This is my experience too. I thought it was just me. I'm fairly knowledgeable about how to find doctors and I used to pride myself on my ability to evaluate doctors based on their education and experience. Now I have difficulty finding GOOD doctors (knowledgeable and able to communicate with patients). I think that doctors have so many patients to deal with and limited amount of time. Even though many have nurse practitioners or assistants who see some patients and take some of the burden off doctors. Even these doctors don't seem to have the ability to perform the referral process. I have asked my pain doctor to refer me to a mental health professional twice. She's passed on my request to one of her assistants and they have never found any one or told me anything. Based on my own experience in looking for a mental health professional - there just aren't many in our area and we are just miles from one of the largest medical centers in the world - Houston Texas. I don't want to have to actually go into Houston for this kind of care but other places I've lived had more qualified mental health people. Here we have a plethora of people who I would call "counselors' - not even qualified "psychiatric social workers". Just social workers and religious counselors. Yet I read yesterday that there are 100s if not thousands of doctors who cannot get jobs because there are not sufficient numbers of residencies slots, which are necessary for graduates of medical schools to get experience to qualify them to practice. As my husband explained it hospitals don't have enough money to hire doctors or to fund residencies. This is probably due in part to cut backs in Medicare payments to hospitals. So I guess this situation is complicated and due in part to politics that put re-election over human lives. In every political campaign the encumbent or the candidate promises to cut taxes and Congress thinks they can keep cutting taxes without any consideration to what those cuts mean to programs that people need. I've probably made a lot of mistakes in this description, but I see this happening to our physical infrastructure and our medical infrastructure and other social programs. Others may be able to shed more light and more accurate explanations of why medical care in this country costs more and yet we have higher mortality and morbidity that other countries.