I am a Millennial primary care physician. I began training before COVID hit, so I have perspective as someone who practiced medicine before, during, and after the pandemic. There are multiple, long-standing issues in medicine, many that have been unmasked by COVID but have been festering for a long time:
Doctors don’t run hospitals. Due to EMTALA, every single patient that shows up to your emergency department has to be treated. When insurance companies and private equity realized that you can’t say no to doing the work, then why should they pay you? Ultra lean staffing prior to covid led to the sh*tshow during the pandemic and, now that everyone is quitting, things are now in total collapse.
Go to any hospital in the country and, even if you have a serious problem like a heart attack, sepsis, a kidney stone blocking off your ureter while your kidney fills up with pus and you’re turning grey and shivering because you’re dying, well, chances are you’re going to be lying in a bed in the hallway.
Up in the ICU hopeless 95 year olds will sit on ventilators and other life support machines for weeks because doctors don’t have any discretion in stopping futile care. You can be a 30 year old pregnant woman, and you will die waiting for your ICU bed in the emergency room. There are 30 rooms in the ER, but 3 nurses overnight…what do you think happens if you have an accident and urinate or have a bowel movement in the bed? That’s exactly what happens. Good luck getting pain medicine for your kidney stone, there’s 10 other patients and they’re all sicker than you.
Number one recommendation: spend $$$ on a concierge primary care doc. Depending on your market can be anywhere from $1,500 to $15,000 per year. Why? Concierge doc will help you triage your problems, give you great access, keep you out of the hospital/ER, and help you cut through red tape if you need to engage the system.
Number two recommendation: seek care in facilities in high-income communities with relatively small general hospitals (i.e. Greenwich Hospital in CT) UNLESS you need tertiary/quarternary care. Why? Much better staffing. Much less riff-raff common people stuff (i.e. like homelessness) and much higher patient expectations about quality of care.
Number three recommendation: pay up for/seek out a cadillac insurance plan from a high quality insurer like Aetna or United with a low deductible (not high) and low copays. Why? Makes the patient experience much better on the back end with much less paperwork if you do engage the system.
Yes, I understand that I'm saying "be rich", but if you can afford any of the three recommendations above your healthcare experience will be MUCH better.