An endocrinologist is a doctor specializing in hormone-related diseases, such as, in my case, diabetes. When first diagnosed in late September 2024, I got a crash course in the huge demand for that profession's services. The first endocrinologist I approached wouldn't see me for a year. The second wouldn't see me at all; he was refusing all new patients.
Figuring I would have to engage another gear if I didn't want to sit around, doing nothing, waiting to go blind, I grabbed my notebook and decided, if I couldn't meet with an endocrinologist as a patient, I'd find out what I needed to know by writing a column. Diabetes affects 40 million Americans; it isn't as if it's a personal affliction.
That third endocrinologist not only spoke with me immediately — barred doors fly open for publicity — but put me in touch with a colleague who, either through a sea change in my luck or, I suspect, some kind of secret doctor-to-doctor dog whistle, took me under her wing as a patient.
If this strikes you as morally squishy — the journalist pushing to the head of the line — I worried about that, too. But I didn't misrepresent anything; the column ran in the paper.
Besides, with health care, you have to be a strong advocate for yourself. Faced with the prospect of letting my condition go unchecked while I hunted with increasingly numb fingers for an endocrinologist with an open slot, I did what I could. At that point, if meeting Morgan Finley in a Cicero motel room and handing over an envelope of cash would have gotten me an appointment, well, I certainly would have considered it.
I thickly assumed this was a problem inherent to endocrinology. Getting diabetes is easy — I just woke up one morning with Type 1. Medical school is hard. Of course, there's a shortage. Now it turns out I was encountering, not a diabetes-specific bottleneck, but a generalized, widespread condition.
This week, The Economist published a story with the musical title, "Hospitals are stuck in a deadly doom loop." Turns out the 2020 COVID crisis not only killed millions worldwide and shut down society, but it also "did lasting damage to health-care systems."
Where? Everywhere, all over the world. What's been damaged? In a nutshell, everything.
"From admission to discharge, hospital care is now harder to access, takes longer and is of worse quality," the magazine reports. "The resulting toll includes avoidable deaths. Almost everyone is affected: across 18 rich democracies, satisfaction with health-care quality fell sharply after the pandemic and remains well below the pre-pandemic norm."
Getting an appointment takes forever. As does getting admitted after showing up in the emergency room. Last year, one in 10 patients visiting an emergency room in England had to wait 12 hours or longer before being shown a room.
And in Chicago, an NBC News Channel 5 report found that Chicago has longer wait times to see a doctor than most American cities — a month to see a primary care doctor. For specialty care, like neurologists, up to five months.
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And yet the healthcare corporations and their top brass rake in millions in profits while cutting staffing and patient care to 3rd world dystopian levels. Doctors owning their own pactices is now an anomoly. Almost everything and everyone is a pared down, rent-a-"insert job or service here". Every person is monetized, assigned a product value to be disposed of when not serving the profit margin. Like devalued migrant workers left dying in the fields. Yet the profiteers continue to use the lie that America is a Christian nation. Our continued history proves otherwise.
ReplyDeleteAmen!
DeleteArticle after article, press release and communication keeps telling me, all of us, that we individuals are responsible for our medical care. Bullshit. Like an abused spouse who realizing they cannot change the abuser, I call out Bullshit. I cannot make any doctor or hospital or insurance do anything they do not want to do no matter the seriousness of the situation. The powers that be can blame it and their mouthpieces can blame it on Covid, but this has been true for decades for the commoner. It's just caught up with the middle and upper-middle classes.
ReplyDeleteI remember conferences in the 1960s and 70s that sounded the warning bell, rang the alarms louder in subsequent decades, but the boardroom masters always wins. $$$ daddy needs another yacht, mansion, concubines...
Don't take it out on me. I'm just the messenger. Believe me, I wish we lived in a world where you'd sneeze and the Walgreens van would roll up with Kleenex. We alas — spoiler alert — do not live in that world. And I didn't write that individuals are responsible for their medical care, I wrote that, in the world we find ourselves in, you need to be a strong advocate for yourself. It helps to be firm but polite when doing so — if you've had a notable lack of success navigating your own health care, perhaps the way you go about it might be a factor. Because your comment ... well, there's a tone.
DeleteNS - i didn't see a personal attack in anonymous. I saw frustration. Maybe it's my gender?
DeleteNowadays you need to be polite because words are now considered assault. It's posted! I've seen patients too sick to do physical harm removed by security or police for the crime of non-personal general swearing.
Luckily, rural Catholic girls are raised to manners to the point of self immolation.
No, now that I re-read it, you have a point. He might not have been referring to me.
DeleteJust wait until the AI overlords start using a bot to determine if you are care-worthy ( that might already be in play) You are likely not to receive care if you cost the system more than a tiny amount. Frankly, I think the AI moguls would prefer to live on an unpopulated planet. That might be how they plan to fix the climate and not run out of resources.
ReplyDeleteI live in a small community near Tucson. When I moved here in 2021, my new cardiologist - who worked out of a major hospital system in the "big city" - would show up at the local clinic once a week. Then it changed to once a month. Then it changed to never, so I reluctantly switched to a new doctor. Then she left to take a new position elsewhere. Today I have my first appointment back with the original doctor, which now requires a 40 mile drive. I never leave a doctor's office without making the next appointment.
ReplyDeleteWe make appointments for six months away, for a semi-annual "wellness check"...and then get a call a few days or weeks later. It's been canceled. Our primary-care doctor is going on vacation and there's a need to reschedule. You'd think they would know. But they don't. This has happened numerous times. Such is the efficiency of the almighty Cleveland Clinic.
DeleteAnd no more "friendly reminders" via snail mail, about scheduling appointments with specialists. Probably a cost-cutting move. You have to keep your own planning calendar. They provide you one, called "MyChart"-- but it's sometimes not accessible unless you jump through a lot of anti-scammer hoops.
When I asked a nurse if the doctor remembered something, she got testy and said "Probably not. He has over 2,500 patients, so he can't be expected to remember just one." I was floored. Maybe I shouldn't have been. The days of the kindly old neighborhood family physician are long gone.
Used to see one of those, but he stopped seeing patients, and his multi-doctor practice was "eaten" by the Clinic. So now I go to one of their satellite clinics. But they still call it "Family Medicine." My wife and I are probably a lot more fortunate than most. We haven't had any major problems seeing doctors. Now insurance companies denying meds...that's another story. But that story is for another time.
We need to know more about the corporate culture that controls so much of our health care. i'd love to know about the salaries of the CEO's and about the amount of money that's spent on commercials for television -- commercials that keep telling us how important we patients are.
ReplyDeleteAh, the cynics emerge today in force. To change the "tone" a bit, I had a coronary bypass operation in 1999 with another in 2014. Since then, I've taken fairly cheap medicines to prevent my chronic A-fib from causing a stroke. I've seen cardiologists on a regular basis for the last 25 years first at Christ Hospital and now at Rush. They talked me into getting the Watchman procedure which basically makes the risk of a stroke even less likely than warfarin. The Watchman has worked to date and I've been happy with my health care, no fuss, no mess. Of course, I'm not a newbe; I'm locked into seeing various doctors every few months. The one time I went to an Emergency Room (for an infection}, it was a semi holiday and I was seen immediately and got a room shortly thereafter. Better to be lucky than to be good, as I believe the proprietor herein has stated from time to time.
ReplyDeletetate
I work for Rush, and there's also something fairly new in play, I think, called a concierge service. Of course, it's not just Rush doing this. But basically, the way it works is, in addition to paying exorbitant costs for your medical insurance, you can sign up for a membership with a doctor who is part of this service. What you get for your membership pretty much sounds like what we used to expect from our doctors: easy access to speak with them and get an appointment when we need them, a more personal relationship, etc. What a scam
ReplyDeleteThe Democrats need to put this issue at or near the top their list of campaign issues at every upcoming election until something is done to fix this problem.
ReplyDeleteI won't pretend to have one iota of knowledge of how the myriad problems of our health care system can be fixed, but consider that the specific one being addressed in this column is wait times. Given that most Democrats generally seem to clamor for some form of national health care, I'm not overly confident that they would be the ones that would make this particular part of the problem anything but worse.
DeleteHealth care is a bipartisan issue and we'd all be better off if it were treated as such. Health care providers, on average, devote 2 hrs of administrative time for every hour of clinical time. Most of this 'non-clinical' time involves dealing with insurance and billing issues, while 'for-profit' insurers do their best to deny or minimize coverage. I have yet to meet a health care provider who chose their career based on a desire to wrangle with insurance companies. For most, its the non-clinical work that frustrates and leads to burnout. So yeah, if there was a way to reduce the amount of time spent pleading for prior authorization approval, or playing phone tag to obtain coverage of a standard treatment, then yes, the clinician would have more time to see patients and wait times would improve. There would also be more health care providers available because fewer would quit over not being able to provide adequate care to their caseloads. Call it national health care, or any other name, but insurance reform would definitely improve wait times.
DeleteFor profit insurance and hospitals limit healthcare availability of care in favor of even higher profits for their corporations. Medicare Advantage plans (which should not use the misleading term “medicare” ) bilk seniors of thousands while denying procedures and medications, or delaying care until it is too late. While I don’t think the government should be the sole provider of insurance, the profit-over-patient-care model needs to be curtailed. Politicians’ push for laws to benefit private insurance profiteers should be investigated. Congress has seen proposals to automatically enroll seniors in Medicare (dis)Advantage plans unless they know enough to opt out. What do politicians get out of it?
ReplyDeleteYounger and employed? Put as much as allowed into an HSA. You may pay more for insurance with an HSA, but if you can afford it, you can build up savings you can use once retired and may possibly have more healthcare expenses. Pay attention to your health when younger. You may not be able to prevent all illnesses, but you can give yourself the best shot possible by exercising, watching what you eat, never smoking, etc. About to retire? Opt for traditional Medicare and a medigap plan. Don’t fall for the Medicare Advantage scam of lower or no monthly premiums. Their system of denials and delays will cost you much more (up to and including your life ) in the long run. Also, it is never too late to start exercising, eat better, get better sleep.
Do they now allow you to "bank" your HSA money? When I was employed (10 years ago), you lost everything you hadn't spent as of March/April of the next year. That's why all those emails for "use your HSA money to get new glasses", or "stock up on menstrual supplies with your HSA money".
DeleteYou are thinking of FSAs, which are "use it or lose it." HSAs last forever (or until you die).
DeleteWait, so did you get the appointment with secret dog whistle, or indeed have to wait a year?
ReplyDeleteI got the first appointment. After that, it was regression to the mean.
DeleteI am a firm believer that once capitalism gets involved the good of a company or organization begins to become hollow and evil. Hospitals are a wonderful example of this.
ReplyDeleteAt some point -- probably sometime around Regan's second term or Bush I -- hospitals started becoming for profit and not about healthcare. When that switch occurred, the world of healthcare began to shift to money making. We started to see mega hospitals, the death of rural care, consolidation of doctor's offices, the rise of impersonal care.
Our society is facing this on a massive scale. We are living in a new Robber Barron Age. an era who's monopolies that would make John D. Rockefeller jealous. There is some light and good in the system; I have found some wonderful doctors and offices, but they are few and far between. I, like you, Neil, have had to wait a year for a doctor. I've also found doctors who were wonderful, but after three years they leave the practice or go concierge (having to bill like a lawyer when you're a GP just doesn't work for good healthcare).
It's frustrating... but i think its because large companies don't care about anything but the dollar. Pam Bondi confirmed that when her defense of illegal acts and actions was to respond that the Dow was over 50,000.
I haven't heard Morgan Finley's name in years ðŸ¤
ReplyDeleteHad to click on the link to refresh my memory. Whatta goniff he was.
DeleteAnd reading his obit led me to the mention of Matthew J. Danaher, another Daley crony, who died suddenly at 47, in 1974...just before the hammer came down on him. Missed that one, as I was living in Florida when he died.
Danaher was drinking, after his indictment, and he was about to be divorced. Which, as a fellow Irish Catholic, made him a pariah in the eyes of Hizzoner, Da Mare. So his old neighbor and pal, Richard the Elder. had about three words for him when he got the news.
Found out last week that jailbird Ed Burke has put his luxurious home on the Southwest Side up for sale. It's on the north side of 51st Street just east of Harding Ave., it's the one on an angle to the street, with the CTA Midway Line behind it.
DeleteStay well,Neil. Same problem in Florida but not quite as bad.
ReplyDeleteMy wife was struck by an automobile a few years ago, and was taken by ambulance to Christ in Oak Lawn. She was seen immediately by the trauma team, then spent more than 24 hours on a gurney in a hospital hallway receiving care but little comfort until they took her into a room for a grueling reduction of her dislocated shoulder. After this, she was given a room, actually a lovely room with a view, but then moved to a much less posh room after one day. A few years later, she presented at UIC hospital with an infection of the lower GI tract, and waited for more than six hours to be seen. I happened to have a case of carbonated mineral water from Costco in the car, and my wife was thirsty, but there were a number of other folks waiting a long time and I couldn't just bring my wife a bottle and ignore all those other folks, so I brought the whole case and offered everyone there including my wife a bottle. Some folks were shy to accept, but I think everyone was grateful for the consideration. Eventually, my wife was seen and admitted. She left the next day and had to be readmitted one day later (for an additional $500 per-admission deductible which could have been avoided had she not been so eager to leave without her condition having been resolved). My wife said she would not use UIC for ER care again because of the wait, and would use NMH instead. But from what I read in your column, that likely would not be a better choice. I am not sure I trust the quality of Loretto nor of Thorek. So I guess we're screwed no matter where we choose to go (if we are even given a choice).
ReplyDeleteBack during the pandemic, health care providers stepped up in heroic ways to meet the crisis. They rose to the occasion and worked long hours under grueling conditions. They were acknowledged by grateful communities with singing, signs, ribbons, donated food, etc.. This kind of heroic effort can only be sustained short-term, however. Any longer and they risked burn out or development of their own health problems.
ReplyDeleteWhen the pandemic eased, hospital management quickly turned a suspicious eye on the very same health care providers who were once hailed as heroes. No longer patriots, administrators now regarded them as wanting to work less for the same pay. Its no wonder so many retired. Health care in the US has visibly deteriorated over the years, and has only accelerated since Covid. Definitely a monetized culture now.
Best wishes to you, Mr. S.
ReplyDeleteInteresting article from Cory Doctrow. A usterity begets fascism. https://catherinedevries.eu/NHS.pdf Cory Doctrow writes about this in his essay today. https://pluralistic.net/2026/04/12/always-great/#our-nhs This is about how austerity is affecting the NHS in England. But as he writes it is just not about the NHS
ReplyDeleteEveryone has had their experiences from emergency rooms to delayed medical appointments. I too have been shocked trying to get an appointment that had a 6 month to a year wait time. But what stands out to me in your article is the Nurse Practitioner. When I wanted to see a doctor out of frustration, Rush Hospital referred me to a NP, and she has been fantastic. I am admittedly not the best patient, but I feel lucky that she has been able to offer the care I needed. And, might I add, with far more empathy that my previous doctor. For what it's worth, all is not lost even though the current administration in Washington is trying to destroy our medical care, schools and rights
ReplyDelete.