never got a call back, called again and was even more specific and that I actually had the original prescription to prove it if there was an issue and still no call back and no new script sent in. My only other option would be to make an appointment which would, because of giant conglomerate management, take months to get. Thankfully I already had one scheduled and it is next week. I guarantee that my doc hasn’t even heard anything from his assistant about it.

I had similar problems at a private practice endo I used to see that was very large and one of few available in a 75 mile radius. The assistant did all prescriptions and any paperwork you needed done. I was always having to call to get things fixed and of course never once talked to the doc or the assistant, I could only leave a message and hope. The worst offence was when I needed FMLA paperwork filled out for work. The company my employer uses requires everything to be filled out exactly and no ambiguities or things left blank. It was the most irritating and stressful experience. The doc didn’t fill it out or send it in, his assistant did that, he just signed it. Entire parts left blank, 3 or 4 times they sent in just the first page, the amount of expected absences was not being filled out properly, wrong dates, etc. It took well over a month trying to get it sorted and the office was an hour away and an appointment with the doctor took a long time to get. It finally came time that I had an appointment and I used a photo editor to add everything that was needed onto the sheet typed and took it with me for him to sign. Something no one should have to resort to. He made the comment that he’d never seen the paperwork need to be so thorough before… He was also not a great endo in the first place (I don’t really need an endo anyways so I stopped going there). Like not doing tests I requested because they are “bogus”, refusing to prescribe me fiasp to try (had to have my primary do it for me!), ignoring certain hormone levels that were below range, etc…

Anyways, doctors are pretty tired of the churn and lack of patient care. It is very hard and very expensive to become a doctor in the first place, so less and less people are pursuing it. Ones that do end up working for a big corp because they need the job to pay their loans off and don’t have the means to start their own practices. Eventually many of those will move out somewhere else, or switch jobs because they can’t stand the corporate environment. Older docs retire and there is no one to take their place, then the big systems buy it up.

Can you believe doctors used to actually come to people’s houses? We have fallen quite a long way since that level of service.

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This reminds me of the doctor that calls a plumber to fix an issue in his bathroom. The plumber arrives, fixes the problem in 15 minutes, and hands the doctor an invoice for $200. The doctor looks at it and says that is crazy, how can you charge so much for so little time? As a doctor, I don’t make anywhere near that kind of money. The plumber sighs and replies, I know, I know, as a doctor I could not make this kind of money either so now I am a plumber.

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I will never forget my moms endocrinologist coming to our house in the mid 1960’s. I recall it so much because his car was parked outside with a radio telephone it. When he completed seeing my mom he went to the car and ‘phoned’ is was a radio phone his notes. Inside the house my fathers scanner picked up the conversation. We and everyone else with a scanner heard his note.

As time went on more and more doctors used the service. Soon my dad was listening to every doctor who used one of those things.

Another reason to say thank God for HIPPA.

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