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[quote=Anonymous]After some very difficult situations with healthcare for a family member who is medically complex I started following a lot of online medical information, including r/medicine on reddit to get a sense of healthcare from the provider perspective. Very eye-opening and this topic comes up pretty often.

We have a physician shortage. I'm in the midwest. The family member had tried to get in to see his PCP, who turned out to be double booked the entire day. He managed (had to push the issue) to be seen at a specialist clinic that has seen him before (they ended up prescribing antibiotics), but learned that if he had not been on their books they were not taking new patients. This is with the biggest healthcare network in our area. This week I mentioned it when I called my PCP office to confirm what orders had been made (I need a mammo and a bone density test) and mentioned this to the receptionist. She said they are scheduling new patients for 2025.

In 1980 there was an influential report predicting an oversupply of physicians, as a result of which (this was pretty well planned out based on how long it takes to turn a college student into a physician) beginning in 1990 med school admissions and residencies were cut. Corporatization of medicine, dealing with health insurers, and Covid have pushed out a lot of doctors, and many more are looking to bail.

I've heard from people moving here from the east coast they were surprised by the relative lack of independent physicians (fwiw, the big network we are part of was blocked by DOJ anti-trust actions from acquiring one independent practice, and more recently the state has passed a law saying that their insurance business--they do that as well--can no longer categorically deny participation from independent providers). I'm told the problem with access is nationwide but am indeed curious to know what is happening elsewhere in the US.

In the corporatized environment, it seems patient reviews can have a big impact--how much in real terms vs subjective reaction I don't know. I also don't know how skewed reddit is as a picture of physician perception, but there seems to be a lot of cynicism across the board.

As to being fired--they have to inform the person and provide care for 30 days. Subsequent providers will be wary of patients who have been fired. EMTALA protects emergency care access though.

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