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Comment by paulnpace | Hacker News Reader

My primary care physician will only do video meetings or wait 6 months for in-person appointment. He does not care.

You think PCPs get to decide what their schedule looks like? Or do you think they have a specific patient load they are expected to meet, which dictates how many in-person vs remote slots they have in each day?

Yes. They just choose to fill it way passed capacity because they want more money and don't want to accept the money they will end up getting for doing a proper non-rushed job.

That's why they have 15min slots and rush you out the door if you look like you'll be taking too much of their time. Maybe blame the insurance for dictating they must charge per-session instead of per-hour, sure, but the doctors at the end of the day prioritize their own salary over patients well being. Not to the extent that one can say they are negligent or do a bad job, but they ride that line between in order to optimize their earnings without getting into (too much) trouble.

Presumably, if the GP comment hasn't switched yet, then there's a bit of a shortage of options. So it's entirely possible that there's a shortage of doctors in general in the area, and a doctor that does care about serving patients in that circumstance will find themselves in exactly the same pattern of behaviour, because there's more need from patients than they can satisfy, so they try to help the most people they can even if that means each person gets less help.

More egregously in that regard, in the UK it's common for doctors to part work for the NHS and part work privately. Anything on the NHS is massively underresourced and so long waiting times for short, overworked appointments are common, but you can get an appointment much faster and with better attention from the same doctor if you pay. But then even these private services are starting to have too much demand, because the problem is more structural as the population grows and ages, while investment in the education and training, not to mention reasons to stay in the country afterwards, has stagnated.

Even people posting comments don't care.

His care does not scale and he has to ration his care between existing patients. For him to give you more care, it will likely come at the expense of someone else's care.

This situation has occurred because somewhere and somewhen else, a chain of other people have not cared and allowed primary care resources to get to this state.

Why don't you change ?

Is it not allowed ?

They might be living in the UK where most of the population has no private healthcare insurance and the nationalized GPs are frequently all overloaded like that.

Yep. That's what I was curious about.

Is that a rebuttal to the idea that the doctor doesn't care?

Why would you think it's a rebuttal?

Six months' wait to see your GP for an in-person visit is a worryingly long wait. If I heard someone say that they were required to wait that long for in-person doctor's visits, I'd wonder why they were still seeing that doctor and ask them polite questions to try to figure it out.

That's the case where I live, there's only a few surgeries I'm allowed to register at and they all have this problem. I think there is some manipulation of statistics the surgeries do to prevent more being created, and to hide the difficulty in getting an appointment. For example rather than having 6 month waiting list, they don't make appointments more than a few weeks in advance, so you just can't get an appointment and it looks like nobody waits more than a few weeks. I think while surgeries are allowed to do this we'll never understand the real capacity.

When you say "surgeries", are you using what I understand to be the UK word for the US phrase "doctor's offices"?

Yes

Cool. Thanks for clarifying.

Man, it should NOT be permitted to play with the "waiting list" stats in the way you describe. I wish you had someone who gave a fuck about (and could do something about) the problem to report it to... that's just bullshit.

> Six months' wait to see your GP for an in-person visit is a worryingly long wait.

I always find it cute to see what Americans consider a long wait for any medical service.

For myself in Canada the very minimum time to see a GP is a month and a half and that's a best case scenario. Get a different GP? Impossible.

No. I was curious as to why they are stuck like that and what country and system they were in.

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