Some thoughts I have had over the past week: Referring to Specialists.
I have several patients that we have been trying to refer to certain specialists in particular endocrinology and rheumatology.
These are pretty much the hardest medical specialists to get patients into. It got me thinking why? Then it occurred to me that they don’t really have procedures.
Let me start at the beginning…..The way the healthcare system currently pays doctors is the more procedures you do the more money you make. Therefore we have lots of Gastroenterologists and Cardiologists. We have no problem sending patients to them due to shear volume of these type of physicians. Endocrinologist and Rheumatologist really don’t have procedures that pay a whole lot. Therefore not nearly as many medical residents choose those fields when they finish their residency as there is not much additional pay for another 2 to 3 years of training.
We are predominantly left with very dedicated doctors who want to go into to those fields of practice.
We are left trying to find an opening for our patients that need to see these specialists in a timely manner and not 3 to 6 months from now.
I am not sure what the answer to that problem is, but it certainly is vexing. I am frequently left with patients who are frustrated because they can’t get seen for months. Usually we muddle through it by me playing Rheumatologist and Endocrinologist for as long as possible.
Occasionally, I get an angry patient who blames me for not being able to get them in faster. You can’t get blood out of a turnip. The fun thing about my job is that I do get to make interesting diagnoses on a daily basis. This does require a lot of detective work on my part. I’m not always right the first time, but it is very satisfying when you diagnose a patient with a disease that is fixable. Not so much so when it’s a terminal disease.
Until next time I must get back to my charting.
Dr. Farley