Doctor attrition at Kaiser vs. private practices/Summit
Hi,
I am a FTM due in August, and after years of being pretty happy with Kaiser, both as good value and good service, I am starting to get really nervous about them having too much doctor attrition to provide sufficient care:
--both my and my partner's primary care physicians resigned. We got assigned new ones but when I looked to see if I could "choose one" almost no one is taking new patients. Our new assigned physicians are always booked weeks and weeks out.
--a PA intercepted my simple question to my OB and decided I need a video appointment with her, but that wasn't available for two weeks. So instead of getting my answer quickly, I got it two weeks later.
--Theres are almost no pediatricians listed as accepting new patients in Pinole, Richmond, Berkeley, and Oakland.
--There are very few OB/Gs accepting new patients.
--my partner got an arm fracture late at night and we found exactly one video appointment in the entire East Bay in the morning with an NP after almost an hour of searching and refreshing --- everything else was either very far away or two weeks out; it will be two days before he can see anyone in person in Orthopedics, and that's an appointment with a Physicians assistant, not an actual orthopedics doctor. We're really stressed out the delays are going to impact his long term recovery because just finding out if it's stable enough to do range of motion preservation is going to take so long, and all indications are.thay time is of the essence on that front.
--Theres is no urgent care north of San Leandro, they don't seem to do walk ins there anymore, they had no appointments until several days from now. Kind of defeats the idea of Urgent care.
--Advice nurse call times seem to be hours instead of an hour.
On one hand it's not surprising. The pandemic was terrible, people are burned out. But as a patient I am starting to get afraid of being trapped in a system that simply doesn't have enough doctors to treat us and especially my baby. We could use the birth as a "life event" to switch to Blue Shield and go back to the world of surfing various practices, using things like Carbon Health, going to places like Quest diagnostics, using Alta Bates. The thought of the paper work alone gives me head ache. But the thought of not being able to see a doctor while recovering post partum or no with a newborn in tow is terrifying.
So what is it really like out there in PPO land? How is urgent care? Are there pediatrician and OBGYN practices accepting new patients? Is the attrition just as bad?
Parent Replies
No idea on PPO experiences so hopefully others will weigh in--but I do have to say I'm so surprised by your Kaiser experience, since we have done many of these things in the past 2-4 months and been impressed with how fast we were able to get care. I wonder if part of this has to do with which Kaiser you are with? (We are with Kaiser Oakland, and have never had to wait more than 24 hours for an urgent care appointment; advice nurse wait has rarely been more than 15 minutes.) The open panels issue is often the case mid-month, though; for switching doctors, check at the start of each month for more selection, since that's when they drop members who are leaving and add new ones. Switch doctors for sure if you aren't able to get urgent appointments with your new ones. (Our pediatrician, GPs, and my OB are all quite busy and schedule months out for routine care, but have always offered to see us within 1-2 days for urgent issues, and offered even earlier appointments if we want to see a colleague instead. However, you do have to call for the same- or next-day appointments since they hold those for urgent issues and illnesses and rarely make them available online, in my experience.) The idea of a two-week wait for a bone fracture is mind-boggling, and makes me wonder if something got lost in translation with the advice nurse. There are typically same-day orthopedic urgent care appointments in Oakland (and at least once our pediatrician referred us directly to the ER for a fracture for faster care when the first available appointment was the next morning). One of the most important things when we had newborns was the proximity and ease of getting care. This was a huge asset for Kaiser Oakland in our particular case, but if the Kaiser near you isn't providing this, you might be better off with a PPO that would give you access to a local pediatric practice. Congratulations on the new baby, and good luck with the decision!
I haven't been experiencing delays in care at Kaiser currently. I have a recent cancer diagnosis and things have moved lightning fast. My friends in the academic/private practice world have been impressed. I don't work in the private practice world, but am a doctor in the public clinic world, and we are quite short-staffed. People are having to work extra shifts to make each others' summer vacations work. We have physician positions that are going unfilled for months to 1 year which is a marked change from before. I don't know if the private practice/Sutter world is any better, but I suspect this problem is likely similar everywhere. Urgent appointments at Kaiser are easier to get by phone than online - once a clinical person (advice nurse) hears your story they'll schedule you appropriately. Routine care, yeah, you may have to wait.
If it's any reassurance regarding the fracture, if a primary care or ER provider has evaluated it and it's adequately splinted and stable, often the ortho visit can wait up to a week. That's when the bone ends start to get "stickier" and ready to heal back together.
I have a PPO but generally try to do most of my services through Sutter, probably for some of the same reasons that one might like Kaiser (one stop shop, same online portal, the doctors know one another). It's very easy to get urgent care appointments or drop in, and I can usually get my kids into a same day pediatrics appointment - perhaps not with my most favorite doctor, but I can get them an appointment in Berkeley or Albany. I schedule the well child checks several months out to make sure I get my preferred pediatrician (shout out to Dr. Lackman - she is wonderful). For OB, I don't know if Sutter East Bay (Foundation) is taking new patients - they probably are - but I have really liked that practice and they around 18 OBs, none of whom I have had a bad experience with. All doctors I/ my kids have seen are still at Sutter (over a 6 or 7 year period, minus one who retired). Another reason I like my PPO is that I don't have to go to a Kaiser pharmacy. With kids, there's always some kind of script to pick up and I like walking down the street to CVS or popping in somewhere that's on my way.
I’ve been using One Medical for many years, and now my baby and 5YO use them as well. While the service isn’t as amazing as it was pre-pandemic, I can still do video visits anytime with about a 15 minute wait and can always get same day appointments. I’ve been with the same doctor for years. It really gives me peace of mind, especially with young children. They do not have specialists though, just primary care.
Had Kaiser for many years, including one full pregnancy and the beginning of another (during the pandemic) before being forced to shift to a PPO, and my experience was that Kaiser was much more responsive — what you’ve described seems very different. I have had the long wait times for the advice nurse, but once you get through they’ve been able to schedule very quick urgent care appointments, even if it meant going to another facility.
I did find that most of the recommended pediatricians weren’t taking new patients, but we lucked out that we had an urgent care appointment when our baby was 3 days old with a great pediatrician (Dr. Tenney) and she offered to add both our kids to her panel.