The other day I went in for my annual exam. During the breast exam, the nurse practitioner noted 2 flat moles on the side of my left breast that she felt I should get checked out.
Both have been there for quite awhile, and neither show any symptoms that are worrisome (bleeding, dark color, change in size, etc.), but when I got home I figured it was a good idea to call a local dermatologist to get in for an exam.
I called an office near my home and told the person who answered the phone what was going on, and she replied that the main dermatologist was scheduling for SEPTEMBER, but that I could see a physician's assistant in April. Needless to say, I went with April.
Isn't that just crazy? That is the longest appointment time I've ever been given. Of course, you have to schedule your mammogram 5-6 months in advance now, and to get an annual exam I have to call 4 months ahead and get on a waiting list. Why is it so hard to get in to see a doctor and get these important tests done?
I suppose if I called back and said these moles were starting to bleed or change in size they'd get me in sooner. At least I hope so! Oh well, April isn't too far away and in the meantime I'll keep an eye on them.
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I find that nurses and physician's assistants are being used more and more for doctor's visits. I have to sometimes actually specify that I want to see a doctor - when I call about seeing a doctor! And my wait can then triple or worse.
Physician's assistants do pap tests, breast exams, and can make a diagnosis (within reason, say flu or a chest infection or UTI) and they can write prescriptions as long as a doctor oversees it.
I wonder why? Managed care? Too many patients? Overworked? Greedy? It sometimes seems the patient is the last to know...
February 22, 2008 - 1:35pmThis Comment
According to the Health Affairs journal, Emergency Room wait times ARE longer *and* the number of emergency room departments in the U.S. are declining.
The median wait time to be seen in the ER, in 1997, for "all adults": 22 minutes
Now, the median wait time (2004) is: 30 minutes
This does not only affect "all adults", as it includes patients with real medical emergencies, too!
In 1997, a heart attack patient would wait: 8 minutes
In 2004, a heart attack patient would wait: 20 minutes!!
The article sited several factors, including:
1. Higher demand of services: the number of emergency room visits, from 1990 to 2006, increased 36%
2. Decreased ER departments: in the same time period, the number of 24-hour emergency room departments decreased 13% (from 1990 to 2006).
Other factors mentioned include an increased aging population, shortage of nurses, and as Tina mentioned, a shortage of Primary Care doctors. So, it's not that it only seems like there is a longer wait...there are significantly longer waits at the ER. Sounds like there are some extremely important issues that the nation needs to look at in the health care system...I'm not even sure where to start!! Looks like large institutions are seeing this as a serious issue, as Harvard Medical School and the Institute of Medicine are currently conducting studies as to this unnerving trend...let's hope there are some solutions...quick!
Sources: Washington Post article (January 15, 2008), and Center for the Advancement of Health article, "What does the E in ER stand for?". Original study published by the Health Affairs journal (from the American Hospital Association).
February 21, 2008 - 1:59pmThis Comment
Then, there's emergency rooms, where there always seem to be long waits. Waited up to five hours once. Granted, I probably wasn't a high-priority patient compared to some of the other people coming in, but it still seems unnecessary.
Wondering if this has anything to do with the looming doctor shortage I keep reading about?
February 21, 2008 - 9:03amThis Comment
The other side to this is that you wait 4 months for the appointment, half an hour in the waiting room, and you're out in 15 minutes. Go figure.
February 20, 2008 - 6:36pmThis Comment