Was it something I said?

October 4, 2007 9:23 AM

Have you had trouble making an appointment with an ob/gyn?

I've called two doctors' offices to make my first prenatal appointment. Neither of them is my current ob/gyn, so I would be a new patient. Each one took my info and said that a nurse would call me back to make an appointment. Almost a week later, no word at all from one of the offices, and one phone message from the other, which I have returned four times to no avail. If it were only one office that was ignoring me, I would chalk it up to bad management and probably wouldn't think anything of it. But the same thing at two different offices? What's the deal? Is it because I'm a new patient? Is this some way of weeding people out? And how am I going to get an appointment?

posted by ubu to health & fitness (29 comments total)

Ob-gyns have been particular targets of medical liability lawsuits over the last 30 years, and as a result a lot of them have left the industry. The rest carry a ridiculous burden of insurance payments for liability insurance. Because of this, in many areas there aren't enough ob-gyns to cope with the demand.
posted by Steven C. Den Beste at 9:38 AM on October 4, 2007

Perhaps the doctors at those practices aren't taking new patients for a while and the appointment people just aren't good at calling back. The private practice I used to go to is the biggest one in town and the doctors there often can't see new patients for a long time.

Do you live anywhere close to a hospital with a good maternity department? I switched from my private practice to a teaching hospital nearby (so I could deliver close to home) and got an appointment very quickly.
posted by pinky at 9:51 AM on October 4, 2007

if you feel comfortable saying what city you're in, maybe someone can suggest someone for you?
posted by twistofrhyme at 9:51 AM on October 4, 2007

I haven't had that problem (no kids) but a few years ago when I wanted to be a "grownup" and see a gyn instead of going to planned parenthood, every office I called said it would be 3-6 months to get in to have an annual exam. I think it's something like what Steven said - not enough to go around.
posted by cabingirl at 9:55 AM on October 4, 2007

Try getting a referral from your primary care physician. I was in a similar situation - my ob-gyn had retired, her old practice changed insurance and I needed to start anew. My primary gave me a referral, which I mentioned when I made the appointment and they gave me an appointment for that week.
posted by bluesky43 at 9:59 AM on October 4, 2007

Assuming you had a gyn prior to needed the OB, a referral from your gyn should get you in the door even if they aren't taking new patients. Lacking the gyn, a referral from your internist / general practitioner will likely be just as good.
posted by COD at 10:00 AM on October 4, 2007

All's I know is that every time I go to see my ob/gyn, my doctor tells me to call the office in 2 weeks if I haven't already received my test results, because there's always a good chance I'll slip through the cracks and won't get called.

Which tells me that the staff is overworked or incompetent -- either way, what it means for me is I have to CALL, CALL, CALL until it gets done.

And that's what you have to do. :) Call every day.
posted by iguanapolitico at 10:03 AM on October 4, 2007

The thing is that I did talk to the appointment person, but I guess for new pregnancies the nurse (rather than the receptionist) has to speak to the new patient to make the appointment. So I do think they are taking new patients, or else they would have just told me that they aren't. But the whole thing just seems kind of weird.

Pinky, you're right--I can get an appointment at a teaching hospital because I am already a patient there. But it is with a doctor fresh out of residency, which is not ideal for me, and I've been warned that delivering at a teaching hospital would be unpleasant due to the constant stream of intern/resident traffic that would come through at all stages. I've never had a baby or spent time in a hospital, so I have no idea if that's the case.
posted by ubu at 10:04 AM on October 4, 2007

Also, I haven't had to go for pregnancy issues, but I did used to go to a clinic and it was always easy cheesy to get an appointment there. I only found myself a "real" doctor when one of my tests came back problematic and I wanted a second opinion.

I think if I were pregnant I'd want to start forging a relationship with my own doctor, though, so I'd avoid the clinic (new doctor every time) route.
posted by iguanapolitico at 10:08 AM on October 4, 2007

Should have previewed--thanks for the referral advice, and the advice to CALL, CALL, CALL. Sigh. I was hoping this would be a slightly easier experience, especially since I loved my former ob/gyn, who is apparently retiring and not taking on new pregnancies.
posted by ubu at 10:10 AM on October 4, 2007

It might help to know where you are and what kind of insurance you have.

In the U.S., many working docs have contracted to accept Medicaid patients in exchange for being allowed to participate in other programs that offer better reimbursement.

The thing to know about Medicaid patients is that in many cases the reimbursement for seeing them doesn't cover the cost of keeping the office open (office rent, receptionist salary, malpractice insurance, electric bills, electronic medical record costs, etc) for the time it takes to see them. If you do the math on this it becomes readily apparent why a lot of these docs are not going to make extra efforts to fill their practice with Medicaid patients.

Also, many medical offices I've worked in have not used a customer-oriented model, where the customer is always right and the customer's needs come first. What this means is that the patient is expected to advocate for their own needs by calling on the phone or visiting the office repeatedly until they get what they need.

This really isn't great, but I'm not talking about how things should be; I'm talking about how things actually often are, and you have to know that in order to know what to do.
posted by ikkyu2 at 10:10 AM on October 4, 2007

Thanks, ikkyu2. I'm in the US and am fortunate enough to have very good insurance.
posted by ubu at 10:17 AM on October 4, 2007

Ask for the name of the nurse who will be calling back. Then, have your current retiring doctor call and ask to speak with her directly. He will get through and get an appointment. At the very least, when you call back the next day, at least you will have someone to ask for.
posted by JohnnyGunn at 10:18 AM on October 4, 2007 [1 favorite has favorites]

Regarding delivery at a teaching hospital: we did this recently, and were offered the opportunity to opt out of grand rounds. We did so, and didn't notice any more traffic in and out of the room than is usual.

Incidentally, have you considered using a Certified Nurse Midwife (CNM)? They can be tricky to locate, depending on the area, but we've used them exclusively and have been very happy with the level of care they provide.
posted by jquinby at 10:23 AM on October 4, 2007

The doctors may also shunt you if you are before the magical 8 week point. It's easier to get appointments at or after 8 weeks.
posted by crazycanuck at 10:48 AM on October 4, 2007

Its problems like this that led me to change to a midwife for the birth of my son. Much more personal attention.
posted by anastasiav at 10:55 AM on October 4, 2007

I switched insurance several months ago and had trouble securing an OB/GYN after going to Planned Parenthood for years, but no longer allowed there under my new HMO.

A few apparently were taking new patients---but not with my insurance plan (even though they accepted my insurance plan! Greedy doctors!). Others weren't calling or were impossible to get appts with.

I finally wound up going to the local public hospital's clinic, which was a horrid, three hour experience. So sometime between now and a few months from now, when I need a new prescription for my pills, I'm going to have to go through this crap all over again.
posted by cmgonzalez at 11:04 AM on October 4, 2007

If you're calling an office with a single doctor, then the front desk staff/nurse will be totally overwhelmed.

You might try locating a group of doctors who share office space and thus have a much more dedicated front desk staff dedicated to bookings.
posted by gsh at 11:07 AM on October 4, 2007

Do any of the ob/gyn offices have a nurse practitioner? If so, you might want to consider seeing the NP -- my own ob/gyn frequently has a wait time of several months, so I see the NP instead for more routine stuff. She's always provided me with fantastic care, and I can almost always make an appointment to see her within a week or two. (In certain states, NPs don't have to be associated with a doctor's office, and can actually work independently. So that's another thing to look into, depending on where you live.)
posted by scody at 11:13 AM on October 4, 2007

Seconding the comment about the "magical eight week point." Most OB/GYNs won't schedule newly pregnant patients any earlier than 8-12 weeks (which is not to say that they should be rudely avoiding your calls -- if they were well-run at all, they'd make an appointment for you in the 8-12 week window). As mentioned above, you may need to do a urine test with your primary doctor to "medically confirm" the pregnancy and then get a referral from him/her. I share your frustration (I'm pregnant and have Army healthcare - doesn't get more inattentive than that!!).
posted by roundrock at 11:40 AM on October 4, 2007

My girlfriend recently moved back home from college, and she has told me the same thing. Most of the ob/gyns in her city are superbusy because of the number of births in her city.

I would second the recommendation of a teaching hospital or nurse practitioner. If you just need a routine check, either should be a fine option.
posted by reenum at 12:15 PM on October 4, 2007

I just went through this a couple of weeks ago, and I'm 9 weeks now.

I went through one doctor's office, who promised calls back that never came, and it seems they felt they had fairly good reasons for not calling back - they felt I needn't be seen until 8 weeks (I felt differently, but might have been less worried if they BOTHERED TO TELL ME I didn't need to be seen) and they had background to do in order to make sure the hospital could accept me for delivery. At any rate, they twice failed to call back in the time promised, leaving me VERY scared that I might not be taking proper medical steps or proper pre-natal vitamins, etc. This being my first pregnancy, I was so nervous in wanting to do everything right!! (But my anonymous AskMe yielded so much helpful advice, that calmed my nerves and helped me do the right things).

Subsequent, I got a referral for a doctor from a local respected parents group, and that doctor made an appointment immediately, in a reasonable amount of time, and I've been enjoying a WONDERFUL experience with them.

You say your current doc is retiring - maybe he/she would be willing to give you the name of another good doctor and even take the time to call that doctor for you and notify them of the referral. I can't speak with authority about the internal practices in doctor's offices, but maybe that extra attention would help you get a call back.

Seriously, a couple weeks ago I was feeling EXACTLY like you are now, and it worked out fine. Relaxation and calmness is the best thing for you and for baby: you'll get where you need to be. In the meantime - LOTS of rest, fluids, folic acid and iron.
posted by bunnycup at 12:20 PM on October 4, 2007

Thanks, bunnycup! I feel the same way--I just wanted to know I had an appointment and an actual date when I knew I could ask whether I could take medicine/eat sausage/lift the laundry basket, etc. There is so much information on all of this on the internet, but much of it is contradictory and somehow it feels like it will be much better to go to the doctor's office and hear it all from someone with a medical degree. I must have missed your anonymous post, but I will definitely look it up now.
posted by ubu at 1:10 PM on October 4, 2007

I'm sorry to hear you're having so much trouble. But congratulations!
posted by pyjammy at 1:32 PM on October 4, 2007

Here is a link to my post, which had been anonmyous because we hadn't told a soul at that point (and family members, friends are mefites).

I don't know your personal situation, but for me, those pre-doctor weeks were the height of time where I felt nauseous and tired (especially week 5) and had no idea of my physical limits, so I refused to lift a finger around the house. My ecstatic husband (lucky to have him) waited on me hand and foot, I slept and read gossip magazines whenever I wasn't at work, and I ate ice cream and peanut butter with a spoon all day. The chief message I got from my AskMe was some good, trustworthy resources so that my reading was safe and sane, and to TRUST my body to show me it's babylikes, babyhates, needs and wants.

I will tell you this - even different doctors will disagree on what they tell you - the one glass of wine is okay or not - benadryl is okay or not - don't run versus running is fine - so there's a LOT of personal preference involved, and more leeway than you think. DON'T let yourself get insane trying to be perfect, really!! So so so much good luck and best wishes to you. Oh sheesh, hormones, now I'm going to cry.
posted by bunnycup at 1:32 PM on October 4, 2007

I've been warned that delivering at a teaching hospital would be unpleasant due to the constant stream of intern/resident traffic that would come through at all stages

Nah, it's not that bad, or at least it wasn't in my experience. You can always kick people out if you want. I preferred the birth I had in the non-teaching hospital, but the number of students was the least of it.

How about seeing a family doctor instead of an OB/GYN? That's what I did with my second. The family doctor sees me for everything, from sinus infections to childbirth, and she's my kids' doctor, too.
posted by The corpse in the library at 1:41 PM on October 4, 2007

Oh, to chime in regarding a teaching hospital...I chose to change hospitals to a teaching hospital, because my pregnancy is high risk. Not that you're going to be high risk, but you never know. (My risk is that we're having triplets. Which we didn't find out until 7 weeks. So you really never know.)
posted by pyjammy at 1:59 PM on October 4, 2007

I'm going to have to recommend "reporting" your experiences to a medical ratings site like this one. Speaking as someone who has grown more and more distrustful of the medical system, I am becoming quite an advocate of consumers taking things in their own hands to put sucky practices out of business.
posted by rolypolyman at 3:36 PM on October 4, 2007

I'm an established patient and it takes me 5 months to get in with my OB-GYN. She's the best in the area. I see her nurse-prac for minor concerns like infections.
posted by IndigoRain at 4:01 PM on October 4, 2007