Your post today is very timely, big discussion on this subject going on in my house. My husband has a very good primary doctor; I do not. (Like you I only go to a doctor if really, really sick.) Hubby's doc is not taking on new patients. Some friends who recently moved to our town can't find doctor, even though they are financially comfortable and have excellent insurance coverage.

I have gone to one of the mini-clinics in CVs for ear problem and our hospital Urgent Care a couple of years ago. When my ship filled with gold comes in I'd like to get a "concierge doctor.

Your story is a familair one . . . In the past 10 years we have lived in Wyoming, Georgia, and now Florida. In every new location we sought out a local physician. When asked whether we had insurance we offered up, "Yes. Medicare".

The conversations always then began, " . . . and we are not taking . . . " at which point we said, "and we have a secondary".

The appointment was then made.

Fortunately, I have the VA Medical when things get expensive. But for the general kinds of things we use the local MD.

I am beginning to think a lot of people are now expected to show up at the hospital ER. Passing an even greater expense to the local tax burden, and at the same time creating a very crowded ER.

Think about it - nothing has changed . . .

The ill informed people have spoken! Those that voted with the intent of cutting taxes and building a bigger military now are faced with (if available 'in your area') an even more expensive medical program.

For those of us who didn't vote with the follow-the follower mob - we suffer the same.

Thanks to all who did vote knowing what was in the 'best interests' for all of us.

Linda C. mentions the phenomenon of "concierge doctors," which has grown exponentially over the last decade. It's too bad that this has removed many competent and physicians from the accessibility of the general population but if I were a recent medical school graduate looking for the best ROI on my hundreds of thousands of dollars of debt, I would probably be tempted to do the same thing. Plus, they don't have to operate within the constraints of those scripted 10-15 minute visits.

Over the years that I worked in social services, the majority of the people we served who were on Medicaid or nothing got their children's medical care by going to the emergency room, even to the point of taking their children in for head lice. After several hours, they generally left with confirmation of the problem, and what they needed to treat it. As for the adults, they did the same in extreme situations, but more often went without care. Our country has allowed health care to become as polarized as most things, and I shudder to think what we may be facing over the next few years.

Why our country cannot provide decent, affordable and adequate physical and mental health care for all is beyond me. I suppose, as with most things, it's because it's not a priority for those in power, and those who have influence with those in power have the means to retain those "concierge doctors." And so it goes.

Lots of truth in your post.

One recommendation, if they are in your area, is Kaiser. They accept Medicare and they offer pretty good care. My kids live in the bay area and the Kaiser hospitals and drs there have been outstanding. In Fresno, some drs are good, some not so much. But, they accept Medicare.

I, too, have a Medicare Advantage plan, and must be one of the lucky few who has a great primary care doctor. He cares, he takes his time, he answers my questions and concerns, and I followed him when he moved from one practice to another about a year ago. Maybe because I live in an area with a very large number of seniors, but I've never had a problem finding a specialist. The only one I see regularly never makes his patients wait, and I'm the one who worries that he's taking too much time for me.

I do feel sorry for the people who don't share my experience, and know it's not going to get any better any time soon.

Very scary not to be able to find a doctor. I see an internist twice a year who is farther away than I want but he spends almost too much time with me. I wanted to find a primary care doctor closer to home and found one who would take me, but they told me I'd have to give up the internist to do it. (Both are with the same hospital so they'd know when they look at my records online.) Never having met the new guy I didn't want to chance the change sight unseen. I figure I will use an urgent care place or drugstore client if needed to supplement the internist.

Ironic that in Costa Rica, there are doctors in even remote villages because the government helps fund medical school for those willing to serve a few years in underdeveloped areas. We have ex-pat friends who operate a B&B in difficult to reach tourist destination Drake Bay. They have been quite happy with their health care for the many years they have lived there. Other friends who used to live in San Jose, C.R., spoke very highly of the specialists they dealt with while living there.

We as a country need to learn so many lessons the hard way. We are letting politics rule without reason.

I'm one of millions that have an advantage plan. Without it I wouldn't have my really good GP at Scripps here. My husband has Kaiser, and when he reaches 65, he will add add Kaiser Senior Advantage plan to his days. I didn't like the dentist...so I pay cash. I like all my other referred docs, thank heavens.

I read your good words, Ronni, plus the great number of revealing comments, and once again feel despair. All of this is so utterly timely - especially since * has just chosen Rep. Tom Price, who has sworn to kill the ACA, Medicare, Medicaid, and no doubt social security as soon as he can. And of course Planned Parenthood. So if we think we have it bad now! --- just think ahead a few months.

I used to go regularly to a clinic made up almost entirely of women doctors, and I was always lucky, insofar as those I then went to were competent, helpful, attentive, etc. Then the last one I had decided to leave [many had just burned out--], and the New Era began. Your account of the doctor whom you most recently saw, who stayed no time at all and touched you only briefly reminded me of the person I saw once my doctor had left - she was pleasant enough, but she concentrated on her computer and never touched me at all. And left promptly.

Nothing really has improved. She did most recently have someone else there to be at the computer, but I felt awkward with a strange person there and, as I tend to do, kind of shut up..

In any case, I join those who fear the new world of * and the * adminstration. He seems determined to pick precisely the people who will destroy whatever department they will head, whether it is Health, Interior, Education, or anything else that we desperately need to be functioning and improving. How often I read now how this or that appointee will "take [you name it, health care, whatever] in a fundamentally different direction." And you better believe it won't be a better direction.

I recently read about a woman in the south somewhere who voted for Trump and at the same time participates in the Affordable Care Act. The reporter who spoke to her reported that she had never connected the two of them, * and the ACA, she likes both of them. I can't even come up with a comment on that one.

Maybe it's the lowering winter weather outside, but gee, this is all pretty scary.

I can say Ronnie, don't drop your current Doctor till you locate one...I'm sure you won't. I have been with same practice for years; have no chronic health matters, so don't see Doctor often. Last year I had a minor thing come up, called for an appt. and was told doctor retired. Really??? No notice was ever received by me. So I began the search, ran into no doctor taking medicare. Back to original practice and since I was a prior patient, I could choose another doctor in the practice..ok fine, can I make an appt.? Yes but she's on maternity leave till this winter. So I see her PA for the Wellness ck up and she spent plenty of time with me and any of my concerns. In short, the system is a mess and at times, I think "they" just as soon see us pass into the sunset. In my area also are rumblings of concierge practices. More and more of my friends use urgent care for minor issues. I have excellent coverage, but what the hell is good about it if no doctor accepts medicare etc. The situation demands seniors be proactive and not all can.

I am still with the GP I first found back in 1973 (benefit of living in same place). He is getting elderly, about ten years older than I am -- and I worry about a replacement. He's of the old school: sits down, listens to everything you tell him (even emotionally) and then it's hands-on. He checks lymph glands, looks in mouth, ears, abdominal area, etc. I dread the day he retires, though he keeps saying they'll be taking him out of his office in a body bag before he retires. He also was my mother AND grandmother's primary doctor!

I did see a younger GP a couple years ago, thinking I might need another doctor at some point. He was young, acted as if I was taking all his time and attention away from his computer. Then when I told him specifically of a problem, he very RELUCTANTLY looked in my ear. That made me feel...I don't know, just icky, as if there was something contagious with me, that he couldn't be bothered to actually do an exam. I was actually there for a full physical. Needless to say, never went back. And oh yeah, spent about ten minutes with him. Sigh.

I'm 73. I've always thought it very important to have a regular doctor that I like, have a long-standing relationship with, and see for check-ups on a regular basis (even more important after 65, when declining health is inevitable). My current doctor is a family practice doctor (recommended by my son) in a group practice that accepted my Medicare Cost plan. I see her every six months and she devotes as much time as we both need for a thorough check-up with all questions answered (30+ min last time). Referrals to wonderful specialists when I've needed them have been generous. And my one day in the hospital last year allayed somewhat my fears about being handed off to some unknown hospitalist who didn't know me or my history.

Further evidence that anyone who talks about healthcare becoming a consumer-driven marketplace is living on Pluto.

I recently became aware of a trend in clinic practice that bypasses much of the insurance mess. It's called direct primary care. The system is being put in place around the country as states pass laws allowing it. Basically, it involves cooperatives of medical Clinics that charge a lower monthly fee to allow unlimited access to primary care providers. Oregon does allow this. I noted three in the Portland area.

Under the system, the direct primary care coverage plus a high deductible plan, which I presume Medicare would count towards, meets ACA rules. Here in Minnesota, the network closest to me cost $75 per month. Now, I rarely see a doctor, but I can see that as I age it would be to my advantage to have such access.

Not free, and maybe not the solution, but it is interesting that docs are coming up with this themselves.

Now that we have normalized relations with Cuba, I'll bet there are plenty of those supposedly well-trained "Castrocare" docs down there that would love to get some of that Gringo Medicare $$.
You could combine a trip to the doctor with a Caribbean vacation.

Tim Hay...
Did you skip reading the final paragraph???

Like Dkzody I have Kaiser. So does my husband. There is quite a turn-over of doctors, but my basic care is OK. I can get my meds and regular blood work, etc. They were great with my late mother-in-law, who died at the age of 97. well cared for right up to the end.
Our premiums have gone up, but they are quite affordable for us, and they are on a sliding scale.

I have basic, not Medicare, and finding a good PCP is still a problem. For years I had a marvelous, caring doctor who left the large teaching hospital system with which my HMO is affiliated. My current PCP is, like Ronni's, a robot who spends most of his time typing on a computer with only a cursory examination. But the doctors I had in the interim before I found him were even worse, so I'm stuck with him. He's mostly a traffic director anyway,referring me to this or that specialist in the University system where the specialists are almost always the best in their field. Fortunately for me, nost of my specialists---heart, vascular, eye---are women. I don't want to seem sexist but women doctors, in general, are, in my opinion, smarter and more caring. On the plus side, the medical system allows half-hour appointments for older patients, so I see him three to four times a year for regular checkups. Hmmm. Is more of a bad thing a good thing?

I just felt the need to vent about the modern practice of medicine. I know the young folk don't want to hear about the good old days, but we are old farts and presumably we can handle it.

I remember during my entire growing up period in a small town that we never even heard of health insurance. At the rare times when whatever we had didn't go away, we would go to one of the two or three local doctors. He (it was always a he in those days) would look straight at us, touch or probe various body parts as necessary, prescribe or advise something, and we would pay our $10 or $15 to his all-purpose assistant. We knew him and he knew us.

When we had a baby or something that required hospitalization, we saw our local OB regularly as above, then went to one of two hospitals in a nearby town for the actual event. The bill was usually in the hundreds---a tab nearly anyone could either save up for or pay on sight. I had only one major surgery with a hospital stay in my first 30 years, and although I don't remember the exact cost, I know it wasn't a disaster. In other words, we wouldn't have had to take out a mortgage to pay the bills. As with our GP, our surgeon knew us by name and "dropped in" to see us regularly.

Later, when I had a husband whose employer provided health insurance, it seems to me that medical costs grew to meet the available payments and they have been growing ever since. Of course by that time we had become accustomed to a very large disconnect between service and payment. I don't know what the moral of this story is, but I do know for absolute certain that life and healthcare have not improved over the years.

Thanks for this post. This is a common problem for elderly people as well as everyone else. What would solve it and reduce the cost of health care is a single payer system- like Canada. Everybody in and everybody gets the same care.
Would not solve all the problems but would help with this issue and reduce costs. I am disabled and my insurance is Medicare and Medicaid. Here is how I find a good medical team. Shop around and diplomatically get rid of doctors and other medical professionals who are not contributing to your health.
Once you find a good doctor, she or he will likely have a list of other doctors and Physical Therapists and other members of the team that she or he likes.
This is a gold mine. Nurses are a great source of accurate recommendations but you have to ask them appropriately. For example, ask the nurse if she had a family member with your particular issue- who would she recommend. Or ask her who a good primary care doctor is.
For your information, offices that take Medicare alone,
not a Medicare Advantage plan are subject to the following problems:
First, Medicare pays them six months after they submit the bill and often does a very poor job. For example, my name is Mary Ellen Greenlaw. If the doctor submitted the bill as M. Ellen or just Ellen Greenlaw, Medicare would deny the claim. I had to get my senator to get my name consistent throughout Medicare, Medicaid and Social Security and I make sure that each office knows how to submit claims in my full name. If you have a Medadvantage
plan, the plan will cover what Medicare covers and usually nothing else but they pay more promptly. So more medical offices will take Medadvantage plans. Try this to see if you can get better care for your insurance dollar.

Second, offices who take plain Medicare are subject to Medicare audits.
The auditing companies are separate from Medicare. I had a technician who made my braces - small independent office that did great work. When the firm doing the Medicare audit started in- they looked for small billing errors,
not did the practionner do a good job. If there was the slightest billing error, he had to pay back the full amount of the bill- and the money paid back did not go back into the Medicare trust fund. The company doing the audit got to keep the money. So Medicare audits, in my opinion are another form of fraud.
My technician had to close up his shop, now he works for a big hospital who have a billing department to deal with Medicare.

There is an opening in the new administration for some changes. All of us need to be active citizens and advocate at every level for better service from
Medicare and I'd suggest making Medicare for all a serious option. Please talk about this and be very outspoken rowdy citizens. Most people in the country did not vote for Trump and would like better health care just like all of us in this discussion.

I live in Canada. I don't get turned away because of my health insurance, we're all pretty much in the same boat insurance-wise here. But finding a GP is just as hard. It took a couple of years after moving to my current location to find one, and a few more years after that to find a good one. In the meantime I did walk-in clinics. One visit to the ER involving a 5-hour wait time in great pain cured me of going there voluntarily. My doc is older than me and says he has no plans to retire, but he has recently taken on a younger female partner ("to do the female stuff") so hopefully I'm covered if his plans change.

In my view, the best way to find a good Primary Care Physician or any other physician (specialist, for example) is by word of mouth. Ask friends, relatives, acquaintances, people at your house of worship, or coloring drop-in group, or senior center or anywhere else if they go to a really good primary care physician that they would recommend to you. And be sure to name-drop: call the physician's office and mention that so-and-so is a patient of the physician and recommended the doctor to you for a primary care doctor.

When I decided to part ways with a formerly good primary care physician who decided to become a Concierge doctor - meaning he was charging $1800 per person per year plus what he got from insurance for consults, etc. - to do what other primary cares doctors do for whatever insurance pays and no Concierge fee (the fee that raises serious ethical questions), I wasn't about to put up with his plans to change to Concierge care.

I asked friends at my house of worship and immediately found a female women's health specialist/primary care doctor who sets aside times for more urgent appointments that are on shorter notice, listens, explains things, does any tests she feels are appropriate, etc. and has ethical objections to Concierge doctors. I have been going to her for 4 years.

And a big plus: the former doctor was way up in Chicago when we are way out in the far south suburbs. My current primary care doctor is about a 25 minute drive from my house. And she has a couple of good associates who cover for her when she goes on vacation for a week once or twice a year.

If you have a really good specialist whose opinion you trust (ear-nose-throat, neurologist, eye doctor, whatever), you may also want to ask the specialist for a referral to a good primary care doctor.

Vicki

Be careful what you wish for. Canadian care is fantastic if you want to be 20 years behind the curve ball, think 1995. It's great if you have the sniffles but everything else gets rejected as "experimental." We currently have all pancreatic cancer patients that want to live more than a few months hightailing it to Germany for nano knife therapy. We have two tier cancer coverage with many chemotherapy drugs not covered - just die already. My husband had a 9 month wait for a diagnosis for a knee injury - yep nine months. He went to Buffalo instead and it was cheaper than the vet bills for my cat, state of the art very accommodating orthopedic center. Amazingly good care compared to up here.

We are the only country in the world besides North Korea that doesn't allow private pay but the chinks are coming in the dyke with a lawsuit before the Supreme Court in B.C. There is a generational shift with Boomers and younger not being satisfied with "free" as the deciding factor. I would rather pay for a new hip or knee or cataract surgery then wait for years when I don't have that many years of quality life yet.

Vera...
You are permanently banned from commenting at Time Goes By. Everyone is allowed to critique whatever the topic is on any given day but racial slurs are never allowed under any circumstance. Goodbye.