As a society we have invested more than $1 billion in web sites, e.g., healthcare.gov, to allow Americans to search for health insurance. Is there an analogous site that lets Americans search for actual “health care”?
Newspaper articles complain that Americans go to the emergency room (“ED” as the docs call it) too much. To some extent this could be because the U.S. has so few doctors per capita and therefore regular doctors are typically too busy to see a walk-in. I’m wondering if there is also pressure on hospital emergency departments from the fact that it is hard to find a provider that (a) is open, (b) has available appointments, and (c) accepts one’s insurance. The market economy provides this for restaurants. For example, one can search with Yelp.com for restaurants that are nearby, open, and accept credit cards. What’s the analogous service for finding medical care? If there isn’t one, should we be surprised that people drive to the nearest hospital instead of spending a couple of hours making phone calls to various clinics and doctors’ offices?
[Fresh data: I have had a sore throat for a week, so today decided to look into the possibility of getting a “quick strep” test from a nurse. I called my regular primary care doctor’s office, meaning that I shortcut the process of figuring out where facilities were located and which accepted my insurance. I was on hold for 7 minutes and 45 seconds before the front desk staff could determine whether or not the office would be able to see me. As it happened, they were able to see me but not able to do a quick strep test. The doctor explained that for a small practice such as this one (she has about five partners in this office) the “federal CLIA” paperwork and regulation was too onerous to make it worth doing even the simplest lab tests on-site. How can CVS clinics do it then? “They’ve got a big company behind them so they can spread out the cost a lot better,” she responded.]
Something like Medibid?
http://www.medibid.com
Consumer’s Checkbook does at least ratings on doctors and specialists. Doesn’t give you hours, but at least does provide some feel for quality.
https://www.checkbook.org/
I’ve used their results in the DC area but haven’t checked Boston.
(4-5 years ago my primary care doctor’s office and my insurance company got into a kerfuffle and the office stopped taking my insurance. I started working my way down the top ranked general practicioners near me in CC’s list. Something like four of eight weren’t accepting new patients, and the remaining four did not take insurance at all- they bill you, then it’s up to you to bill your insurance on your own. Thankfully my primary care and insurance providers made up in the meantime…..)
Excellent point about emergency room use that I’ve not seen made anywhere else.
Bill: Thanks for the Medibid link. That looks like it might be useful to plan out elective surgery a few weeks or months from now. I don’t see how it could be used to find same-day treatment (and the $25/request fee is more than what many people would wish to spend for research).
Les: Checkbook doesn’t seem to be aimed at the problem described in the original posting: finding a doctor who is available and nearby and who accepts insurance plan X.
If all you need is to test for strep, you can buy your own test from Amazon. Here are a couple of examples:
http://www.amazon.com/dp/B004Z4LO3Y/ref=wl_it_dp_o_pC_S_ttl?_encoding=UTF8&colid=17HIWYZC3414J&coliid=I1FEKUZG4F5TLH
http://www.amazon.com/dp/B00TXTZD10/ref=wl_it_dp_o_pC_nS_ttl?_encoding=UTF8&colid=17HIWYZC3414J&coliid=I6HTRR2E0WPVT
I haven’t tried them myself but they have pretty good reviews. I am considering buying a kit myself for the next time I get a sore throat. I currently have a high deductible health plan in the last time I went to see the doctor to get tested for strep, the visit plus test plus prescription for antibiotics cost me over $300. An that was with the discount I got through my insurance.
Another option that may or may not work for you is to try one of the CVS Minut Clinics. According to the following price list, you shouldn’t have to pay as much as I did. They have a link to a clinic locator in the same page:
http://www.cvs.com/minuteclinic/services/price-lists
Doctors Express [1] is what you are looking for, no?. What about MD Live [2]?
I get Live Health on Line [3] through my employment (never used it, co-workers told me it is good).
The issue with seeing a Dr. whom you never saw before is that the new Dr. has no idea about your medical history and thus your “words” is all s/he got to go by. Until when this hurdle is addressed, the ER will still be the place to go to. Not that the ER has all of your records, but they got a team and the team can reach out to your primarily Dr. and records — after a loooong wait.
[1] https://www.doctorsexpress.com/
[2] https://www.mdlive.com/
[3] https://livehealthonline.com/
zocdoc.com
Can see and make an appointment immediately.
Also for quick and easy things like strep – many Walgreens/CVS would have a health clinic, where you can walk it and get tested/prescribed antibiotics by a nurse. Usually there’s zero wait
Philg – are there no Urgent Care centers in your area? Rapid Strep test would be right up that alley/gap.
Elisa – strep tests should be taken in context:
http://www.mdcalc.com/modified-centor-score-for-strep-pharyngitis/
I don’t think I’ve been to a hospital emergency room since I fell out of a tree and broke my arm in 1969. I have, however, gone to a local urgent care center three times over the past ten years for minor ailments. Along with a $20 co-pay, my employer-funded HMO plan covers the service. I was treated by the on-duty P.A. and the wait was zero to ten minutes. There are a couple dozen of these centers in my county covered under my HMO plan, w/ 7-day nearly 24-hour service. I think they’d treat strep throat.
Wow, just reading this from people who I assume earn a decent living, tells me that the American health system is truly broken.
Why do we continue to fail in Healthcare reform? Why not just take a model that we know works, like the Swiss healthcare system (https://en.wikipedia.org/wiki/Health_care_in_Switzerland), and give people the option to buy complementary insurance policies to get additional services. We don’t need to reinvent the wheel.
“The compulsory insurance can be supplemented by private “complementary” insurance policies that allow for coverage of some of the treatment categories not covered by the basic insurance or to improve the standard of room and service in case of hospitalisation. This can include complementary medicine, routine dental treatments, half-private or private ward hospitalisation, and others, which are not covered by the compulsory insurance.”
In 2014, the average monthly compulsory basic health insurance premiums (with accident insurance) in Switzerland are the following:[12]
CHF 396.12 (PPP-adjusted US$ 243) for an adult (age 26+)
CHF 363.55 (PPP-adjusted $ 223) for a young adult (age 19–25)
CHF 91.52 (PPP-adjusted $ 56.14) for a child (age 0–18)
GermanL – That may work for the Swiss, but not the entrenched, monied interested parties in the US.
Don’t forget that a lot of regulation varies by state. For instance, in Massachusetts many ‘self serve’ options are illegal. To wit: directlabs.com. I’m not sure why a bureaucracy would prohibit a person from proactively advancing their own health.
I second the use of urgent care facilities. I live in the woods (Barkhamsted, CT), 9 miles to milk and bread. Three urgent care facilities are within 12 miles of mostly country roads (each different directions w/different hospital sponsors). I’ve used them a few times, excellent service, and no wait. None. There’s usually a nurse and PA on duty, limited night hours. I use a Medicare Advantage Plan, $65 all in.
Small town New England living has it’s advantages.
Folks: Of course we do have urgent care clinics of various types, including CVS. However, for many of them the only way to determine what health insurance plans they accept is to call. Google Maps will show you the urgent care clinics but it won’t let you filter by insurance accepted. Thus for any given individual it might well be quicker/simpler to go to the nearest hospital ED.
@philg: for many of them the only way to determine what health insurance plans they accept is to call.
I easily determine which urgent care clinics accept my insurance before I need to go. Or, failing that, I just quickly look it up on this internet thing.
ZocDoc lets you filter practitioners by insurance.