Front Porch: Too few doctors mean too many stories of delays and worse in receiving health care

When I wrote two weeks ago about the difficulties of accessing – in anything close to a timely manner – health care specialists, I had no idea what a raw nerve that column would expose.

I’ve heard from so many people, with their own stories, that I felt I had to revisit this, even so soon.

Most of us aren’t complaining that doctors and nurses and other providers don’t care or aren’t competent. The complaint, beyond the god-awful bureaucracy that is medical care, often is that there just aren’t enough of them out there, especially specialists, even in a health care center like Spokane, so that delays in getting to see the very people who can help us – even save our lives – are excruciating in their length and potentially fatal.

We have great caring professionals and marvelous technologies. What we don’t have for too many of us is decent access. No one is OK with that, from the providers to the patients.

Yet here we are.

A retired medical professional wrote me about a relative who had to work her way through the time-consuming maze of referrals before receiving the devastating diagnosis that she had a particular terminal illness. There was a medication possible for her that was not a cure, but could give her as much as a year longer to spend with friends and family.

Unfortunately, it was told to me, approval for that medication was complicated and “more shuffling around ensued, and finally, by the time all the specialists got their ducks in a row to approve the treatment, she had become too weak to receive it.”

Her relative died this month.

I heard a story about a woman with breast cancer whose lumpectomy took so long to schedule that by the time surgery could be performed, the cancer had spread and a mastectomy was required instead.

Another Spokane resident told me of a recent trip she took to Hawaii with her husband, where he had an accident in which his back was broken. He was placed in a neck brace, and they returned home to see their primary care physician. It was going to be six weeks or more longer before they could get in to see a spinal surgeon, so they began looking for surgeons on the West Side of the state, and a virtual appointment took place with one. They also saw the local surgeon … eventually.

An additional problem was getting the CT and MRI imaging from Hawaii, which took weeks. “You may want to inform your readers that should they need imaging done while traveling, they can request the images be given to them (on disc) prior to discharge.”

Her frustration was great, especially, as she shared that “I’m a retired nurse and I know how to advocate for patients, as well as for myself and my family.”

There’s one more communication I’d like to share, from a woman with long experience in health care and who has dealt with her own chronic disorder for many years. The specialist that she had been seeing retired a few years ago. The specialist who took over didn’t have a subspecialty in her specific issue. She did find one (and only one) appropriate physician in Spokane, but that person is swamped and not taking new patients. She found another doctor in Portland, whose practice is closing; and no specialist was located in Seattle.

“I only need annual monitoring at this stage,” she wrote, “and I know how to take care of myself. As I get older, though, I am more concerned.”

She continued with the observation that specialists’ first line of defense seems now to be the ER. All of the physicians she’s dealt with concerning her issue are advising her to go to the ER when she has issues because scans, tests and labs can get done there faster than anywhere else, she said.

She laments that, of necessity, emergency rooms, overworked and overburdened as they are, “have become the first line of defense.

“Today’s medical world is ruled by the ER. Have you been in the ER lately? I’d rather stay home and die.”

She said this while noting that she has a Ph.D. in health. “And I do have money and health insurance. I still can’t get the health care I need.”

Many of us don’t have a primary care physician, and when ill, either tough it out or go to an urgent care facility or ER. This is not optimal, not anywhere and certainly not in a first-world nation like ours that boasts of the biggest and best.

As I wrote here two weeks ago, I and some of my family members and friends have received remarkable attention and concern from caring doctors, nurses and clinicians, but we, too, have experienced the fright that comes with fighting for access to those things when specialists are needed.

I know personally people whose conditions have worsened while waiting, and I now have first-hand stories of some who have died while standing (metaphorically) on a line somewhere awaiting a turn.

We do not make health care a priority in this country. Look around you carefully, especially in the more rural areas, and you’ll see for yourself … or anytime you need a specialist. If the access issue hasn’t happened to you or a loved one yet, it will.

Do better, America.

Voices correspondent Stefanie Pettit can be reached by email at upwindsailor@comcast.net.