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where i stand Why it can take weeks to see a doctor

October 12, 2018

Marlene Cioffoletti asked some important questions that warrant an answer in her Sept. 19 commentary “Why do we have to wait weeks for a doctor’s appointment?”

I am not an employee of Western Connecticut Health Network (WCHN), but the reasons why it is more difficult getting a doctor’s appointment these days apply to all doctors.

As a primary care physician in practice for over 40 years I have seen many changes.

The rapid advances of medical science, new medications, and an increasing number of seniors with chronic diseases, like heart disease and diabetes, are some of the changes that have complicated health care for doctors and for patients.

But the biggest change that has made medicine seem unresponsive to patients’ needs and that has depersonalized health care is the intrusion of insurance companies. They have burdened all doctors with numerous regulations — not only are they a serious distraction but also they take time away from seeing patients.

Primary care doctors are hit the hardest.

Here is a list of some of the intrusions that make it difficult for doctors to see patients promptly.

Doctors have to get “prior authorization” for ordering tests like CAT scans and MRI and consultations. This is time-consuming and not only does it wear doctors down, but it distracts their staff as well.

Many of the insurers’ intrusions are “invisible,” e.g. the use of electronic health records (HER) is required to report data. EHR is a serious distraction. It could even cause a medical error and result in a malpractice suit. I always wondered why our lawmakers never thought about this.

Every few months insurers (including Medicare) audit doctors’ medical records. This is another time-consuming chore.

Almost daily doctors get notices from insurers stating that a patient is not getting their medications refilled. This is not the insurer’s responsibility.

Doctors frequently get notices to use a “cheaper” drug than the one they prescribed because the insurer will not pay for it. This requires a phone call to the pharmacy and to the patient explaining the problem.

When patients go “out of network” the paperwork and phone calls and reports that have to be faxed to other hospitals causes a real slow down in the office flow.

Physicians are mandated by state law to maintain their knowledge. It called continuing medical education (CME). This can take time away from the office.

These are just a few of the reasons why patients sometimes have to wait longer than expected for a doctor’s appointment. They are also the reasons why the personal connection between doctors and patients is weakening.

So far physicians have not been able to break free from the regulations that insurance companies have forced upon them — regulations that really are obstacles that stand between them and their patients.

Clearly, insurance companies have transformed the practice of medicine into a business. They have eroded patients’ assurance that their doctors are acting in their best interests.

But if more patients were to express their concerns publicly, like Marlene Cioffoletti, it would awaken lawmakers to the seriousness of this problem and oblige them to do something about it.

If that happens, and if lawmakers minimize insurance regulations, she and other patients will get quicker and more personalized service when they need it.

Edward Volpintesta is a primary care doctor in Bethel.

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