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About this blog: So much is right — and wrong — about what is happening in Palo Alto. In this blog I want to discuss all that with you. I know many residents care about this town, and I want to explore our collective interests to help ...  (More)

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Absurdly long waits for doctors' appointments are an escalating health care problem

Uploaded: Apr 19, 2022

I don’t know whether I should laugh out loud as I think about the iabsurdly long waits we now encounter in getting a doctor’s appointment -- or bury my head in my hands and simply sob away.

“We are now accepting appointments for October. Do you prefer morning or afternoon after the 14th?” This is a frequent refrain I hear when trying to get an appointment. “But this is April 19th! That’s six months away!”

“I know,” the voice replies. “Our first opening is Oct. 14 at 4:45 p.m. Will that work? If not, we have one the 21st at 8 a.m. Or you could look for one in November. We are half-filled already for that month.”

No, those are not made-up responses. And the inordinate wait is not acceptable. But . . .

I can’t do anything about it except ask to be put on a waiting list -- which I did several times but only got called once fin the late morning or an opening in Palo Alto Medical Foundation’s Fremont office early that afternoon.

Lots of people complain about the delays – friends, neighbors, even my physicians and their assistants. It is a local problem – at PAMF and at Stanford clinics. My daughter-in-law in Seattle has complained about long delays in seeing her physician, as has my best friend now living in Kentucky, my college roommate outside Boston, and more.

While I hesitate relating my tale of waits, I will today use my own experiences as an example of what is to me an escalating problem.

My GP referred me to the Stanford Pain Clinic in Redwood City for a back pain, suggesting there might be a long wait for an appointment. There was. Six months. The doctor I saw was great, and she suggested an MRI. I asked her assistant for a referral to PAMF in Palo Alto, since it was more convenient. She inadvertently referred me to the Newark office. I called and asked the scheduling clerk to change it to Palo Alto and she said she didn’t see on the sheet the doctor permitting an outside Redwood City appointment. I told her the physician referred me to Newark, and that’s outside; she said she didn’t see it on my sheet and could not do it. Her reasoning resulted in a bit of consternation.

The next day I called again; the staffer on duty said she would make the transfer. Then the following day I got a call from the same appointments desk saying she understood I wanted to transfer my MRI appointment to Palo Alto. I told her the appointments yesterday said she did that. No she didn’t, was the reply.

When I was finally referred on Jan. 3 to PAMF in Palo Alto, I called for an MRI appointment. The earliest? Jan. 30. I called for a follow-up appointment after my MRI test. I got one a month later. My physician wanted to undergo a procedure. Earliest date? May 24.

Need I say more about delays?

Second example: On Jan. 17 I woke up dizzy. I talked to my GP and she said I need an appointment with a neurologist. Earliest appointment at the PA, Redwood City, Mountain View or Fremont office was April 25. I’ve been dizzy every day since that January morning, But as much as I ask, I am told the office is booked up until ….

WHY? Why all these delays I kept on asking the physicians and their staff. I received six not-so-certain answers:
a) There is a shortage of doctors in the area, particularly GPs.
b) More and more patients want appointments, particularly because many were reluctant to come to the clinic during the pandemic.
c) PAMF is given a budget each year by Sutter Health, its owner, and it is up to each clinic to allocate the budget money. Except there’s not a surplus to go out and hire new physicians. The CEOs supposedly could cut salaries of other physicians, but that sure isn’t good for MD morale.
d) It’s hard to attract new physicians to the area because living costs are so high. True.
e) More people have insurance now because of the Affordable Care Act, so the demand is higher.
f) Sutter has a reputation of being a bottom-line operation, where profit and loss become determinant considerations in running their business.

So that brings me to figuring out Sutter’s logic. If there are a lot of patients who want to go to PAMF or to Stanford, why not try hard to hire more, perhaps by offering higher salaries? It might work, because California, with its wonderful weather, is a great place to work, especially here in Silicon Valley.

Don’t more patients mean more money coming into Sutter? Last year the health organization had financial problems; this year it is faring better.

And last – but really first—all these health organizations are in the business of helping those who are sick and ailing. Do they have a moral responsibility to provide quality health care to all of their patients – without extremely long waits? I would think so.
Community.
What is it worth to you?

Comments

Posted by Anneke, a resident of Professorville,
on Apr 19, 2022 at 7:57 pm

Anneke is a registered user.

May I suggest that you ask for a Doctor's Practitioner? This is not a doctor, but close, and they are great. We have seen several at Stanford Hospital. Hope that helps.


Posted by Allen Akin, a resident of Professorville,
on Apr 19, 2022 at 9:21 pm

Allen Akin is a registered user.

I'm on month 11 of attempting to get a replacement Primary Care Physician at PAMF. If there's no success next month, I'll go elsewhere; the question is just "where"? All this is symptomatic (sorry) of the unbalanced growth in the Bay Area.


Posted by Bette Ulrich, a resident of Los Altos,
on Apr 20, 2022 at 7:38 am

Bette Ulrich is a registered user.

These delays and extended wait times are common at the larger clinics that offer advanced medical services and diagnostics.

For regular check-ups that only require a primary care physician, we simply go to our general practitioner who maintains an office and examination room at his residence, kind of like Dr. Marcus Welby for those old enough to remember.

When I was a child growing up in the Midwest, the local undertaker also operated out of his home and and had a specialized room where he performed embalmings and cosmetic preparations for casket presentations.

I am not sure whether Palo Alto residential neighborhoods can be zoned for these types of services but it would certainly reduce the lag time for various exigencies.


Posted by Greg Lassiter, a resident of Old Mountain View,
on Apr 20, 2022 at 8:08 am

Greg Lassiter is a registered user.

The Mountain View PAMF is always quite busy as well.

As a result, we are curtailing our visits there and shifting more towards homeopathic and holistic medical treatments and diagnostics.

My niece is a veterinarian and at times we have also consulted with her on various medical issues and concerns.


Posted by John Donegan, a resident of another community,
on Apr 20, 2022 at 9:36 am

John Donegan is a registered user.

This is a lesson in the law of unintended consequence for the wealthy and reliably liberal people of Palo Alto. As programs like Obamacare have increased access to healthcare by the less affluent, usage has increased and the finite number of doctors available stretched thin. While the wealthy previously had more physician time available, they now have to share it with the less affluent. This may be fairer, at least depending where your land on the social equity continuum, but was probably unforseen.


Posted by lina+crane, a resident of Duveneck/St. Francis,
on Apr 20, 2022 at 10:49 am

lina+crane is a registered user.

[Post removed.]


Posted by Ginger Poston, a resident of Downtown North,
on Apr 20, 2022 at 11:05 am

Ginger Poston is a registered user.

"As programs like Obamacare have increased access to healthcare by the less affluent, usage has increased and the finite number of doctors available stretched thin. While the wealthy previously had more physician time available, they now have to share it with the less affluent. This may be fairer, at least depending where your land on the social equity continuum, but was probably unforseen."

Excellent point. Prior to Obamacare, poorer people had to rely on social service provided healthcare clinics, urgent care, and ERs for prompt medical attention.

Now they are eligible for comprehensive healthcare services and provisions under Obamacare.

The complainers of long waits and delay times are most likely the privileged and well-to-do who are only concerned about their own well-being.

In other words, the purely self-centered types who believe the world revolves around them.

Not so.






Posted by Judy Tavares, a resident of Menlo Park,
on Apr 20, 2022 at 11:58 am

Judy Tavares is a registered user.

When I was a child back in the 1950s, our family doctor made house calls and there was no waiting other than for him to arrive.

This practice should be reinstated as most doctors today drive cars and own a smartphone.


Posted by Bobbi Calloway, a resident of Old Palo Alto,
on Apr 20, 2022 at 1:24 pm

Bobbi Calloway is a registered user.

By paying considerably more, one can conveniently free him/herself and one's family from the current healthcare network and its pitfalls.

This provides far more latitude in regards to choosing one's own personal physician and specialists.

As a family, we have chosen this route and it really is the only way to go as the doctor-patient relationship is far more attentive, personal, and expedient.


Posted by Jay White, a resident of Bailey Park,
on Apr 20, 2022 at 1:44 pm

Jay White is a registered user.

We need to be encouraging and training more healthcare professionals and this begins with better educational practices and curriculum.

In India, one can earn an MD in four years and upon passing the CA Medical Board Exams, they are licensed to licensed to practice medicine in California.

In the United States it requires earning a four-year BS degree and a subsequent four years of medical school plus passing the medical board exam and residency requirements. Add even more time if one opts to specialize.

If we can expedite more qualified doctors and nurses (whether in America or from India), there will be more clinics and lesser waiting times for the hurried.


Posted by Anneke, a resident of Professorville,
on Apr 21, 2022 at 10:15 am

Anneke is a registered user.

Can we do something radical in the US to increase quality of medical care and reduce healthcare costs?

How about offering patients a yearly money reward if they do not smoke, do not drink too much, exercise, stay within their BMI range, have a healthy cholesterol number, and more.

I would like to see more teachings in elementary and high school on how food can be your "medicine," not an abundance of pills so easily given out by medical professionals. Teach and show in videos how good foods and taking precautions against being in the sun too long can factually help your skin look at its best.

Common sense ideas taught to students in their teens can do so much to increase health and reduce costs for everyone.

It would give people who do need medical care more access to doctors, as many of the appointments would not be necessary.


Posted by Outside Observer, a resident of University South,
on Apr 21, 2022 at 10:16 am

Outside Observer is a registered user.

Old Soviet Union joke:

"Thank you for purchasing your new car. We'll be able to deliver it ten years from now."

"Will that be morning or afternoon?"

"Ten years from now? Does it really matter?"

"Well, the plumber is coming in the morning..."


Posted by Outside Observer, a resident of University South,
on Apr 21, 2022 at 10:16 am

Outside Observer is a registered user.

Old Soviet Union joke:

"Thank you for purchasing your new car. We'll be able to deliver it ten years from now."

"Will that be morning or afternoon?"

"Ten years from now? Does it really matter?"

"Well, the plumber is coming in the morning..."


Posted by Online Name, a resident of Embarcadero Oaks/Leland,
on Apr 21, 2022 at 10:57 am

Online Name is a registered user.

Someone needs to do a comedy skit on PAMF appointments. I got my usual reminder about my annual mammogram via a no-reply message without the usual phone number or link for scheduling it.

I dutifully find the info and schedule the appointment. I then get 8+ reminders to schedule the appointment already scheduled, reminders to confirm the appointment already scheduled and confirmed and reminders of the scheduled appointment -- all sent late at night so I've got to get up and clear the phone pings.

Then I get a call the day before the scheduled and confirmed appointment asking if I can reschedule due to staffing shortages.

All this a minor travesty vs the ridiculously long waits for specialist appointments, When I comment on that, Sutter says they can't get good help these days. When I suggest that maybe they stop their constant ads for new patients, they laugh uncomfortably,

Recent events had us discussing Sutter and its MBA culture. I urge you to check out the new young CEO and his background for a hint of things to come.


Posted by ALB, a resident of College Terrace,
on Apr 21, 2022 at 11:42 am

ALB is a registered user.

Where is the hard data backing up reasons for delays in getting appointments? That smacks of entitlement and is not the core reason.
Doctors are leaving to br concierge practitioners. There are several reasons for these unconscionable delays. Obamacare is not the issue.


Posted by tom kearns, a resident of Charleston Meadows,
on Apr 21, 2022 at 11:56 am

tom kearns is a registered user.

I feel you pain, but oddly enough I get my medical care at
the PA Veterans Hospital and I never have to wait for an appointment.


Posted by Green Gables, a resident of Duveneck/St. Francis,
on Apr 21, 2022 at 12:11 pm

Green Gables is a registered user.

Doctors at PAMF do not see patients every day. Wonder why? Would they get paid more? Is it that Sutter is cheap and does not want to hire more physicians?


Posted by Claudette, a resident of Woodside,
on Apr 21, 2022 at 12:15 pm

Claudette is a registered user.

Just heard from a friend who tried to make an appointment at Stanford for counseling services. No new patients ... august or October ,maybe ...I think psychologically a wait that long is prescription for disaster.


Posted by Claudette, a resident of Woodside,
on Apr 21, 2022 at 12:15 pm

Claudette is a registered user.

Just heard from a friend who tried to make an appointment at Stanford for counseling services. No new patients ... august or October ,maybe ...I think psychologically a wait that long is prescription for disaster.


Posted by Wei Jung, a resident of Charleston Meadows,
on Apr 21, 2022 at 12:17 pm

Wei Jung is a registered user.

The VA is a very good medical facility.

Perhaps more Americans should consider joining the armed services and serving their country to procure these timely healthcare provisions.

Many Chinese families encourage their children to enter the medical field and as a result, we receive timely and medical attention at home.

Long-standing American citizens could easily do the same but many are peroccupied with raising spoiled children who don't care about anything except social media and superficial entitlements.

Children are the future of our society and if parents are lax, their children will be lax.


Posted by Byron Lane, a resident of Mountain View,
on Apr 21, 2022 at 3:51 pm

Byron Lane is a registered user.

Whenever I go the the MV PAMF, it seems like the majority of physicians are either from India or China and more power to them.

>"In India, one can earn an MD in four years and upon passing the CA Medical Board Exams, they are licensed to licensed to practice medicine in California."

> "Many Chinese families encourage their children to enter the medical field and as a result, we receive timely and medical attention at home."

What is wrong with American kids today? No ambition?

There are a lot of college students today who are sluffing by and majoring in the humanities with nebulous plans to enter law school but we already have enough lawyers.

Our son currently attends UCSC where he appears to be more focused on surfing, snowboarding, eating fish tacos, and smoking pot.

And when time permits, he has been majoring in useless subject matter like Eastern Philosophy.

As a result, we are cutting him off for next fall.


Posted by Mildred Decker, a resident of Los Altos,
on Apr 21, 2022 at 4:12 pm

Mildred Decker is a registered user.

"What is wrong with American kids today? No ambition?"

@Byron Lane

Permissive Baby Boomer parents + self-entitled Millennial offspring = useless individuals with no sense of direction.

The fruit does not fall far from the tree.


Posted by Michael Dauner, a resident of Blossom Valley,
on Apr 21, 2022 at 4:46 pm

Michael Dauner is a registered user.

For those majoring in the humanities all is not lost if one really wants to become a physician.

At St. George Medical School in Grenada, one has the option of completing med school either online or attending in person.

The warm Caribbean breezes, secluded beaches, and exotic local food offerings provide an ideal educational environment and to date, there are roughly 7,000 St. George med school graduates who practicing their craft in America (primarily in the Midwest).

Besides, a diploma is just a piece of paper (to some).


Posted by Michael Dauner, a resident of Blossom Valley,
on Apr 21, 2022 at 4:54 pm

Michael Dauner is a registered user.

Edit:
> there are roughly 7,000 St. George medical school graduates [both past and present] in the United States as state medical board certifications vary.


Posted by Former Resident, a resident of another community,
on Apr 21, 2022 at 8:21 pm

Former Resident is a registered user.

This should be a surprise to anyone who's involved in health care. Primary care physicians, because of the insurance industry restrictions, can't charge as much as specialists for care. Yet they come out of med school with the same crushing debt. Who can blame them for skipping primary care and going into a specialty?

At the same time, this scourge of "concierge medicine" is luring primary care physicians into a model of gross inequality, where only the rich can have their doctors available when they want (and yet, those patients still need insurance for when they need hospital or specialist care). That's reducing the number of primary care physicians available as well.

Add the ridiculous pressures of the pandemic, with physicians and other health care professionals simply fed up by the idiocies in the community.

And finally, thank the AMA and Congress (Web Link for imposing artificial restrictions on the number of medical school graduates allowed.

The problem is only going to get worse before it gets better. And by the way, up here in the Portland area, we're having the same problem. My annual January physical is scheduled for October.


Posted by Former Resident, a resident of another community,
on Apr 21, 2022 at 8:21 pm

Former Resident is a registered user.

This should be a surprise to anyone who's involved in health care. Primary care physicians, because of the insurance industry restrictions, can't charge as much as specialists for care. Yet they come out of med school with the same crushing debt. Who can blame them for skipping primary care and going into a specialty?

At the same time, this scourge of "concierge medicine" is luring primary care physicians into a model of gross inequality, where only the rich can have their doctors available when they want (and yet, those patients still need insurance for when they need hospital or specialist care). That's reducing the number of primary care physicians available as well.

Add the ridiculous pressures of the pandemic, with physicians and other health care professionals simply fed up by the idiocies in the community.

And finally, thank the AMA and Congress (Web Link for imposing artificial restrictions on the number of medical school graduates allowed.

The problem is only going to get worse before it gets better. And by the way, up here in the Portland area, we're having the same problem. My annual January physical is scheduled for October.


Posted by fred, a resident of University South,
on Apr 21, 2022 at 10:00 pm

fred is a registered user.

The factors causing the waits are mostly related to the pandemic.

Delayed treatment during the pandemic , catching up on 2 years in a short period of time
New illnesses related to the pandemic plus long COVID
Medical personal cutting back, dropping out, or leaving the area
People have more money to spend on elective treatments
People working from home have more time available for medical care

When the recession comes, demand will drop. Anybody for a government gatekeeper to prioritize your need for care.
Single payer like the UK would be option if you think you would like that better, but many Americans have bought into the medical advertising that health care is a consumer good/service.


Posted by Barron Parker Too, a resident of Barron Park,
on Apr 21, 2022 at 10:06 pm

Barron Parker Too is a registered user.

The long wait for specialists is because there aren't enough. The question is why? Apparently, the main reason is the cost of housing -- young doctors can't afford to live here, whereas in most places they can buy a house. So they're choosing to leave if they are here, or not to come in the first place.

I know someone who has waited a year to see a neurologist for Parkinsons, and their current appointment is still 4 months out. It had been scheduled twice starting a year ago, each time for 6 months out, and both had to be rescheduled because the physician left the area. They are now waiting on the third appointment.


Posted by fred, a resident of University South,
on Apr 21, 2022 at 10:07 pm

fred is a registered user.

Regarding PAMF, when my wife's primary left the practice, she had a specialist she was seeing write a referral to a primary doctor for some related testing she needed. With that referral, she got in pretty quickly.

At that appointment, she worked to develop rapport with the doctor, and by the end of the appointment, the doctor was willing to accept her as a new patient. If you need care, there are ways to get it.


Posted by Neighborhood moms, a resident of Duveneck/St. Francis,
on Apr 21, 2022 at 11:48 pm

Neighborhood moms is a registered user.

It has been crazy time to get appointments. After seeing my Ortho (originally made because I noticed a problem but by the time of the appointment, I was on crutches) , he's having me wait another week for a mRI (where it used to be done right then) I had even requested a MRI when I was in urgent care a few days prior to no avail.) If I had wanted the follow up with the Ortho dr it would have been in THREE Weeks-just for a consult. The swelling in my knee is still profound-this has been more than frustrating as it has impacted what I can get done on a daily basis plus the quality of my sleep.
I did notice though that's there's a “Sutter Health Plus";that's a HMO. Could it be that Sutter Health has added too many? On their web site they promise “to see people for “emerging issues" within 48 hours." That hasn't been my experience. (Perhaps that's why PTs need doctor referrals even though in CA the law says you don't?)
A quick shout out to the Rhuemtology Doctor that came down to check on me at Urgent Care at 7 pm. Amazing and I am so thankful we were able to rule that out!
However, there are other options we can choose. For instance: For Mammograms and ultrasounds, Welch Road Imaging" is amazing. Personable, quick appointment times and parking right out front.!
Soar Medical group is also a good resource for bone issues. I wish I had remembered them to begin with instead of descending into the PAMF rabbit hole.
It is so sad, There are so many great doctors, nurses and staff at PAMF But they can only do so much with so little.


Posted by Melba Jamison, a resident of Menlo Park,
on Apr 22, 2022 at 8:27 am

Melba Jamison is a registered user.

[Post removed.]


Posted by Annette, a resident of College Terrace,
on Apr 22, 2022 at 8:46 am

Annette is a registered user.

@Online Name hit the nail on the head: the influence of the MBA culture on the practice of medicine has not improved the delivery of health care in this country. Quite the opposite. The insurance industry hasn't helped, either. And, in the SF Bay Area, the high cost of housing contributes to the problem. All these things influence a young person's decision about whether to commit 4 - 6+ years to medical school, internship, and residency and then a career that involves an inordinate amount of bureaucratic paper work and hurdles that essentially separate doctor and patient.

To this add the issues that are currently front and center at SUH and LPCH: the staffing cutbacks and shortages that have resulted in 93% of the CORNA nurses voting to strike. This is a thorny, multi-faceted problem. The best solution for every individual is to stay as healthy as possible. Another solution: get Big Pharma off television. The number of drug ads suggests that they work which means Americans must be way over-medicated. We banned cigarette ads; we should do the same to drug ads. Doing that would likely also help in the battle against fentanyl b/c we would stop sending the endless message that there's a drug for everything AND everyone uses them.

Reforming comp and benefit practices will be another part of the solution. PAMF's former CEO's total comp was in the multi-millions. Multiply that sort of warped pay by the number of health care CEOs and other managers and the need for reform there stands out like a sore thumb. I'd rather the lion's share of my medical spend went to those directly involved w/the delivery of medical care, rather than removed-from-the-fray managers. I think that would go a long way towards assuring that pursuing a career in health care is a good choice that rewards, financially, the hard work and dedication that is required. And that will help with the supply/availability problem.


Posted by Ashley Preston, a resident of Portola Valley,
on Apr 22, 2022 at 9:43 am

Ashley Preston is a registered user.

I was pre-med in college with plans to specialize in orthopedic surgery.

Upon passing my entrance exam and getting accepted to Princeton, I opted out because the road to financial success is a long one and nowadays, whose got the time?

Fortunately I minored in Computer Science and found work at a start-up venture during the late 1990s.

After the company went public in 2005, I was able to cash-out and fully retire by my early 30s.

Most of the MDs today are either Chinese and/or East Indian, proficient and well trained. Some lack a certain 'bedside manner' and are all business but this is understandable given the workloads and expectations.

Earning big money is not a good incentive for attending medical school and becoming a physician as there are other more viable outlets.

My cousin is a high school dropout who runs a successful roofing company and he makes far more than most physicians and lawyers. They work for him as needed.

The extended wait times at various medical clinics will only get worse and more people will be turning to ERs and urgent care centers for immediate attention.

The problem is that these two options are also leading to longer wait times as well.


Posted by Annette, a resident of College Terrace,
on Apr 22, 2022 at 11:49 am

Annette is a registered user.

Your example is a perfect illustration of what I assume is an unintended consequence of turning medicine into a business practice rather than a care-giving practice. I was raised by an orthopedic surgeon and my first husband went into the same field. My father practiced during what I think must have been the golden years of medicine in the US. He worked long hours, made house calls, was on-call essentially 24/7 and LOVED it. But he also saw the changes and didn't much like the impact on the profession. He and my spouse had "interesting" conversations about the changes and were in full agreement that they were not good for the practitioners or the patients.




Posted by Oscar Morales, a resident of North Whisman,
on Apr 22, 2022 at 12:04 pm

Oscar Morales is a registered user.

The taxpayer dollars being allocated towards the defense of Ukraine could be better used towards improving healthcare in America.

What goes on in the Ukraine is the sole responsibility of the Ukrainians to address and resolve regardless of the outcome.

A lot of this has to do with the racist nature of America as it does not intervene on the countless attrocities taking place in Africa, Mynamar, or Latin American countries...only in countries where the populace is predominantly white.

Quality medical care is imperative and what happens in other countries is less important than caring for and attending to the immediate healthcare needs of tax-payong American citizens.


Posted by Dave Willis, a resident of Barron Park,
on Apr 22, 2022 at 1:35 pm

Dave Willis is a registered user.

Given the choice, I think most Palo Alto residents assign more importance to timely PAMF medical services than what goes on in the Ukraine.


Posted by Sunny Storm, a resident of Woodside: other,
on Apr 22, 2022 at 6:13 pm

Sunny Storm is a registered user.

One can get still an appt at one of the Urgent care locations within a day or two thankfully.

The Am. Medical Association has restricted the number of doctors through their policies in the past, which doesn't help.

And now we have an aging US population AND an aging physician population with large numbers retiring or burning out.

And frankly, who in their right mind would devote the 300k bill for college then 300k for medical school unless they have family money to support them? In other countries the education is highly subsidized by the government, and can be completed in 4-6 years.. Not in the US, a leading the descent to 3rd world status.


Posted by Tim Graham, a resident of Menlo Park,
on Apr 23, 2022 at 1:49 pm

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"...who in their right mind would devote the 300k bill for college then 300k for medical school unless they have family money to support them? In other countries the education is highly subsidized by the government, and can be completed in 4-6 years.. Not in the US, a leading the descent to 3rd world status."

^ One way to encourage more American citizens to enter the healthcare fields would be to excuse all student debts related to their professional education.

It currently costs the American government (aka taxpayers) $7.5B in monthly interest payment collections...mostly incurred by deadbeat humanities majors pursuing useless M.A.s and Ph.D.s in these non-luctative and non-productive fields.


Posted by MyFeelz, a resident of Nixon School,
on Apr 23, 2022 at 7:21 pm

MyFeelz is a registered user.

The bigggest abyss in Santa Clara County is the hole where people with complex medical situations fall in, and never get out. If you're on Medi-Cal, you are forced into Mandatory Managed Care. There, you can forget your complex needs altogether -- speaking from personal experience, they won't be met. If you manage to extricate yourself from MMC maze, you are met with many practices in this county who don't accept new Medicare or Medi-Cal patients. Again, speaking from experience. If you do find even one, it's an NP who is not going to be able to keep up with the whirlwind of cascading downward spiralling medical events that happen with rapid fire in a medically complex patient. I live in this vortex and seriously regret ever having set foot in Santa Clara County. But it's easier to get in than to get out. Meanwhile, multiple chronic diseases just have their way with me. I think perhaps the intent of the overburdened system is to weed out those who are just a drain on society and the state coffers. Maybe they expected COVID to take more lives than it did, and staffed accordingly. It's not surprising that nursing homes had such a high rate of COVID deaths. There's a pattern, but I am just too worn out from battling the medical system goliaths that exist here, to be able to figure it out.


Posted by MyFeelz, a resident of Hoover School,
on Apr 23, 2022 at 7:37 pm

MyFeelz is a registered user.

To "Neighbor Hood Moms" your comment about the referrals struck a chord in me. I have always been able to refer myself, because I'm Medi-Medi. However, in Santa Clara, no doctors accept this route. I have to wonder if there is some kind of quid pro quo going on, backscratchers club or good ol boys network at work. If we could refer ourselves, we would reduce our wait time to get into the specialist by at least 3 months. Because as it stands right now, I have to wait 3 months to get to my primary doc to request the referral, and another (at least) 3 months waiting to get into the specialist. I don't know if I can live that long. And many doctors, I fear, are hoping for that exact outcome.


Posted by Marion Bailey, a resident of Blossom Valley,
on Apr 24, 2022 at 10:17 am

Marion Bailey is a registered user.

How about utilizing more online appointments via ZOOM or Microsoft Teams?

That way patients don't have to drive, park, and wait to meet with their primary care physicians and specialists.

Surgery and dentistry would be obvious exceptions to online consultations but everything else could be easily accommodated.

It is time for medical clinics and patients to start putting on their thinking caps as this problem is solvable rather than having to be a continual complaint.


Posted by Online Name, a resident of Embarcadero Oaks/Leland,
on Apr 24, 2022 at 10:33 am

Online Name is a registered user.

Many of us already use Zoom appointments but the delays for even those are long and many PAMF staffers seem unaware of them. I was told to schedule an appointment before one specialist would prescribe a drug she'd already told me and the rest of the care team she'd be prescribing.

Her first available appointment was about 5 months out and it took me several days to push her staff to schedule her first video appointment which was "only" 5 weeks out!


Posted by Fritz Weatherly, a resident of Barron Park,
on Apr 24, 2022 at 11:51 am

Fritz Weatherly is a registered user.

"One way to encourage more American citizens to enter the healthcare fields would be to excuse all student debts related to their professional education."

"It currently costs the American government (aka taxpayers) $7.5B in monthly interest payment collections...mostly incurred by deadbeat humanities majors pursuing useless M.A.s and Ph.D.s in these non-luctative [sic] and non-productive fields."

A valid point. Why does the United States (most notably California) have to rely on physicians trained in other countries?

Is it because too many American kids simply enter college for some form of extended vacation from their parents?

My nieces and nephews are currently studying Psychology and Art History in college to the tune of over $50K per school year.

And for what? So they can become erudites employed in flunkee jobs?

We need more of our kids to realize that if they are going to college simply for kicks, they can do it on their own dime.

And those who pursue government student loans to major in soft subjects should be fully responsible for paying back all of their student loans with interest.




Posted by Callie Davis, a resident of Atherton,
on Apr 24, 2022 at 2:57 pm

Callie Davis is a registered user.

• "How about offering patients a yearly money reward if they do not smoke, do not drink too much, exercise, stay within their BMI range, have a healthy cholesterol number, and more."

Yes! Why should health conscious people take a back seat to irresponsible patients with preventable afflictions?

Obese people and substance abusers immediately come to mind.

An annual MD checkup/report card would validate such a concept and those who fail miserably should fall to the back of the line when it comes to appointments and procedures.

Gluttony and substance abuse can be easily curtailed with a sense of willpower.


Posted by LongResident, a resident of another community,
on Apr 24, 2022 at 6:21 pm

LongResident is a registered user.

I wonder if you are talking about Medicare Advantage. It should be called Medicare Disadvantage. You can get insurance where you don't need a referral. Why limit to PAMF? They seem to be a bad place to go. Waiting an extra month is one thing but waiting 6 months says something is wrong. I bet people who don't opt for managed care like Medicare Advantage don't have this problem to the same degree. Sutter Health is ripping everyone off.


Posted by Pepi Morgan, a resident of Downtown North,
on Apr 25, 2022 at 8:06 am

Pepi Morgan is a registered user.

> "Why should health conscious people take a back seat to irresponsible patients with preventable afflictions?"

>> "Obese people and substance abusers immediately come to mind."

>>>"The factors causing the waits are mostly related to the pandemic."

>>>>"Delayed treatment during the pandemic , catching up on 2 years in a short period of time"

^ These are key points as patients not taking preventative measures on their own increase the wait times for others seeking medical attention.

The hospitalized anti-non vaxers created extensive gridlock during the pandemic and obese individuals often require a bevy of specialists to repeatedly advise or remind them to lose the excess weight.

In other words, the patients who don't care about their health make things far harder for those who do.

A solution: when it comes to medical appointments and treatments, place these individuals at the back of the line.


Posted by Melissa Vogt, a resident of Los Altos,
on Apr 25, 2022 at 11:01 am

Melissa Vogt is a registered user.

I agree with the previous post.

While drug addicts, anti-vaxers, and obese people are entitled to the same healthcare benefits as health-conscious individuals, why should they receive any priorities when it comes to immediate medical diagnostic and/or treatment procedures?

Overcoming gluttony, drug abuse, or simply getting vaxed against COVID can easily reduce the growing number of medical clinic and hospital patients.

No sympathy here for the ignorant, reckless, and blind faith adherents who disdain modern science in lieu of taking any personal responsibility for their personal health and well being.

There is no reason to be obese or a drug abuser and getting vaxed is a simple procedure.


Posted by Cal Bednar, a resident of another community,
on Apr 25, 2022 at 1:08 pm

Cal Bednar is a registered user.

"No sympathy here for the ignorant, reckless, and blind faith adherents who disdain modern science in lieu of taking any personal responsibility for their personal health and well being.

There is no reason to be obese or a drug abuser and getting vaxed is a simple procedure."

While getting vaccinated against COVID is a relatively simple process, most drug abusers and chronically obese people are psychologically battling other demons.

It does not take a Dr. Phil to concur that many of these individuals hate everyday life as well as themselves and often turn to refined sugar, alcohol, drugs, and fatty food binging to temper their discontent with life itself.

As a nutritionist and having served as a moderator at various Overeaters Anonymous meetings, partaking in excessive amounts of food, alcohol, or drugs provides a convenient comfort blanket of sorts for some and they are 'self-medicating' on their own terms.

My neighbor who is a clinical psychologist recommends electroshock therapy for those who cannot control their impulses and the same applies to sex offenders.

Like Pavlov's Dog, humans can be programmed to promote good and bad behavior.


Posted by Gina Potter, a resident of Midtown,
on Apr 25, 2022 at 2:08 pm

Gina Potter is a registered user.

My neighbor likes to joke that she would be within the proper BMI range if she were one foot taller!

We go out all of the time and she can easily eat two Express Burritos at Celia's along with a couple of bowls of chips with salsa.

At home she can consume an entire half gallon of Haagen Daz in one sitting while watching TV.

Truly amazing as I would be sick.

Gluttony and obesity seem to go hand in hand as the "I have a slow metabolism" or "I'm big boned" explanations have their limits.

It wouldn't surprise me if she weighs more than my Toyota Prius.




Posted by Robert MacDougal (ret.), a resident of another community,
on Apr 25, 2022 at 8:40 pm

Robert MacDougal (ret.) is a registered user.

"I get my medical care at the PA Veterans Hospital and I never have to wait for an appointment."

The Palo Alto VA hospital is one of the best medical care facilities around and the PAMF could take a lesson or two from them.

Appointments, follow-ups, and various procedures are always expedited with limited wait times.

The PA Veterans Hospital is also a teaching hospital that operates on conjunction with the Stanford Medical School and Hospital.

While I am unfamiliar with other VA hospitals around the country, the Palo Alto facility has raised the bar and in an ideal world, it would be part of the local healthcare network regardless of prior military service.

The federal government also provides full medical practice insurance coverage for its VA MDs and malpractice suits are extremely rare, practically nonexistent.

Speaking as a former combat medic and current physician's assistant, it is a shame that so many readers here are experiencing significant delays when it comes to their basic healthcare needs.

In a modern country such as the United States, this is unacceptable with cause for reform measures.




Posted by Avery Stone, a resident of another community,
on Apr 26, 2022 at 9:36 am

Avery Stone is a registered user.

• My niece is a veterinarian and at times we have also consulted with her on various medical issues and concerns.

As a kennel owner and canine breeder, I have oftentimes done the same when addressing minor aches and pains.

Veterinarians are highly skilled physicians with a keen knowledge of physiology and anatomy.

In rural Wyoming where I am originally from, it was not uncommon for a vet to tend to urgent human medical needs like setting broken bones or applying stitches.

The only drawback is that they cannot
write certain medicationss for humans unless the prescriptions are applicable to animals.

And major surgery is out of the question.


Posted by Julian Lopez, a resident of Old Mountain View,
on Apr 26, 2022 at 11:49 am

Julian Lopez is a registered user.

Getting proper medical attention while incarcerated at the San Jose Main Jail (or at Elmwood in Milpitas) is a lot more difficult than those who are complaining here.

Let's get real.


Posted by Jesus, a resident of Stanford,
on May 6, 2022 at 2:21 pm

Jesus is a registered user.

Excellent article.
Important related questions are:
1) Why aren't we importing more doctors from abroad?
There are tons of Latin American and South Asian physicians that would love to come practice in the USA.
2) Why aren't we making it easier for foreign doctors and physicians in general to become certified, like waiving prohibitively expensive USMLE testing fees, and making the tests more practical and reasonable, based on critical thinking, as opposed to academically and theoretically complex, relying on useless memorization of facts that can be found in books or on Google?
3) Why isn't the government forcing all higher education institutions to offer Medical Degrees? There are tons of public universities and private universities that receive public funding (via NIH and NSF grants) that do not offer Medical Degrees. If we want to have more doctors, we need to train more doctors! Pre-kindergarten logic.
4) Why is it so difficult and expensive to get a general Medical Degree to begin with? Specifically, why do MD students need to complete 4 years of college *before* starting Medical School? Such practice is ABSURD! This is not how most other countries in the world do things, many of them with much better health care outcomes than the USA. It suggests that there's a MEDICAL MAFIA that wants to keep the numbers of doctors low to artificially inflate profits from practicing medicine. This is inherently unethical!


Posted by Jesus, a resident of Stanford,
on May 6, 2022 at 2:21 pm

Jesus is a registered user.

Excellent article.
Important related questions are:
1) Why aren't we importing more doctors from abroad?
There are tons of Latin American and South Asian physicians that would love to come practice in the USA.
2) Why aren't we making it easier for foreign doctors and physicians in general to become certified, like waiving prohibitively expensive USMLE testing fees, and making the tests more practical and reasonable, based on critical thinking, as opposed to academically and theoretically complex, relying on useless memorization of facts that can be found in books or on Google?
3) Why isn't the government forcing all higher education institutions to offer Medical Degrees? There are tons of public universities and private universities that receive public funding (via NIH and NSF grants) that do not offer Medical Degrees. If we want to have more doctors, we need to train more doctors! Pre-kindergarten logic.
4) Why is it so difficult and expensive to get a general Medical Degree to begin with? Specifically, why do MD students need to complete 4 years of college *before* starting Medical School? Such practice is ABSURD! This is not how most other countries in the world do things, many of them with much better health care outcomes than the USA. It suggests that there's a MEDICAL MAFIA that wants to keep the numbers of doctors low to artificially inflate profits from practicing medicine. This is inherently unethical!


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