How to get through to your doctor

Our health care system has a supply and demand problem.

During the COVID-19 pandemic, many of us delayed seeing a doctor, or didn't go at all - sometimes resulting in negative health consequences. This has led to pent-up health care demand. Meanwhile, the supply of health care providers is contracting. In 2021, according to one study, 117,000 physicians left the workforce while fewer than 40,000 joined it.

If you've tried to get in to see a doctor lately, you're seeing the effect of this crunch. A 2022 survey by the physician research firm Merritt Hawkins reported “average physician appointment wait times have increased significantly since the survey was last conducted in 2017 and first conducted in 2004.” In the 15 major metro markets surveyed, patients waited an average of 26 days to see a doctor, up from about 21 days in 2004. For certain specialties, such as ob/gyn and cardiology, the waits are even longer.

So should you even expect to be able to get an overwhelmed doctor on the phone? I think you should, in certain circumstances.

A friend recently tried to reach his cardiologist through the patient portal and by phone to ask a question. Both times, a nurse who didn't seem to fully understand the question responded, acting as the doctor's gatekeeper.

Frustrated, the man's wife hopped on the phone and told the nurse in no uncertain terms that her husband needed to speak with the doctor. The doctor called back and the question was resolved in a couple of minutes.

I wouldn't try this if you or a loved one is experiencing a health crisis. Whenever you call a doctor's office, the voicemail tells you, “If this is a life-threatening emergency, hang up and dial 911.” A persistent high fever; severe chest, pelvic or abdominal pain; trouble breathing; a suspected concussion; or weakness or droopiness in the limbs or face all merit a call to 911 or trip to the ER. If a doctor can't call back for an hour, do you want to take the chance a health crisis will deepen?

It's not fair to the doctor, either, because a patient can't be properly evaluated over the phone. A doctor in Wisconsin is facing a malpractice suit because he didn't respond to a call in a timely manner with a patient in a health crisis who later died.

That said, a question that doesn't require an immediate response - such as the results of a test, a non-life-threatening symptom or a change in medication - could be answered by phone or message through the patient portal.

Whichever method you use, be sure to provide complete information while being succinct. Here are some guidelines.

 At your first appointment, ask the doctor for the best way to reach them. Do they mind a phone call, or do they prefer a message through the patient portal (via personal computer or cellphone app)? How quickly do they typically respond? If it's after hours, is there an on-call service?

 Ask to speak with the doctor directly when you call. If you are stonewalled or get a song and dance, don't be shy about advocating for yourself, or ask a loved one to do it for you. (Sometimes it's easier to advocate for someone else than for yourself.)

 Be specific about your question or symptoms you're experiencing. This will avoid multiple messages or phone calls back and forth.

 Set a time frame before hanging up. You'd like to hear back before the end of the day, maybe, or within 24 hours. I have found that health care providers typically respond to portal messages in a day or two.

 Be assertive but not rude or threatening. Health care providers are humans, too, and respond better to patience and politeness.

There are times your doctor won't be able to speak with you because of privacy or other concerns. For example, they have to somehow be sure it's really you on the line (which is one reason the patient portal is a preferred method of communication). Sometimes they don't want to discuss test results because they want to re-examine you, the discussion will take too long or the initial results were inconclusive.

I have noticed some hospitals and doctor's offices are doing better with customer service these days, thanks to innovations like telehealth and more sophisticated technology. Our supply-and-demand problem in health care, though, will take time to resolve, and it may never be. It's up to us as patients and advocates to do the best we can for ourselves and others to navigate the system we have.

Teri Dreher is a board-certified patient advocate. A critical care nurse for 30+ years, she is founder of NShore Patient Advocates (www.NorthShoreRN.com). Her new book, “How to Be a Healthcare Advocate for Yourself & Your Loved Ones,” is now available on Amazon. She is offering a free phone consultation to Daily Herald readers; call her at (847) 612-6684.