I finally found a doctor. It shouldn't be this hard.

I founded and still lead a company called "Think Patients". You'd think a person with that background would have a pretty good handle on their healthcare. But until recently, it had been about six or seven years since I had a primary care physician despite having no obstacles to that other than an inability to find a decent one, in a practice I liked, and in which I could get an actual appointment for care without having to wait for weeks on end. This says a lot about the state of healthcare, and in particular primary care, in this country.

When Kate and I got married more than 25 years ago I had a fantastic internist. Kate ended up switching to him as well. He practiced in a university-owned health system considered one of the best in the nation, and all was well for several years. But we started noticing a change in the rate of staff turnover accompanied by a lack of patience from everyone in the system. No one knew us by name anymore. Then one day our doctor told us that he'd had enough of the pressure to see more and more patients every day, faster and faster. He was leaving to join a pharmaceutical company, and that was that. 

We switched to another provider in that system, and then followed him when he bought into a local private practice. We were never thrilled with the staff there, but when it got to the point that we were told to wait four weeks for an appointment even when acutely ill, we knew it was time to move on. Kate tried another practice or two, but I just drifted into using urgent care centers when necessary, and seeing specialists such as our dermatologist. Then Covid hit, we made our move to rural Maine, and discovered an area with a real shortage of physicians. The practices I wanted to join weren't taking new patients, and after almost three years of being on what I'm all but certain are imaginary waiting lists. I decided I needed to take another approach. 

I spent about two years trying to make it work with a sort of “back to nature” physician, but after having him recommend some concoction of herbs and garlic when I’d had a respiratory infection for a few weeks (he was a fully licensed DO, so it wasn’t like he couldn’t prescribe an actual antibiotic), and then having him recommend some $2,000 series of sessions on a machine that would stimulate my abs, I decided I’d had quite enough of him. I was all but despondent at my inability to find a decent physician, in a practice I liked and trusted. Then out of the blue, the physician on whose waiting list I had allegedly been parked for years left that large health system and joined a local "direct primary care" practice. I nearly did cartwheels, and joined immediately.

This is what some people call "concierge medicine", but that’s a very bad description. There's no insurance involved. You pay a set fee each month, and in return you get a guarantee that your physician won’t take on so damn many patients that you’ll be forced to wait weeks to see them. When you're sick, you'll be seen, usually the same or the next day. When you need to schedule something like a physical, you can do that without waiting for months. When you have tests run, your doctor calls and you have a meaningful conversation about the results. I feel like a king, but I’m pretty sure this is how healthcare is supposed to work. My first visit lasted more than an hour. The practice is 45 minutes away, but it’s not like I need to go there every week. And I’m finally, after years of what has basically been neglect caused by it being so damn difficult to access decent care, getting caught up on my tests and such. I couldn't be happier, except that some of the results aren’t quite what I had hoped. We’ll see what comes of further testing.

This is going to cost me a more because my high deductible health plan won't reimburse me for the monthly charges. And Kate is now under Medicare, so if she decides to go this route we’ll be paying out of pocket just so she can have better access to a physician, even as she’s forced to have some other primary care physician as well, to keep the Medicare Advantage people happy. But we'll have access to regular care from a physician who actually knows us, and who seems genuinely interested in our health beyond just getting us back out the door so the next patient can take our place.

My new physician is younger than me by perhaps two decades, so this might be the last primary care physician I'll ever need, even if I last two or three more decades. I'd be very happy if that's the case, because it has taken a long time to find this one. I don't think that says much for our healthcare system. But finally, at least for now, I finally found a doctor I like and trust and I get to go see him without waiting forever and a day.