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Healthcare delivery + availability crisis in North Carolina
In the past few weeks, major problems have surfaced in Asheville NC. GenesisCare, an oncology specialty center with the most skilled surgeons in the area, was given a shutdown notice bc the national business entity filed bankruptcy. The 6 multi- certified surgeons were terminated and their doors were closed. It happened that I called to reschedule my surgery on that day. I've learned from the news that there aren't qualified surgeons in this area to replace them. So the Drs are desperately scrambling to transfer in-process patients. These patients have to be transferred very far in many cases. We feel heartbroken for everyone. The office told me they all hope to regroup+ reopen asap independently. Two days later, I received a letter that my neurosurgeons group had spilt into three different groups which will be conducting business at three different locations+/, each affiliated with different business entities. My Dr joined HCA. Physical Therapy did too.
Asheville is a fairly small city but it's not rural. The upheaval began right before COVID hit when Mission Hospital non profit sold itself to HCA, a corporate for profit healthcare management company. Everyone was taken by surprise. Many Drs + nurses were unhappy and made changes. For whatever reason, as these changes were welcomed by patients, they are falling apart before our eyes. I've never experienced mass instability in Physician and medical services before. I lived in a very stable, healthcare rich area prior. My surgery isn't that complex so mine can be transferred to someone else locally. I can still see the same neurosurgeon but associated with HCA and under their protocols. ALL is in flux. I don't know if this is happening elsewhere in our country. I never realized how unsettling it could be to have healthcare delivery in widespread disruption. The shift involves our top specialists. And they are our only ones for what they are skilled to do.
Then, I needed to visit the ER and noticed my paperwork did not list my Dr. They told me I had to get my medical records to get his name. Turns out, the ER is using Traveling Doctors to cover ER staffing for doctors. I have no words.
I thought others might find it eye opening to hear about this. I would never have foreseen this. And I'm sure I only know a slice of the actual local situation. I truly can't put all this into words. I don't even know where the solution will come from.
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@rsfcowgirl, I’m very sorry to hear this disturbing news about the acute healthcare crisis in your region/state. Like you, I have no words. One needs care options close to home.
Having said that, if travel is possible for you, Mayo Clinic Jacksonville may be an option to consider.
My thoughts are with you and presumably the thousands of others who may be impacted by this upheaval.
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6 ReactionsThank you so much Colleen. I will check the map to see if I could get there and if they take my insurance, etc.
Many people are traumatized by this unexpected upheaval. Sicker people have it the worst. It's not something anyone expected. I'm now thinking about moving. It's almost surreal.
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4 ReactionsI'm sorry you are going through this. Unfortunately your story is far from unique.
This is happening weekly, all across the country. For profit health care stepped into gaps over the past several years, and now, as it becomes obvious to them that with caps on Medicare and insurance payments and rising costs, that the profits aren't there, closures are rising.
At the same time, small market/small town and rural providers cannot compete on salary and benefits, so are faced with severe staff shortages. To compensate, they hire travelling nurses, docs, techs... paying roughly 2-3 times what it would cost for permanent staff. When reserves are depleted, these small facilities are yet one more casualty of our system in crisis.
And after 3-4 years of short tenure and uncertain future, the lure of higher pay is beginning to fade for the travelers and their families. This doesn't even take into account the lack in continuity of care, the resentment of permanent staff for the "temps" making twice as much as they are and able to choose their shifts, turn down overtime, and move on whenever they want.
To everyone thinking of moving to chase better care - the crisis is everywhere! The shortage of care is everywhere. We are in a medical Eden, with medical schools, teaching hospitals and Mayo all within an easy commute, we have excellent insurance, and we have the same problem with access, long waits, and staff turnover as others here are reporting.
Great minds are needed to find the solution.
Sue
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7 ReactionsThank you for the reality check. I didn't know. It's pretty dark of a picture for our country.
Matter of fact, I had not heard of 'Traveling Doctors" before. Nurses, techs etc, yes. But not Docs. Something feels very cringy about that for some reason.
I'm speculating without much deliberation that universal managed care w rationing is what is going to enter in. We already have informal rationing by virtue of extended appointment times of 8 plus months out for endocrinology, neurology and other specialties.
I'm overall pretty unhappy with many unexpected realities. This is not the retirement I envisioned or planned for. I had only a few simple medical problems before COVID. I had allergies, minor disc. I didn't take any prescriptions. I have BRAC1 but just believed/knew I would be ok with just great healthy lifestyle. I was thankfully correct in that. So as a single retired woman, I felt confident relocating. Then soon after came COVID + I contacted COVID.....twice. The dominos went into motion. I have many significant + disabling medical problems now for the first time. And now I don't have the services. The irony of it all.
Who my heart goes out to the most are the exceptionally talented specialists who had the ideal medical practices they ventured out to establish on their own when corporate-dictated medicine was
too much patient- compromised care for them. They offered what medicine should be. They are the ones who couldn't endure. They are the ones w the true talent. And compassion. And dignity. At least 6 are sitting at home. Master surgeons for complex cases. And personable people with patients too. And one brilliant Psychiatrist. Perhaps there are more. I wish there was a just solution. I would work as a volunteer to my capability if it would help. It's heartbreaking to see great doctors unable to do what they do.
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2 ReactionsPS. I want to add that it's even worse to see doctors provide substandard care bc that's the requirement under corporate management care.
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4 ReactionsDuke University Health System in Durham is an option.
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3 Reactions@rsfcowgirl I was very fortunate as I moved to Charlotte area of NC at the start of the pandemic. I felt my care was excellent and stable with all specialties I needed.Even the Wake Forest University system was expanding (being purchased) I know Charlotte is still a hike for you, as would be Duke. I’m surprised that an area as populated (and visited) as yours is that difficult, and it’s sad.
So I recently had to move to SC, Charleston area, starting over with medical doctors and dentists etc. After 6 months, I have lost or are losing 2 of them because they have terminated their partnership with my insurance companies. One was ENT/Oncology (my cancer follow up needed) and my dentist, point being they are two separate insurances. It’s a pain to have to change but is cost prohibitive (actually for some reason one group won’t even take you if you don’t have an insurance they work with, cash not honored?) It’s not the first time in my life I have had to change doctors because of coverage changes, but I wonder if it could be related to the cost squeezes the medical corporations are making since Covid.
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3 ReactionsThe U.S healthcare system, inasmuch as it can be called a system at all, is both more expensive than anywhere else, and produces worse results. That is surprising to me, but it is backed up by hard data. See the attached chart, which is from the Financial Times in about 2014.
The Centers for Medicaid and Medicare Services (CMS) has an innovation center (CMMI, I think) that studies policy changes that could improve the US healthcare system. Their web page is https://www.cms.gov/priorities/innovation/overview I have not looked into it, but my impression is that CMS is where a lot of the action is for US healthcare policy. CMS is one of the agencies that make up the Department of Health and Human Services.
I do not have a good handle on why our healthcare system is so messed up.
FT healthcare -Document_20211126_0001 (FT-healthcare-Document_20211126_0001.pdf)
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3 ReactionsI hope you secure the care you need. Each state is different too. As is insurance.
I read so many different views on the causes of the current health care delivery system each week. They really are multiple factors. But one recent article, which I'm trying to find to verify to you, stated United healthcare is the largest employers of DOCTORS in the country. It appears that doctor who see us are actually employees of UHC. Unless I don't understand how Drs are employees of an insurance company. They're not reviewers. Not over 71,000. More when I find that article.
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