About a month ago, I woke one morning with a mystery malady: randomly placed aches on the front, sides and back of my torso in about half a dozen specific locations which change from day to day.
These are entirely different from muscle pains I get when I occasionally overdo my fitness workout.
Because I hardly ever get sick and when I do, it is easily identifiable and not terribly important; and because I spend as little time with doctors as I can get away with, I followed my usual procedure when something goes wrong: wait and see.
By mid-afternoon that first day, I still hurt. I tried a pain pill, went bed and waited an endless 90 minutes for the medication to kick in.
This routine continued for next couple of weeks. The aches would be there for a day or two and then I would wake the next day feeling, unless you count general lethargy, almost my normal self again and got on with life believing that whatever had caused the aches was resolving itself.
But nooo. After one pain-free day – or two sometimes – the aches returned. Finally I broke down and went to the doctor. And this is where the story I came to tell you today begins.
Over a period of 15 or 20 minutes, the pleasant and clearly competent physician's assistant took my vital signs that, she said, were all within normal range and asked about any changes from what she read out on my chart. The doctor then arrived, sat down at the computer and started typing.
I had a written list of my mystery malady symptoms so I could be concise, along with a couple of unrelated, minor symptoms I wanted to check on while I was there.
Reading off my list, I explained my mystery symptoms and noted that for the previous day and that day, I was pain free but I'd been there before and didn't think the malady had corrected itself.
The only time the doctor looked at me directly and touched me was when he felt the glands under my chin pronouncing them, after a few seconds, to be normal. He returned to the computer and, I assume, entered that information.
The following conversation ensued (paraphrased):
DOCTOR: I can't see that there is anything going on we need to be concerned about and you said that the pain has subsided so you're apparently getting better. Give the MT a urine sample so we can check for a virus.
The doctor then walked toward the door.
RONNI: Wait. I have two other small things I want to ask about.
DOCTOR: Sorry. We're out of time.
And he left after being with me for 10 minutes - probably more like seven or eight minutes.
I peed in the cup and drove home in growing fury – and a little bit of fear. (Two days later, I was informed that the urine test indicated no infection or virus.)
FINDING A NEW PRIMARY CARE PHYSICIAN
For a couple of days I thought the pains had finally gone away but they returned and have continued that haphazard schedule of a day or two on, a day or two off.
Clearly it was time to find a new primary care physician. I'm 75. There is an old folk tale I'm unwilling to dismiss entirely that no matter how healthy you are, after 75 it's one damned thing after another.
A year or so after moving here, I used online listings of both primary care physicians and geriatricians to find a new doctor. My preference was for the latter but there are fewer of them every year so there's not much chance of finding one with room in his or her schedule.
These days, the web pages of most physicians list what kinds of insurance coverage they accept and I quickly learned that if Medicare is not listed, it is not a oversight. It means they won't consider you.
It took me several days to call all the physicians who listed Medicare and in every case the phone conversation went like this:
RONNI: I'm looking for a primary care physician and would like to make an appointment.
PHONE PERSON: What kind of insurance do you have?
PHONE PERSON: I'm sorry, we are not accepting new patients at this time.
I kid you not. Every single one said this.
(I did not find a doctor until I needed cataract surgery a couple of years ago that could not be performed without a full physical exam first. When I explained I did not have a primary care physician, the eye doctor made an appointment with the one I now see.)
A week or ten days ago, I asked a friend who has lived here for decades about finding a physician and she said, “Good luck with that. In this town, they all have waiting lists.” A neighbor I spoke with agreed.
Before long, I will need to repeat the exercise – it's been several years since last time – of calling the list of primary care physicians (and maybe take a stab again at the geriatricians) within a somewhat reasonable distance from my home to see if any will accept Medicare AND a new patient.
(One list is the Physician Compare Directory at the Medicare website where all the doctors do take Medicare. There are other online lists from various sources, often local, usually searchable by Zip Code in addition to specialty.)
Before that, however, another friend has offered to make an inquiry for me and we'll see how that goes.
But the point remains that if Medicare is your health coverage and you need a new physician for whatever reason, you may be out of luck. Of course, when/if I find one, there is no reason to believe he/she will spend any more time with me than my most recent encounter and we don't get to do job interviews before choosing a doctor. It's more like, if one will take you and he or she is still breathing, don't say no.
A fairly short trip around the web turned up multiple stories of elders with Medicare unable to find a physician willing to accept them.
A 2013 NPR story about this dilemma noted that between the year 2000 and 2012, the number of Texas doctors accepting Medicare dropped from 78 percent to 58 percent. There is no reason to believe it is any different in the other 49 states and god knows how low the percentage is now, four years later. Further:
”Seventy-eight-year-old Nancy Martin is one of the seniors who had a tough time finding a physician.
“'I felt frustration, disappointment and I would say, despair. A lot of days I would get to the point where I would think, I'm never going to find a doctor in Austin,' she told the NewsHour. It took a full two years for Martin to find one.
Ten thousand people a day turn age 65 so this problem isn't going away any time soon.
PRE-EMPTIVE NOTE: We are not here for any long-distance diagnoses of my mystery malady so please don't. The issue at hand is important – our experience, discussion and advice (if any) on finding a physician.