First, her favorite doctor in Providence, R.I. retired. Then her other doctor, at a health center a few miles away, left the practice. Now, Piedad Fred has developed a new chronic condition: distrust in the American medical system.
"I don’t know,‘’ she said, eyes filling up. "To go to a doctor that doesn’t know who you are? That doesn’t know what allergies you have, the medicines that make you feel bad? It’s difficult…I know that I feel cheated, sad, and like I have my hands tied.‘’
At 71, she has never been vaccinated against COVID-19. She no longer gets an annual flu shot. And she hasn’t even considered whether to be vaccinated against the respiratory syncytial virus, or RSV, even though her age and asthma put her at higher risk of severe infection.
"It’s not that I don’t believe in vaccines,‘’ Fred, a Colombian immigrant, said in Spanish, at her home one morning last fall. "It’s just that I don’t have faith in doctors.‘’
The loss of a trusted doctor is never easy. But it’s an experience that is increasingly common.
The stress of the pandemic drove a lot of health care workers to retire or quit. Now, a nationwide shortage of doctors and other professionals who provide primary care is making it hard to find replacements. And as patients are shuffled from one provider to the next, it’s eroding their trust in the health system.
If any US-based folks know the secrets for finding a good medical provider that can be trusted, I’d be interested in hearing them.
I moved to a new area quite some time ago, and to this day, most of the local / semi-local practices are not accepting new patients from the general public. I ended up finding a clinic that would accept me, though it’s the type of place where nurses handle all the patient care instead of doctors. That’s not necessarily wrong or bad, but my experience and opinion of it is mixed.
That aside, I don’t have a lot of trust in the primary care system for several reasons.
Privacy is a big issue for me. I’m constantly running into issues like front desk staff asking me sensitive information while other patients are around, and I’m not really comfortable broadcasting things like what medications I’m taking, what the reason for my visit is, or what my sexual orientation is. Can’t we discuss that some place other than in a waiting room full of other patients?
The other trust issue I have is that far too many of my health complaints essentially get ignored. It seems like if an obvious cause doesn’t show up in simple blood work, then things don’t get taken seriously. It definitely erodes my trust. And, because I’m overweight (25 - 27 BMI, never more), very frequently health complaints get blamed on that.
I’ve also had issues with providers not really properly explaining things to me or just assuming I should know things. For example, the necessity of fasting before some types of blood tests. I guess they just assume that everyone knows which tests require fasting and which don’t? I learned I had to ask after an incident where ended up having to go to 3 different appointments because they didn’t tell me I needed to fast initially, so they couldn’t do the test on the first appointment. Second appointment, I fasted 24 hours ahead of time and when they found out they turned me away because that was too long of a fast (they never told me I should only fast overnight). The worst part was that I still had to pay the co-pay on those wasted visits.
Well, my list could go on. I’m really only yelling at the clouds now anyway.
Ask someone with local roots and a young family.
The AMA lobbies Congress to limit the number of residencies so that doctors can make more money. They’re also the reason GPs have a stranglehold on primary care.
https://blog.petrieflom.law.harvard.edu/2022/03/15/ama-scope-of-practice-lobbying/
GPs shouldn’t even be doctors. They don’t do anything a competent nurse can’t do with a half-functioning database. Change prescription law and nuke the AMA and let the problem sort itself out.
Note that only about 15% of doctors are part of the AMA.
Had no idea about this. Thanks for sharing.
Not to mention unexpected costs. It’s happened to me a few times where I’ve gone to the dr, gave them my insurance, and then a few weeks later get a bill in the mail they never mentioned. Fortunately they were all under the amount where it can’t affect my credit score 😈
sometimes it’s not like that, like when I got a vasectomy or got my wisdom teeth removed they told me at the desk when I first went in how much my insurance covers, how much was out of pocket, and I was able to make an informed decision on whether it was worth it, and paid right there. The surprise ones wouldn’t have been worth the out of pocket cost, so I would’ve said no if given the chance
I can relate. I’ve had probably five different family doctors in as many years. I have great trust in doctors individually, but I have zero trust in the system. I haven’t seen a doctor since an annual two years ago when they wanted to run tests and then told me they didn’t have an opening to discuss results for seven months. Why should I bother with the tests when they’re going to be outdated before they get read?
I have coverage, I just don’t see the point in going to the doctor. I’m at an age where everything hurts and when I talk to a doctor I hear that’s just the aging process. Well fine everything is just normal aging until I have to go to urgent care or the ER. What do I need a doctor for then?
I do try to vaccinate for anything I can though. Now I guess CVS is my primary care physician.
I can’t really have a relationship with my family doctor because of insurance. If I say the wrong thing, it changes the appointment from preventative care (free) to a couple hundred that I don’t really want to spend to mention I have noticed a lot more headaches lately or this one weird rash. It’s become adversarial.
As someone with an extremely complicated health history with lots of medications and multiple chronic conditions, I would probably just give up if my PCP retired or moved out of the area.
two long-time gp retired recently here. all i hear from anyone is the wait times for seeing the ‘new docs’. 6-9 months out. it’s almost as bad as next door at the dentist.
Expect things to get worse before they get better.
I’ve given up on doctors. They just charge you $100, tell you to take Advil, and send you home.
