Seeking family practice & ob-gyn with urgent care, not ER

We moved here a couple years ago and I've been consistently horrified by the health care system(s) here. Our experience has been primarily with Sutter, with a few out of network exceptions (equally bad). After going through a pregnancy and dealing with other family health issues, I'm wondering if we're just not dialed in, because I can't imagine that what we've experienced is broadly accepted as normal (but maybe it is?). For context, we have a Blueshield of CA PPO plan paid for out-of-pocket (we're self-employed) and sometimes wonder why we have insurance at all because we can rarely access health care when we need it. Example - for a fairly routine but potentially serious postpartum health issue, I was told by both my Sutter gyn and PCP that the next available appointment is in Sept (it's May) and to go to Urgent Care. Urgent Care told me to just go to the ER. The issue was urgent but did not rise to the level of requiring an ER visit and I imagine the ER is clogged with relatively minor issues because more often than not, that's where I've been directed for pretty much anything that requires same-day but not emergency care. We've also needed urgent assistance on the weekends that could be easily resolved with an on-call nurse able to assess and write a prescription if needed. But of course, Sutter will just refer me to the ER for this. I don't think we have the option of switching to Kaiser until Oct (and not sure that's the best option) and have been referred to OneMedical, but reviews aren't stellar. We take our kids to Berkeley Pediatrics and we're in LOVE with their practice and in an ideal world, would be able to find the same thing for adults. 

Questions are: Does anyone know of/have a great family practice that offers an after-hours number to call for urgent but non ER issues AND who takes Blue Shield of CA? 

                        Any recommendations for a ob-gyn practice where appointments aren't booked months out and that also offers after-hours assistance (and takes BSofCA)? 

Thanks for reading.

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You should try One Medical. I don't put too much stock into reviews. They have family practice offices (for adults and kids) as well as general women's health (not OB though specifically). There is also 24/7 access to on-call providers via video and phone. Their access isn't as great as it used to be but you can often get an appointment within a day or two. 

I'm so sorry you're experiencing this. Unfortunately, my family has experienced much of the same with Sutter. We've found two things that help. The first is finding an excellent primary care provider within Sutter who can be your advocate and get things done quickly. We have not found an OB who fits that bill - we've had to do a lot (and I mean a LOT) of self advocacy when things aren't completely textbook. The second thing that has helped is calling Sutter's corporate HQ when you have a reprehensible situation like being told to wait until September for an urgent postpartum situation. We had a similar situation, where we were told my six week follow up post c-section would be three months after the birth. We called Sutter's HQ to complain, which led to us getting a call from Sutter' Milvia location a half hour later with an appointment the following Monday. The whole situation feels terrible. I've heard great things about some concierge doctors (outside of Sutter), though that's more expensive as many fees are out of pocket. 

I had really positive experiences with all of the OBs at the Sutter East Bay Medical center on Milvia, including postpartum complications and pretty severe postpartum depression that hit the week of the shelter in place mandate in March 2020. They were still available for me. Dr. Kadri was my primary but everyone I met there was great.

Perhaps you might need to switch to a different doctor who is more compassionate and connected to their patient. No, you may not always be able to see your specific OB for an urgent issue, but you should be able to see one. Also, if you have a relationship with your OB they will make referrals.

In the event your OB dismissed your pospartum depression concerns that is serious and you should look for another doc. I think this is less about the network and more about the specific doc. I had a means to email my doc which I didn't abuse but did use to alert her to issues when they were serious.

cheers,

I use John Muir for my PCP, and they have same day appointments for urgent issues (not sure about after hours though). And Milvia obgyn, which is sutter affiliated for my OB. They are busy but I’ve never had to book that far out. 

Unfortunately I don't have a good suggestion but I agree with your observation about the healthcare systems in the Bay Area.  I had appendicitis earlier this year and both the Carbon Health urgent care center and the Alta Bates ER failed to diagnose me correctly.  I ended up with a ruptured appendix and was seriously ill and hospitalized for a week.  I had to be hospitalized again a month later in Chicago due to complications from the original surgery, and the quality of care in Chicago was amazingly better (and much less expensive).  It actually makes me nervous to live in the Bay Area long term...