4 ms·

> I showed up for my intake appointment and the young, rushed doctor said they wouldn't enroll me as an official member "Intake appointment"? "Official member

> I showed up for my intake appointment and the young, rushed doctor said they wouldn't enroll me as an official member "Intake appointment"? "Official member"? What kind of system is this?

LeifCarrotson 9y ago
Sounds like a typical American family doctor's office? All of them in my area have long waiting lists. You don't just show up at the front door like it's an auto mechanic's shop, you call to schedule your annual physical. They're typically booked solid for a few months in advance. Calling to book an appointment requires being a registered patient or member of that office. If you want to change your primary care physician, you call around and see which offices are accepting new members. If they are, they'll get your medical records transferred and set you up for an intake appointment where they check to make sure that they know your status, and then you are able to schedule future visits. You certainly don't just call any convenient office and expect to get an appointment in the next couple days, that would be anarchy.
- joncrane 9y ago
  Exactly. You have to be an established patient to get some of the benefits, the most important being (IMO) being able to see a doctor within a day or two if you're really sick. (But not emergency room sick)
  - heimidal 9y ago
    Even as an existing patient, I’ve been quoted wait times of more than three weeks to see my PCP.
    - emodendroket 9y ago
      Me too, but it seems like there's a hierarchy depending on what your complaint is. When I needed to schedule a follow-up post-hospital discharge they had no problem getting me in, but when I had other complaints it was see an NP or wait months.
      - walshemj 9y ago
        Yes as they say that's what the receptionist is to triage patients so that the worried well or those with a cold who want antibiotics dont get seen as quickly as those of with chronic conditions
        emodendroket 9y ago
        I think it's not quite the same as what Gawande describes, but a similar enough idea.
- tonyedgecombe 9y ago
  that would be anarchy Yet it's exactly what we can do in the UK, I remember needing to see a doctor whilst on Holiday in Scotland, I just phoned the local GP and got an appointment the next day.
  - pjc50 9y ago
    That must have been a while ago or in a quiet area; if I want to see my GP I have to either redial and hope from 8am or wait at least a week.
    - tonyedgecombe 9y ago
      It varies, my local surgery has a triage system that brought down appointment times. Fortunately I haven't had to use it recently.
  - deleted 9y ago
    [deleted]
  - maxerickson 9y ago
    A huge percentage of the US population lives within a 10 minute drive of an urgent care facility. Same day appointment, billed similarly to a GP office visit.
    - westbywest 9y ago
      Billing is not always similar. Many urgent care facilities are outright predatory in pricing, to the extent they begin to look like the payday lenders of medical care. It would be a poverty to consider these kinds of operations part of the solution. https://www.nbcnews.com/health/health-care/you-thought-it-was-urgent-care-center-until-you-got-n750906 https://www.nbcnews.com/health/health-care/you-thought-it-wa...
      - maxerickson 9y ago
        Go tell the Texas legislature about it. In any case, I was talking about places that advertise themselves as urgent care and do care in the style of a basic office visit, not about facilities licensed as freestanding emergency rooms. Actual urgent care facilities are a fine option if you don't have a PCP or can't get an appointment.
- walshemj 9y ago
  Its the same in the UK you have to register with a GP's Practice.
- vonmoltke 9y ago
  > Sounds like a typical American family doctor's office? Not any that I have ever been to, and I have been to several across two different metro areas. > All of them in my area have long waiting lists. I have yet to encounter a waiting list. > You don't just show up at the front door like it's an auto mechanic's shop, you call to schedule your annual physical. Actually, I just book an appointment. Only once have I started out with my physical being the first appointment. Calling to book an appointment requires being a registered patient or member of that office. > Calling to book an appointment requires being a registered patient or member of that office. I am not a "member" of my doctor's office, not have I ever been. I just go on ZocDoc or my insurance company's website, pick a doctor, and make an appointment. Sure, some are marked as "not accepting new patients", but I just ignore those. > If they are, they'll get your medical records transferred and set you up for an intake appointment where they check to make sure that they know your status, and then you are able to schedule future visits. I have never had my medical records transferred, nor have I ever had an intake appointment. I just go in, discuss my issues, present any relevant history myself, and go from there. If I ever become dissatisfied, I just start going somewhere else. > You certainly don't just call any convenient office and expect to get an appointment in the next couple days, that would be anarchy. That's all I have ever done, so I don't see how I "certainly" don't. In fact, here is a ZocDoc PCP search using my insurance centered on Grand Central: https://www.zocdoc.com/search?address=Grand%20Central%20Terminal%2C%20East%2042nd%20Street%2C%20New%20York%2C%20NY&insurance_carrier=324&day_filter=AnyDay&gender=-1&language=-1&offset=0&insurance_plan=2778&reason_visit=75&after_5pm=false&before_10am=false&sees_children=false&sort_type=Default&dr_specialty=153&ip=69.191.241.34 https://www.zocdoc.com/search?address=Grand%20Central%20Term... There are seven doctors on that list that I could see today. No intake appointment, no physical, none of this crap you are talking about. So I ask again, what kind of system are you dealing with?
  - overthemoon 9y ago
    It's all anecdotal, so I guess we can all take each other's stories with a grain of salt, but long waits and impenetrable bureaucracy has been my experience, as well. My wife is currently trying to get treatment and she's had to wait months to see various doctors and specialists. We live in a metro area in the US.
- DanBC 9y ago
  > you call to schedule your annual physical. Annual physicals cause harm. You should avoid them unless you meet a reasonably narrow range of criteria. > They're typically booked solid for a few months in advance. Even in our underfunded NHS I can get a same-day GP appointment (if it's an emergency) or within 48 hours (if it isn't an emergency). And that's within a range of provision: pharmacy for general advice; 111 telephone service for advice and triage; GP for general stuff; MIU for minor injuries; A&E and 999 for life threatening injury.

> I showed up for my intake appointment and the young, rushed doctor said they wouldn't enroll me as an official member "Intake appointment"? "Official member"? What kind of system is this?

LeifCarrotson 9y ago

Sounds like a typical American family doctor's office? All of them in my area have long waiting lists. You don't just show up at the front door like it's an auto mechanic's shop, you call to schedule your annual physical. They're typically booked solid for a few months in advance. Calling to book an appointment requires being a registered patient or member of that office. If you want to change your primary care physician, you call around and see which offices are accepting new members. If they are, they'll get your medical records transferred and set you up for an intake appointment where they check to make sure that they know your status, and then you are able to schedule future visits. You certainly don't just call any convenient office and expect to get an appointment in the next couple days, that would be anarchy.

joncrane 9y ago
Exactly. You have to be an established patient to get some of the benefits, the most important being (IMO) being able to see a doctor within a day or two if you're really sick. (But not emergency room sick)
- heimidal 9y ago
  Even as an existing patient, I’ve been quoted wait times of more than three weeks to see my PCP.
  - emodendroket 9y ago
    Me too, but it seems like there's a hierarchy depending on what your complaint is. When I needed to schedule a follow-up post-hospital discharge they had no problem getting me in, but when I had other complaints it was see an NP or wait months.
    - walshemj 9y ago
      Yes as they say that's what the receptionist is to triage patients so that the worried well or those with a cold who want antibiotics dont get seen as quickly as those of with chronic conditions
      - emodendroket 9y ago
        I think it's not quite the same as what Gawande describes, but a similar enough idea.
tonyedgecombe 9y ago
that would be anarchy Yet it's exactly what we can do in the UK, I remember needing to see a doctor whilst on Holiday in Scotland, I just phoned the local GP and got an appointment the next day.
- pjc50 9y ago
  That must have been a while ago or in a quiet area; if I want to see my GP I have to either redial and hope from 8am or wait at least a week.
  - tonyedgecombe 9y ago
    It varies, my local surgery has a triage system that brought down appointment times. Fortunately I haven't had to use it recently.
- deleted 9y ago
  [deleted]
- maxerickson 9y ago
  A huge percentage of the US population lives within a 10 minute drive of an urgent care facility. Same day appointment, billed similarly to a GP office visit.
  - westbywest 9y ago
    Billing is not always similar. Many urgent care facilities are outright predatory in pricing, to the extent they begin to look like the payday lenders of medical care. It would be a poverty to consider these kinds of operations part of the solution. https://www.nbcnews.com/health/health-care/you-thought-it-was-urgent-care-center-until-you-got-n750906 https://www.nbcnews.com/health/health-care/you-thought-it-wa...
    - maxerickson 9y ago
      Go tell the Texas legislature about it. In any case, I was talking about places that advertise themselves as urgent care and do care in the style of a basic office visit, not about facilities licensed as freestanding emergency rooms. Actual urgent care facilities are a fine option if you don't have a PCP or can't get an appointment.
walshemj 9y ago
Its the same in the UK you have to register with a GP's Practice.
vonmoltke 9y ago
> Sounds like a typical American family doctor's office? Not any that I have ever been to, and I have been to several across two different metro areas. > All of them in my area have long waiting lists. I have yet to encounter a waiting list. > You don't just show up at the front door like it's an auto mechanic's shop, you call to schedule your annual physical. Actually, I just book an appointment. Only once have I started out with my physical being the first appointment. Calling to book an appointment requires being a registered patient or member of that office. > Calling to book an appointment requires being a registered patient or member of that office. I am not a "member" of my doctor's office, not have I ever been. I just go on ZocDoc or my insurance company's website, pick a doctor, and make an appointment. Sure, some are marked as "not accepting new patients", but I just ignore those. > If they are, they'll get your medical records transferred and set you up for an intake appointment where they check to make sure that they know your status, and then you are able to schedule future visits. I have never had my medical records transferred, nor have I ever had an intake appointment. I just go in, discuss my issues, present any relevant history myself, and go from there. If I ever become dissatisfied, I just start going somewhere else. > You certainly don't just call any convenient office and expect to get an appointment in the next couple days, that would be anarchy. That's all I have ever done, so I don't see how I "certainly" don't. In fact, here is a ZocDoc PCP search using my insurance centered on Grand Central: https://www.zocdoc.com/search?address=Grand%20Central%20Terminal%2C%20East%2042nd%20Street%2C%20New%20York%2C%20NY&insurance_carrier=324&day_filter=AnyDay&gender=-1&language=-1&offset=0&insurance_plan=2778&reason_visit=75&after_5pm=false&before_10am=false&sees_children=false&sort_type=Default&dr_specialty=153&ip=69.191.241.34 https://www.zocdoc.com/search?address=Grand%20Central%20Term... There are seven doctors on that list that I could see today. No intake appointment, no physical, none of this crap you are talking about. So I ask again, what kind of system are you dealing with?
- overthemoon 9y ago
  It's all anecdotal, so I guess we can all take each other's stories with a grain of salt, but long waits and impenetrable bureaucracy has been my experience, as well. My wife is currently trying to get treatment and she's had to wait months to see various doctors and specialists. We live in a metro area in the US.
DanBC 9y ago
> you call to schedule your annual physical. Annual physicals cause harm. You should avoid them unless you meet a reasonably narrow range of criteria. > They're typically booked solid for a few months in advance. Even in our underfunded NHS I can get a same-day GP appointment (if it's an emergency) or within 48 hours (if it isn't an emergency). And that's within a range of provision: pharmacy for general advice; 111 telephone service for advice and triage; GP for general stuff; MIU for minor injuries; A&E and 999 for life threatening injury.