Our Healthcare System Is So Broken, Even This Doctor Couldn’t Get An Urgent Appointment
Recently, I came across a video by Dr. Beachgem, a popular doctor over on TikTok, who shared how hard it was for her, a doctor, to get an urgent appointment.
Dr. Beachgem is a pediatric emergency medicine physician in Florida. To keep her professional work somewhat private, we will refer to her by social media name, "Dr. Beachgem," throughout.
Dr. Beachgem explained that she's been having some concerning symptoms, so she immediately made an appointment with her doctor. Also concerned about the symptoms, her doctor requested "stat" labs and imaging.
Dr. Beachgem said, "They were like, 'I want you to just go walk into this place, and they should be able to take care of everything today.'"
Dr. Beachgem explained that "stat" usually indicates that a test must be done immediately. She told BuzzFeed, "It often means that there is significant clinical concern from the physician ordering the test."
"These can mean different things in the inpatient and outpatient settings, but often, if there is a serious or life-threatening issue, the patient should be seen by the emergency department." Dr. Beachgem explained that most of the time, "stat" imaging can and should be done on the same day. However, she said scheduling "stat" can become difficult with some modalities, like MRIs, which are precisely timed and aren't often available to "squeeze" another study in.
In Dr. Beachgem's case, she was able to get the labs done immediately, and even get the results back quickly. The imaging, on the other hand, she said, "I hand the lady the thing and said it's stat. She says it doesn't matter; you can't do this, you have to call and make an appointment. I said, even if it's stat? She said, 'Even if it's stat.'"
Dr. Beachgem called, and the earliest she could get her "stat" appointment was a month away. She explained, "I called a couple of other places. No one else can get me in in the next three weeks. So I just leave it."
@beachgem10 / Via tiktok.com
Dr. Beachgem continued, "My doctor calls me today, and they're like, 'Friend, where's this imaging I ordered for you?' And I said I haven't been able to make it happen. I said it's a month away. They were really upset that my 'stat' imaging was a month away."
Dr. Beachgem's doctor asked her, "Why don't you pull some strings? Like, you're a doctor, try to make some phone calls." And so Dr. Beachgem did — using her local physician Facebook group, she was able to schedule an appointment the next day, even if it was a bit of a drive away.
She said, "I pulled some strings, had some resources, and I have an appointment at 7:30 tomorrow morning to get this done."
But these resources aren't available to most people. As Dr. Beachgem said, "I'm a doctor and I have the resources, and the 'doctor card,' and I can pull strings, but what about all these other people that are not medical professionals that don't have the strings to pull, like how do we expect them to navigate the medical system?"
First, many people in the comments were grateful to hear a doctor speaking up about this, and acknowledging the concerns many Americans face with the US health system.
Others reiterated Dr. Beachgem's point that most people don't have the connections and strings to pull to get appointments. Many shared they've had to wait months and months for what should have been "stat" care.
And the problem seems to be two-fold. On one hand, imaging techs report being understaffed and underpaid, and there's a problem with too many things being ordered "stat."
On the other hand, many doctors claim that sometimes they have no choice but to order things stat or send things directly to the ER to get their patients care.
Dr. Beachgem reiterated that it's common for patients with extremely long wait times for "stat" testing to get sent or go to the ER for their originally intended outpatient imaging and testing. This, in turn, creates a bottleneck in the ER, increasing emergency department wait times and decreasing resources available to care for sick patients.
In some circumstances, Dr. Beachgem stated that many patients become "lost to follow-up," which means they do not receive the care they need because wait periods are too long and tests cannot be performed.
Delays in testing and results can, of course, contribute to the progression of whatever condition is being evaluated. Dr. Beachgem said that without access to "stat" tests, "Diseases will be picked up later, by weeks or months sometimes, taking something that was potentially easy to treat and making it more complicated." Or, other people might give up, be "lost to follow-up," and just not get the imaging done at all.
But what's causing all this? Dr. Beachgem laid out a few problems going on within the healthcare system. First, she said, "During the pandemic, many people left clinical practice. Now, we are having shortages of radiology techs, nurses, respiratory therapists, lab techs, etc. Without techs, imaging tests can't be done, and with so many tests being ordered, they are unable to keep up, so there are delays."
Second, she said, "There are often issues with insurance approvals and prior authorizations, which can take time, and sometimes imaging is denied by the insurance company, causing more hoops."
Additionally, "Insurance reimbursements are not matching the increased costs to provide care, and primary care is not well reimbursed compared to other specialties. There are shortages in primary care providers and other specialists, so the wait tends to be longer, and they have a hard time 'fitting' in sick appointments."
And lastly, "Many physicians are experiencing burnout and are leaving practice for other opportunities."
Overall, Dr. Beachgem said to improve wait times for "stat" care, there would need to be "multifactorial" changes. To name a few: more healthcare providers, improved support and compensation for these healthcare specialists and providers, fewer insurance hurdles, and more incentives for primary care providers.
And if you're in a similar situation needing "stat" care but are having trouble getting an appointment, Dr. Beachgem suggests you ask your provider for recommendations on getting a timely test. She said, "It may be acceptable, but if not, your provider may be able to call and advocate for your expedited care."
Dr. Beachgem added, "It may also be helpful to bring an advocate with you to appointments, someone who may know the system and feels comfortable helping you advocate for your care."
An advocate can be a close friend, relative, spouse, or caregiver who knows the system well and can advocate on your behalf, or you can find a patient advocate through the healthcare system. Many hospitals have patient advocates on staff who can help you understand your bill, apply for financial assistance, and access medical records. They can speak up for you and help you get your needed care.
If you're looking for help, you can call your hospital and ask if they have a patient advocate on staff, or reach out to the Patient Advocate Foundation online or by phone at 1-800-532-5274.
Unfortunately, unless there are systemic changes in US healthcare, it seems long wait times will continue. Dr. Beachgem's inability to get timely care without her resources is just another example.
But what about you — what has your experience been like navigating the healthcare system? How long have you had to wait for urgent appointments? Let me know in the comments.
For more from Dr. Beachgem, you can keep up with her on TikTok and Instagram.
