@teelea68 HR can be a good resource! Depending on the size of the company, they also have the power to put pressure on their insurance broker, who can put pressure on the insurance companies to improve their provider network. My current job is helping independent physician practices negotiate with insurance companies. Sometimes the contracts they offer are so bad that the practice decides to terminate the relationship, and one of the things we advise is for the practice to have their patients contact their HR departments and complain. We've had insurance companies come back and make an offer good enough for the practice to rejoin the network, because the insurance brokers complain that they won't be able to sell their products to employers if the employees can't find good doctors.
This also reminded me that some companies I've worked at have a dedicated company that's called something like a "benefits advisor" to help employees navigate various insurance issues. Another thought for folks in a similar situation is to ask coworkers what doctors they see, since they often have the same insurance and live in the same area.
@teelea68 We have Medicaid and haven’t been able to find mental health or therapy care for my son for years. He needs a psychiatrist and the only ones our insurance covers are providers for drug rehabilitation, or they’re 2+ hours away. He also needs speech and OT and no where within an hour accepts it, and those that do accept it are “full”.
@absolute1963 Exactly. That's a crisis at this point. Here in California, where we are supposed to have the best "Affordable Care Act" service in the nation, getting quality adult care of any kind can really be tough. Mental health care will be provided generally by your local county or county contractor and some sites have a 6 month wait list for a first appointment. Specialist appointments can take more than a year.
The LA Times did a story about people dying waiting for specialist appointments with Medi-Cal about a year ago and the government response was basically to deny the LA Times story.
@teelea68 My research university affiliated hospital system has a number you can call for a primary care "matchmaker" for lack of a better term. Tell them who my insurance is, what part of townI'm open to appointments in, and any special requests (provider gender, language competency etc). Got matched to a lovely NP in my neighborhood who had openings a few weeks away and takes my plan without a concierge fee.
@teelea68 I'd recommend searching for a residents' clinic. They usually have a lot of openings. Downsides are that appointments might take a while, the doctors are still being trained and chances are low that you'd see the same resident for subsequent visits. Upsides are availability and that you essentially get two doctors' opinions -- the resident who does most of the visit and the attending who weighs in on diagnoses and usually comes in to say hi. And you're helping people learn.
@teelea68 Correct. Medicare funds physician residencies. You must complete a residency to work independently as a doctor. NPs can have good or bad degrees and some schools don't even supervise their rotations.
These means NPs are much cheaper. And thus medical groups love them.
It also includes the fact that there's simply not enough physicians. Medical schools are hesitant to accept more students bc if they don't match to a residency they're fucked. And schools are judged by the match rate. The feds need to dramatically increase residency seats now so we can get physicians in the pipe line.
We also need to demand our states not allow fully independent practice for people that didn't complete medical school and residency and the medical licensing exam and their specialty board certification. We all have the right to care by a real doctor.
I hate the for profit model of medicine. It's objectively evil.
@tabitha007 I was going to say this. Why ER? Those are for critically ill people. Keep looking for doc but for everyday issues…an urgent care is much more appropriate. ERs can be very expensive too. Please don’t waste ER space for strep or typical viral issues. I wouldn’t go to an ER for something I would a GP about.
@christopheralan88 And then we get the question “why was I charged $1,500 for the doctor to say I have a cold”. They don’t realize the base ER charge is the same for everyone regardless of reason. The total charges will change depending on lab/diagnostic testing but the base is the same.
My brother has been on the phone trying to see a simple physician for a checkup… can’t afford it. He is literally being told that there is a wait list until JULY.
The other place is saying he would need $1800 do get checked out there. What the fuck.
