How is this a thing when there are conditions that could likely get drastically worse in between the symptoms showing and the actual appointment date? And also people getting no assurance it’s not something life threatening causing extra anxiety and stress?
I have no expertise in economics or the medical industry so I’d appreciate any insights.
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While there are a lot of specialists Doctors, there’s only ever a handful in any particular field.
Depending on your region there may be few of a specific specialty, or one, or even none.
Some specialties will very quickly accumulate a list of patients with chronic problems that require frequent visits limiting their ability to take on new patients.
While many specialists have limited clinic days for patients as they have to spend many days performing surgery or doing rotations at hospitals.
Some also don’t work as a specialist full-time. Their specialty is so specific that they’ll only get paid for 1 or 2 days a week as a specialist and spend the rest as a General Practitioner or hospitalist.
Specialists also often require a referral which depending on their workload and their staff can take weeks to process.
Doctors will assess the severity of your condition on a visit and if it’s truly urgent there’s things they can do to speed things up, but there’s also a lot of ‘hurry up and wait’ in the industry that you can’t avoid.
Some Doctors are legit putting in a lot of hours and trying to address ever single patient they can, but just like in any other job there’s an equal amount of Doctors that just don’t answer their damn pager.
If your family doctor has 1,000 patients they see every once in a while it is not long before they can see you. If 1,000 doctors each have 1 patient a month to see a specialist there is not enough time in a month to see them all and possibly also have to do surgery.
The key is in the name. A specialist is someone who specializes, or is an expert, in one specific thing. There are fewer of them than general practitioners(your normal doctor) because 1) it’s harder to get certified in that specific field and 2) it’s more expensive because you have to be in school longer. This naturally means there are fewer specialists then we’d like.
Since we have no idea what country you are in or what specialty you are referring to there is no useful answer to give beyond the most generalised: specialists are trained extensively in one field, which means there are fewer of them than general doctors, and waiting times are dependent on your specific condition.
There are two components, one that’s universal and one that’s more specific to America.
First, the universal one. Doctors, like any human, only have so much time in the day. If there are more people who want/need to see a specialist in a given physical area than there are doctors with that speciality it simply takes time to fit in to the schedule.
Second, the American one. Because insurance companies will do everything they can to not pay for it. Specialists are expensive. For profit health care doesn’t like expensive because, well, they are for profit, and the less money they have to spend the more money they can keep as profits. So using any and every means legally possible (and sometimes illegal too) to deny or delay care works in their favor. Especially since you can’t really switch insurers whenever you feel like it, especially since insurers will try and use pre-existing conditions to either charge you drastically higher rates and/or deny you coverage at all.
I saw an interesting article on reddit a while back that talked about the shortage of doctors in general in the US.
Back in the 70s, they did some studies that showed that there was a doctor surplus and over the next couple decades it would get worse. In order to combat that, they decided to restrict medical school admissions.
The problem was, that study basically estimated the number of patients in the future by multiplying the current patient load by the estimated population growth. What it didn’t take into account was that in the decades since the 70s, access to medical care has expanded a lot. A lot of people that wouldn’t be able to afford medical care back then are now able to see a doctor. So the demand for doctors has increased far beyond what that old study predicted, and restricting the supply of doctors was actually a dumb fucking thing to do!
If you’re American, the answer is “private for-profit insurance companies hate paying for specialists, so they contract with almost none of them, meaning that everyone on your particular health plan is competing to see that one specialist”
I’m a specialist. To my knowledge, there are approximately 1400 board certified specialists in my field in the United States. The average time spent on a waitlist to see myself or my colleagues is approximately 6 to 12 months. Part of this is because we can only see one patient per day (two if we have a specially trained assistant), as each appointment typically takes a minimum of 4 hours but may last as long as 12 hours. Even with an assistant, we’re capped at about 8 per week, which equates to maybe 416 patients per year (not accounting for patient no-shows, cancellations, holidays, sick leave, etc.).
Beyond this, there are certain barriers to entry. For instance, you typically need to see another specialist before that provider refers you to me. Sometimes you need another specialist to refer you to that specialist.
Other posters have touched on a couple of the factors involved, but one I haven’t seen mentioned yet is that establishing care with a new patient takes longer than seeing a patient you have seen before. It takes more time to go over what the patient’s previous medical history is, what they are seeing a specialist for, what else has been tried around this issue, and so on. When I was scheduling for a specialist’s office, a standard patient checkup was a 15 minute time slot (of the physician’s time, not how long the patient was there in the office). But a new patient appointment was an hour. The doctors couldn’t see too many new patients in a day, or they wouldn’t have enough time to see the other patients. So each doctor only had one or two ‘new patient’ slots per day in their calendar. It didn’t take much time at all for those appointments to fill for months out.
What if I tell you that in Ukraine, for example, if you really need to see a doctor you can get an appointment (in most of the cases) like in one hour. 🙂 and to a really professional doctor with huge experience and not a wrong diagnosis as it’s in rest of the world.
Do you need surgery (professor is a doctor, mom had a surgery two weeks ago)? No problem! You can get one in a week. Money? Nah, 800 hundred dollars minimum can work. Rare cases when it’s few thousands. The level of professionalism is much higher than in other developed countries. And it’s now – when it’s a real war is going on. 🙂
It’s insane that it’s totally different in such a developed countries like EU, UK and the US.
I really don’t get it and was shocked when I moved and saw the world and lived in a different countries.
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