@ Adult PCP vs. Pediatrician differences

[karinothing]

Could not figure out what to title this post, but anyway. . . Why do adult PCP providers operate so differently than pediatrician officers. I just called my PCP to reschedule my physical in August because we will be out of town. The next available appointment is in January. It is ridiculous that I have to schedule an appointment 7 months out! Meaning I called today to schedule my kid's 7 year appointment. He turns 7 July 29th. I was able to get an appointment for August 1st. My PCP has about as many doctors and PAs as my kid's pediatrician. I am just curious as to why pediatricians seem to be able to get my kid in same day and handle everything immediately and I Have to turn to urgent care for my PCP. Sometimes I feel like I just keep a PCP so if I every wind up in the hospital they will have someone to call.

AND as long as I am on a vent rant, my PCP is STILL not seeing sick patients (only virtually). Last time I had a cough for 6 weeks (and multiple negative covid tests) they told me to go to the ER to evaluate my lungs. Way to keep medical cost down. We are now over 2 years since the start of the pandemic, I feel like they should start seeing normal sick patients again. My kids pediatrician never stopped seeing patients with covid symptoms (I realize this last rant is likely my Dr specific. I really love my individual doctor and like that the practice I go to also shares a records system with Urgent Care and the hospital and my OBGYN so its nice to have everything connected. But it also seems a bit ridiculous at this point.

[lemoncupcake]

Maybe you just need a new PCP? It sounds like they’re operating in multiple ways that don’t meet your needs.

I have used a Dr at the same (large, citywide) medical group that my kids see a Pedi at and haven’t had any issues like that. I’ve been able to get last minute sick visits and have had plenty of availability in scheduling annuals.

[abs]

I would find a new PCP because that isn't the normal experience.

[noodleoo]

I'm guessing because its because there is probably a shortage of adult PCPs. At least that's my experience. And if it makes you feel better, I just tried to set up a physical with a new PCP that opened in town and the first available with an MD is February 2023!!! I couldn't believe it. I got in with the NP for July. Good thing it isn't urgent <eyeroll>. I asked why so long and she said the demand has been huge since they sent out flyers in our town. And I live in a suburb of Boston, healthcare is one of our things!

[karinothing]

May 19, 2022 8:29:30 GMT -5 noodleoo said:

I'm guessing because its because there is probably a shortage of adult PCPs. At least that's my experience. And if it makes you feel better, I just tried to set up a physical with a new PCP that opened in town and the first available with an MD is February 2023!!! I couldn't believe it. I got in with the NP for July. Good thing it isn't urgent <eyeroll>. I asked why so long and she said the demand has been huge since they sent out flyers in our town. And I live in a suburb of Boston, healthcare is one of our things!

Yeah I might call back to reschedule with an NP or another physician but I really like the relationship I have with my dr. Well, when I actually get to see her lol.

[carmenere]

I've had the same experience with several different practices and sadly I think it's becoming the norm. My doctor is great but is under pressure to fit in as many patients as possible every day. Even before the pandemic I could rarely get an appointment with my doctor on short notice. I'm not sure why pedi offices are different, but I think PCP offices have so much pressure to generate revenue. And like noodleoo said I've heard about a shortage of adult PCPs. Our healthcare system is so broken 

[loira]

I'm sorry it's such a long wait. We have a huge shortage of GPs in my province and it's starting to become a crisis.

Also this reminds me that for the longest time, I didn't understand the joke on friends about how Ross still went to his pediatrician. We generally have family doctors here and kids will go to the same doctor as their parents. They only go to pediatricians if referred for something specific the family doctor can't treat.

[quesyrah]

I have been with multiple PCPs over the last few years and I find that to be a common issue. It is incredibly frustrating.

[ssmjlm]

I haven't had that issue with my PCP (well she's a PA), I can easily see all of the available appointments in the app.

The pediatrician is a whole other issue for us. I wish they had an app like my PCP and often times appointments are hard to get.

[sent]

I have not been to mine since fall 2020. I found the paper for the blood test she prescribed while I was clearing my desk a few weeks ago. I had told myself that 2022 is the year I finally get my health back on track so I made an account on Quest and got the blood test done. The results showed full blown diabetes with really horrible numbers. My PCP's office called me right away and got me in within a week to get me started on meds. All this to say maybe they're overwhelmed focusing on the sickest patients so the relatively healthy ones are getting pushed further out.

[picksthemusic]

I work in primary care, and that's nuts. Does your insurance dictate who you get to have as your PCP, or do you have a PPO? If you can see whomever you want, I'd start asking around for recommendations for a new clinic/office/provider.

We've been seeing sick folks in-house for at least a year now, and while it's a PITA due to Covid (we have to get all gowned up/N95/face shield), we do it.

ETA: It's also on your PCP's office to manage their time better, honestly. We always keep same day appointments open, and configure our schedules to accommodate specific needs. I don't know what their staffing is like, nor what their management is like, but it's highly probable that it's ineffective.

Do you have a way to express your concerns? Do they do patient surveys? If so, I'd for sure make it known how displeased you are.

[wildrice]

I am guessing it's because there is a PCP shortage. I think it's one of the lowest paying routes to go as a doctor, and also one of the most difficult because you have to know about such a broad range of stuff. I don't know what peds pays but I think it's a lot more popular of a specialty so there is a bigger supply of doctors.

That said, I guess I haven't scheduled a physical with a PCP in a couple of years, but I've seen her for various other things and she's been able to get me in quickly. She has her own practice, not sure if that makes a difference. I would look into switching if your practice isn't able to accommodate all of their patients. I agree January is kind of absurd.

[ellipses84]

I think this is related to your particular PCP practice. We’ve moved around a lot so I’ve had to switch PCPs and Pediatricians fairly often between that and medical insurance changes. Some are just too busy and don’t have enough Drs. on staff or space to expand. Location makes a difference too, like with the same medical group with offices 10 minutes apart, the one closest to a major metro line was way busier (I switched after having to wait for 1-2 hours past my appt time on several occasions).

[mrshandy]

I would find a new PCP. I live not too far from you and I'm able to get into my PCP whenever I need to. I've never had to face anything serious so I don't know how "good" he is, but mediocre/adequate health care is better than no health care IMHO. I would explore other options.

[lea]

I have largely only seen NPs and PAs for my regular physicals and for basic sick visits since I was in college. @ I saw the OBs during my pregnancies but now I just see the NP for my annuals now that I’m done procreating. I find I can get in with them more easily. But I’ve been fortunate to not have many complicated health issues that would require more in-depth care (although the NPs and PAs are all probably more thorough than most of the MDs I’ve seen).

[rubytue]

On thing I haven’t seen mentioned is that physicals I believe are generally 30 minute appointments, where are the others are 15 min. So, scheduleing them is limited, and there might be like 1 or 2 per week to fill. So those book up 6 months out. My doctor is like that, but I don’t have much problem getting in for a problem visit (I haven’t had a sick reason in several years, but a couple of injuries). At my last one, for a muscle spasm, she also wrote out blood work for the typical physical.

[charlatti]

I have the opposite experience — I got in quickly with my PCP for my physical but pediatric well visits need be scheduled quite a ways in advance. My area has more adult than pediatric practitioners?

[savan]

I have never seen my PCP. I only know her name. Every appointment I’ve had in the office, even my annual well woman, has been with the NP or PA. I don’t mind and can be seen pretty quickly that way. If I wanted to see my actual PCP it would take months.

[pixy0stix]

My PCP and my kid's pediatrician are one and the same person. It's rare that we even try to see her for illness, we go to urgent care. However, she reviews and gets back to us same day through our patient portal if she wants to do a follow-up. It works for us.

[plutosmoon]

This is very normal in my experience, but I live in a ruralish community with a large elderly population and a primary care shortage. The pediatrician schedules our next appointment when we leave, but if you need to reschedule, it usually gets pushed about 2-3 months out from the original date, pretty reasonable considering they book well visits a year in advance. It took 11 months to get into my PCP for a physical last time I scheduled one, most doctors aren't even taking new patients. You can't make your next appointment when you leave either, so you need to remember to call back and make the next annual appointment like a month after your appointment. Sick visits are not an issue at either the pedi or my pcp, those can be done same day.

When I first started my job, I had to have an HMO with a primary, the PPO was only available to those who lived outside new england, the HMO network only covered docs in new england. I live 10 minutes from the NY border, but would have to go to Worcester (2 hours), Springfield (90 minutes), or even Boston (3+ hours), rather than Troy or Albany (less than an hour) for specialists. I switched to the PPO as soon as they began offering it to new england residents.

[macmars45]

PCPs are in really short supply in my city. My family all see a NP because she was literally the only provider with an opening in our city summer 2020 when we moved here.

[Gato]

My PCP and pediatrician both belong to a huge collective (is that the right word?) of doctors.  Both my kids' and my own annual checkup must be booked many months in advance.  But we do get to see the doctors in person, as of sometime last year.  These generalists have a rewards system for referrals - it's a large part of how their bonus is determined - so they are constantly trying to send us to specialists.  It's annoying as a non-doctor to have to ask yourself, is this really needed?  Then if we don't go, they send me sternly-worded letters and I feel guilty.

Back when we lived in New Jersey, it was the opposite. It seemed like a fight to the death to get an appointment with some specialists; there just weren't enough.  Like literally, I had to call at a certain hour once a month, and when the appointments were filled up for that month, that was it.   I eventually found shortcut by scheduling a semi-bogus appointment with another doctor who worked in different specialty in the same practice, who then arranged the appointment.  But it was very easy to schedule a checkup just a week or two in advance.