Dr. Manny: Specialty doctors will be hard to find under ObamaCare

Handsome successful doctor speaking to a senior patient

Today in many markets, Medicaid patients find it nearly impossible to seek a medical subspecialist. Most patients have to go to hospital clinics and wait weeks at a time to get an appointment with a specialist.

Most of the time, specialty clinics are run by residents or fellows-in-training – while under the supervision of a senior doctor.  Continuity of care by the same doctors is almost impossible, since physicians often rotate through different clinic services. Patients covered by Medicaid often have no choice but to hope their problems are being addressed at these clinics in an adequate manner.

So imagine what’s going to happen once ObamaCare expands Medicaid enrollment, or better yet, when some basic health plans pick up more patients who are looking for more affordable insurance premiums.  Are you going to be able to easily find a dermatologist, ophthalmologist or orthopedic surgeon – especially during a limited timeframe in which your problems need addressing? I don’t think so.

Unless some drastic changes occur, subspecialists will rarely participate with these health insurance plans, and as of latest reports, the most prestigious teaching hospitals are saying that their specialists will not be available under the ObamaCare exchanges. As a consequence, you will be forced to wait until it is your turn to have your elective visit.  Let’s say you need a knee replacement or treatment for your eczema.  It may take weeks to get an appointment in a specialty clinic in order to get your problem fixed.

This is the way it works in Europe, and if it’s good enough for them, why not for us, right?

I know how the European method works first hand.  My mother-in-law, who lives in Sweden, needed open heart surgery for blocked arteries.  She was short of breath for six months and her heart was enlarged.  It took two months to work her up through her general practitioner, one month to see a cardiologist, and another month to wait for scheduled surgery.  Finally, one day, after all of this waiting, she received a phone call, and a date for surgery was given.

The day before her surgery, the hospital picked her up in a minibus, along with other patients from her region who were also scheduled to have open heart surgery.  They traveled four hours to a teaching hospital, where she met her surgeon for the first time.  The next day, they performed the surgery, and three days later, she was discharged back to her town, where she was told she would need to follow up with her local medical clinic.

So this is our future – or better yet – our present.  It’s just the way President Obama and Health and Human Services Secretary Kathleen Sebelius wanted our health care system to be: Efficient, affordable and easy.