I called a new primary care physician (I recently moved) with a complaint of hip pain. It took me 2 weeks to get an appointment. He saw me briefly and told an office worker to draw blood. I waited for him to come back and conclude the visit. He didn't come back. The visit was over. I was hustled to the front desk to pay and to make a followup appointment.

I made a followup appointment for 8 days later (he wouldn't see me any sooner). The day before my appointment, his office called and cancelled. I said "The hell with this guy." I called another doctor and it took another 2 weeks to get an appointment. It turns out I had Lyme disease, but that was a coincidence. It wasn't causing the hip pain. The new PCP told me to see an orthopedist who would do an xray in his office.

I called the orthopedist's office and asked 1.) is the doctor taking new patients, 2.) does the doctor take my insurance? The answer was yes to both questions. They gave me an appointment for 2 and a half weeks later. I went to the appointment, handed them my insurance card and the receptionist snapped "We don't take that insurance." I explained that I called ahead of time and asked if the doctor accepted my insur--- "We DON'T take that insurance! Now do you want to see the doctor or not?" Uh.... no.

(I called the insurance company. Turns out the doctor dropped my insurance the previous month. I guess he didn't inform his idiotic staff. Or he did and they were too stupid to take note).

I had to find another orthopedist. I called and made an appointment with a new orthopedist. The doctor would see me in 2 weeks. When I finally got to the appointment he said "We don't have xray equipment here, I'll have to give you a prescription to take to the hospital several towns away for an xray."

Are you getting the picture here? If I'd walked into the ER and said "I'm having terrible hip pain. I can't walk" they'd have taken the xray within 24 hours. Sure I might have to wait 10 hours in the ER, but I'd take a book with me and read.

And that is why people go to the ER.

Because they get jerked around by doctors and their idiotic office staff.

And there is the 'rational choice' the author was talking about. As a "service industy" Dr offices suck.

I just thought I'd share how something like this would play out up here in Canada.

If you have an established G.P. (general practitioner, like a primary care doctor), you can usually book an appointment within a week. I usually see an intern rather my G.P. if I need to make an appointment for the same or next day. If I need an X-ray, I can get one free, usually within 24 hours.

If you don't have a regular G.P. or don't want to take time off work, most cities & larger towns have extended-hours free public clinics which go from morning until nine or ten at night. There is an organized courier system for sending records back to your regular doctor. Sometimes there is a registration fee of under $50 for a first visit if you're from another province. My city, with 200,000 people has three extended-hour clinics with about 15 doctors each, and enough G.P's to fill several pages of the phone book.

I'm not saying our system is perfect. We have longer wait lists for most types of essential surgeries, but they are available to 100% of our population, not just 75%. There is a doctor shortage, but I think it's less than in the USA. Since the 80's, government funding for doctor training has dropped in both real and nominal dollars (alongside a reduction of corporate income tax rates to the 15-25% range (federal & provincial combined). The waiting lists to get a regular GP can be a few years, while the public extended-hour clinics are overworked, and follow-through is often weak at them.

The point is, our 100% public system has been severely gutted over the past quarter century to a point most Canadians find barely functional, and it still holds up well against the American system. (If you compare the quality of primary care to that in France, France has about twice as many doctors, and they do it for much less money.) You pay about 17% of your GDP on health care; we pay about 9-10% for similar quality. Our government eats up a few more percentage points of GDP, but ours includes health care. (And we're not running up deficits. Our current government is severely disfunctional, so the comparison bar is very, very low.) If you think of health insurance & other health costs as tax, Americans are among the highest-taxed people in the developed world.

Funny thing is, Canadian neoconservatives seem to believe that the American health care system is perfect, and adopting a private system like you have will solve the types of problems listed in the article.

I have a high deductible health plan, so I avoid the ER like the plague but I can completely relate to your story.

A few years ago, I also had severe hip and knee pain to a point that I could barely function. The soonest doctor's appointment (after calling about a dozen offices) I could get was about 2 weeks. I agonized for awhile and eventually saw a doctor. After my exam, he wanted me to get X-Rays. So, I got an Rx for an X-Ray and was referred to the county hospital. I went to the hospital, waited about 4 or 5 hours and then got the X-Ray.

Several days later, my doctor's office called me and told me that the X-Rays were ready but wouldn't give me any info over the phone. I then made a follow up appointment for two weeks down the line. I went in and was told the X-Ray was negative but since my symptoms were worse, I was referred for an MRI. Got the MRI done (which took about 3 weeks to get in) at the hospital and then had to make another follow up with the doctor (another two weeks).

At that point, we found out that I had several ruptured discs in my back that were causing all of the hip and knee pain from sciatica. Looking back, I should have just gone to the ER and gotten fast tracked for the X-Rays and MRI.

I think doctor's officers are under a lot of pressure and since they don't get paid for a phone call, you can never actually talk to anyone besides a receptionist. They also go out of their way to maximize the number of follow up visits they can charge patients for.

If they really cared about making money, you'd think they'd follow the phone sex model and charge $5.99/minute to talk to an actual doctor.

Yeah, I have to get an MRI too, KB. First, it has to be pre-approved by the insurance company. I'm still waiting for that. Then I have to schedule it.

The dr ordered an MRI for my hip only. I have disc problems in my neck and lower back. I asked :"Can't you MRI both by hip and my lower back?" and the dr said no, it wouldn't mean anything. I had an MRI several years ago which showed disc problems and nerve impingement and if I get an MRI of the lower spine again, it is going to show natural degeneration of the spine due to age and the nature of the injury. In other words, it's going to look worse no matter what.

But if the MRI of the hip turns out to be ok, the orthopedist said I should see a neurologist who will do testing to see if I have more nerve impingement..

WTF? I started trying to get an answer to my problem back in late May. I am taking anti-inflammatories and Percocet and I do not like Percocet. I'm the opposite of a drug seeker, I hate that crap. But I can't walk without taking it. How long will I have to take this stuff? How long til I get an answer?

A few years ago when I lived in NYC, my dr would have given me over to a sports medicine specialist who would have examined me, done an Xray right there, sent me for an MRI and immediately started me on physical therapy.

My present-day dr said "I recommend gentle stretching exercizes" I said "Are you going to get down on the floor and show me how to do them? Then watch me do them and tell me if I'm doing it right?"

I wish I could go straight to a PT. I don't want drugs. I want massage and I want to be shown exercises. I don't have the money to go to a PT on my own without insurance.

I'm starting to consider chiropractic, even though I know the score with those guys -- I know how they work the insurance companies for maximum profit, too. But at least they touch you.

Since we've moved to the States, even with a low deductible, health costs a freakin' fortune. I've had to go out of network several times, because the in-network docs are overbooked, far away or non-English speakers (I'm sure they're fully qualified, but trying to explain "hysterectomy" in sign language was too much.).

Another example of the Canadian system, my MIL had a problem with her bowels. She was in a doctor's office within 18 hours and in surgery within the next 24. She had to stay in the hospital for a good two weeks before she could leave.

Out of pocket expenses? Zero.

Being a new (4 years) immigrant to Canada, I still haven't been able to find a doctor who would accept me. I'm young, no big health problems,but would like to have a family physician.

What's the use of universal health care when there are no doctors?

My parents live in France - for the moment our health care is okay but it's not sustainable - there are fewer and fewer people working to pay for the social security of more and more people. If we ask for a new technique, the most common answer is "we're not in America here!"

I forgot to say that in France, although the health care is good, at the moment it takes at least 2 months to get appointments with eye doctors, dentists, gynecologists, cardiologists, and other specialists. Many of them just say that they aren't taking any new patients.

aladdin:

I forgot to say that in France, although the health care is good, at the moment it takes at least 2 months to get appointments with eye doctors, dentists, gynecologists, cardiologists, and other specialists. Many of them just say that they aren't taking any new patients.

We have the same problem in the US. It can take several months to see any kind of specialist. When I injured my back, the soonest consulation I could get with a neurosurgeon who was within a 3 hour drive was 2 months. My wife had similiar problems finding an OB/GYN. During a physical, the doctor noted an unusual mole on my shoulder. It took over two months to get an appointment with a dermatologist.

When I was in college, things were even worse because I was w/out insurance. Even though I was more than willing to pay cash upfront, I had a lot of trouble finding a family doctor who would see me.

From the sounds of things, the health care system is pretty much broken everywhere. Thank God for those of us who live in depressed rural or urban areas, that doctor's from Pakistan and India are willing to practice in some very depressed areas in the US. If it wasn't for them, I think our entire system would have imploded years ago.