Top Doctors 2023: Is Your Physician One of the Best in Columbus?

preventive care visit :: Article Creator

Why Seeing A Doctor Takes So Long — And How To Get Health Care When You Need It

Everyone has experienced it: It can take forever to get an appointment to see your doctor. We dig into the underlying problems and offer hope for a better future.

With the wait for doctor's appointments taking longer than ever, medical care in Philadelphia has gotten complicated.

If Philly is one of the greatest medical cities in America, why does it take so long to get a doctor's appointment here — and does it have to be this way?

By now, most of us understand that access to care is one of the many issues that plague America's beleaguered health-care system. But there's been a sense, I think — at least among those of us in the habit of absorbing the daily headlines — that the problems have mostly revolved around certain specific, desperate contexts. The medical deserts plaguing rural America, for instance. Niche specialists facing exceptional bursts of demand, like child psychiatrists since COVID. And the increasing number of patients in our country — the poor, the undocumented, those seeking reproductive or gender care — at the mercy of merciless legislative crusades.

What's becoming more and more apparent, though, is how much more widespread, even mundane, the issue of getting to your doctor — or a doctor — really is, particularly when it comes to primary and preventative care. You know, the kind of care that keeps chronic conditions in check and keeps you out of the more expensive, overcrowded ER and also just generally helps keep you up to snuff and/or alive.

When I say widespread: Anecdotally, everyone I know — and probably you, too — has a story about waiting. A friend of mine who called for a physical with her Jefferson-based primary-care doctor in October couldn't be seen until February. Another got a quote for a year-and-a-half waitlist to see a Penn Med gynecologist for an annual exam. When she looked instead to private practice, she took the best they could offer: a telehealth visit in two months. Still another friend who had an iffy mammogram at Penn was told she'd need to wait a stomach-churning month before she could even call to make an appointment for a biopsy.

Meantime, a Main Line Health patient I know needed a sick appointment, but her doctor had left the practice and they were booked out three months for "new patients." When her asthma flares up, she says, her MLH pulmonologist appointments are regularly three to six months out. One of my neighbors waited upwards of four months last year for a run-of-the-mill pediatric allergy appointment at the Children's Hospital of Philadelphia (CHOP), while another sought an appointment with a CHOP autism specialist and was told there were none, and no waitlist, no cancellations. "Please don't call back," the scheduler said. Keep reading …

Illustration by James W. Yates

It's easy to feel helpless when you need to see a doctor but can't get in for weeks or months (or longer!). But there are steps you can take to potentially speed up the process. Here, tips and strategies for getting a doctor's appointment sooner. Keep reading …

Illustration by James W. Yates

Can't wait for the next opening in your doc's schedule? Don't have a primary-care doctor? (Eighteen percent of us don't, according to a 2018 city survey.) Here, a rundown of places you can turn to for medical care when you need it. Keep reading …

As much as telemedicine, that Jetsonian marvel, has boosted accessibility for patients in recent years, the quest to deliver more health care more efficiently is never-ending. Plenty of other innovations and adaptations in this brave new world might change how you get your health care. Like, for instance:

Membership Models

Illustrations by James W. Yates

Consider the crazy-expensive concierge-medicine model disrupted. One interesting NYC-based health start-up, Summer Health, is a doctor-led platform offering 24/7 text-based pediatric health advice on everything from belly pain to breastfeeding to fevers for $20 a month — providing on-call support without an appointment or a wait. Meantime, Parkway Pharmacy, located in Fairmount, is in the process of partnering with Big Tree Health to open a neighborhood walk-in primary-care clinic — self-pay only, no insurance — for which $70 a month buys a patient unlimited access to the in-house provider (a physician's assistant or nurse practitioner) in person or via telehealth, with clinic services and some 185 common prescriptions included in that price along with some preventative medical services, like remote patient monitoring of blood pressure. "What we're trying to do is be your preventative care," says owner Dennis Czerw.

Shared Appointments

Group appointments have been around since the 1970s but have gained serious traction in recent decades, in part because they lend themselves well to conditions like asthma, diabetes, sleep apnea, hypertension … even physicals. It works like this: Members of a small group — say, five to 10 patients with a shared condition — meet individually with a clinician for a few minutes to go over personal details, after which everyone gathers for a longer shared time with the doc. Part checkup, part education, part support group, shared appointments aren't just about efficiency, says Charles Bae, Penn Med neurologist and associate CMIO for connected health strategy, but also comradery and old-fashioned curiosity: "Some people really prefer them!" Cooper University Health Care offers shared appointments for a handful of conditions; other local systems have just dabbled here and there.

AI in the Exam Room

Most everyone these days is looking at ways AI technology can lighten the load for practitioners. One seemingly promising use: ambient listening. In March, the AMA announced that the Permanente Medical Group's rollout of ambient AI scribes — essentially, dedicated smartphones with microphones — saved physicians an average of an hour of typing time a day by transcribing (but not recording), summarizing and documenting the visit. The point here, Permanente's director of virtual medicine, tech and innovation has noted, isn't to find time to squeeze in more patients. Instead, it's to stem the tide of burned-out physicians and create a little more room for "patient-care experience enhancement." As with all of AI, though, there are still some kinks to work out: In one instance, when a physician mentioned a patient's hands, feet and mouth, AI summarized — oops — a diagnosis of hand, foot and mouth disease.

Our all-new Top Doctors list is here!

Our all-new list: the 3,047 best physicians in the Philadelphia region, as chosen by their peers. Whether you're looking for a dermatologist, a cardiologist, a pediatrician or a family doctor, consult our list, and sort by name, town, or specialty to find the doctor you need. Read more …

Published as "The Waiting Game" in the May 2024 issue of Philadelphia magazine.

Recent Data Shows Adolescents And Teens Are Not Getting The Preventive Care They Need

Prev Next

Recent data shows adolescents and teens are not getting the preventive care they need.

Recent data shows adolescents and teens are not getting the preventive care they need, and this is leading to a resurgence in something that was once eradicated.

"You know our grandparents told us this when we were growing up that an ounce of prevention is worth a pound of cure and it certainly rings true today," said Dr. Daniel Meltzer, Executive Medical Director for Regence.

Dr. Meltzer said he can't emphasize enough the importance of preventive care.

"I mean, first of all, if you look at the data, people who get preventive care tend to live healthier and live longer," he said.

The latest numbers show Utah does well when it comes to babies and toddlers but needs to do better for adolescents and teens.

"Not just for physical conditions, whether its growth or development or how their various organs are functioning, height, weight, etcetera, but we also do inquiries around behavioral health challenges and we know Utah for example ranks third highest in the nation for severe major depression, so preventive care helps us address physical conditions, but also behavioral conditions, particularly in teenagers, as well," said Meltzer.

Nationwide, only 70-percent of children ages 12-17 have had a preventive care visit and that trend is getting worse. Vaccination rates are also decreasing.

"The challenge that we're seeing now is many diseases which we thought we eliminated, for example, measles in 2000 was declared eliminated, but just over a week ago now we're seeing over a hundred cases of measles in the United States, which is a highly contagious and devastating disease, which is fully preventable," said Meltzer.

Meltzer also said it's important to take advantage of these practices of the past which have helped eliminate many devastating diseases, while also taking advantage of new medical advancements.

"In the last five to ten years we have many scientific breakthroughs where we're able to immunize children in their teenage years against certain diseases. Human Papilloma Virus which we know can cause cervical and other cancers, takes decades to develop, children can now be fully immunized for," said Meltzer.

As well as meningococcus – a cause of the potentially fatal meningitis infection, where a two-dose series can help eradicate the threat.

"So, these were at one point diseases we had no prevention for and now we have fantastic prevention for, if we get our kids in for their annual wellness visits," said Meltzer.

Doctors Concerned About Lack Of Preventive Care For Adolescents And Teens

Healthier Together is sponsored by Regence BlueCross BlueShield of Utah.