I’ve recently been extremely baffled and disturbed by the difficulty in accessing my primary care provider. I am in the Kaiser Permanente system in Seattle, bought a few years back from the venerable Group Health Cooperative (GHC) system. Group Health had a long and storied history and, for the most part, I was very happy with my providers and service. Big medical institutions can come with many annoyances but the quality of my care was top-notch. I had 2 primary care providers who worked together, a PA and an MD, and they were fantastic. It was easy to access them and make appointments within a day or 2, they both answered emails promptly, and I felt very special.
When Kaiser rolled into town, I was apprehensive. Most members of GHC could vote on whether to accept the offer from Kaiser. Kaiser easily won the day and it was good-bye GHC, hello medical giant. Not much changed immediately. When I asked about the change, my colleagues were enthusiastic and said the only things that were changing were that much-needed infrastructure repairs (like replacing old worn carpeting throughout the many buildings) were occurring. Nothing else seemed amiss and life went on.
Then in March 2020 came the COVID-19 pandemic and everything changed throughout medicine. Fast-forward to 2021 and things started to return to normal, although my favorite and esteemed health care providers retired.
Today, I have a new primary care provider whom I have never seen but have spoken to once and she seemed very nice. Recently, I’ve had a few reasons to see her, including a COVID-19 diagnosis and management of a variety of odds and ends (fractured hand, treatment options for arthritic knees, laboratory monitoring, medication management, etc). It has been a total circus trying to access her and her team.
I got COVID-19 in June 2022, well after clinics and hospitals were opening back up and seeing patients. I began to feel terrible on the return flight from my first plane trip since the start of the pandemic. I tested positive for COVID-19 and immediately tried to contact my PCP’s office with a stunning lack of success. As someone in the OAD (old as dirt) category, I knew about the recommendations for the antiviral combination nirmatrelvir/ritonavir (Paxlovid™) and knew that it was thought to be more effective the sooner it was started following the onset of COVID-19 symptoms.
To contact my PCP, I went online, I called, and I emailed her and her team. It was radio silence for 3 days: nothing, not a peep. I finally gave up and went to the Kaiser urgent care clinic in Seattle; I had a positive PCR test and almost before I got back home, I had a box of Paxlovid sitting on my doorstep.
When I tried to follow up with my PCP a few weeks later, I received the same response, crickets. I finally got a response from a medical assistant on the Kaiser website who suggested that if I needed to speak to a physician is should call the Kaiser video access line where I could speak to a total stranger. I thought, no thanks. If I need injections for my knee pain, I first must have a neurology examination to receive a referral to an anesthesiologist. So I try to set that up by making an appointment online but find that it will be 2 months until the next available visit.
I know that many people have it worse than I do and struggle to get the most basic of health care. But for goodness sake, it’s hard to understand why so many parts of the system seem broken. I know there are many explanations: supply chain, staffing shortages, etc. A recent piece in The News Tribune, a Tacoma, WA, newspaper, talked about some of the many other reasons: “Hospitals are struggling to cope with high patient loads that are not COVID-related. According to a new report released Sept. 15, hospitals also are on track to have their worst financial year since the start of the pandemic. Loss of staff over the course of the pandemic has left its mark. Employees have left from burnout, long-COVID or death, rejection of vaccine mandates, or to earn more money as traveling staff among other reasons.”1
It makes sense that many of these issues impact outpatient care, particularly in large institutions such as Kaiser. Maybe it’s good for health care providers to experience this from the patient’s point of view to remember what it’s like to be a patient. And sometimes, it’s not very fun.
1. Cockrell D. Long COVID for WA health systems? ‘Hospitals are struggling and will be for awhile’. The News Tribune. Updated September 23, 2022. Accessed September 26, 2022. https://www.thenewstribune.com/news/coronavirus/article265933021.html