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You'll notice on the varying Find-A-Doctor websites very few younger MDs and a very high number in practice 20+ years which is a little bit alarming given retirement numbers pending in the coming few years along with FL's population growth.
Florida has eight medical schools yet few graduates stay afterwards which alludes to salary potential and cost to practice with malpractice insurance apparently the real killer.
This is a problem now. It will become an even bigger problem now when the 50 year old doctors reduce hours for better work-life balance or decide to retire early. The state of Florida knows about this and is brainstorming ways to try to encourage a growth in the number of doctors in the state at a point when they’re fearing a shrinkage.
The current political climate doesn’t help drawing in new physicians- the current state surgeon general is definitely putting politics over best medical practices and while, not as bad as Texas or Idaho, there are reasons for a OBGYN to think twice about setting up practice in the state.
I have a primary card physician with a reasonable wait time for appointments. I find her to be mediocre but then I have pretty simple health care needs so she can be mediocre as long as she gets me set up for my annual mammogram.
Most medical care in the panhandle is expensive and mediocre. The nearest burn center is in Mobile, Alabama and I know a fair number of people who have gone to Gainesville or Jacksonville for cancer treatment because it’s a level above what you can find locally.
When we head out of here in a few years, one of our relation criteria is 'within 30 miles/minutes of a level 1 trauma center' because we aren't going to have simple health care needs forever and I figure that youre going to gt a decent specialist cluster surrounding said Level 1 trauma center.
The beef is the "specialist" down here and the hospitals. They suck. The general doctors are okay if not a large group, but these days most of your general internist send you to a specialist now for just about everything.
The last two years I've had an injury issue the doctors can't figure out but one ortho surgeon thinks it's Thoracic Outlet Syndrome. I've had like 5 MRI's done, CT scan at the ER. in the ER 3 times. Spent about 10k total on medical bills for this. At first thought it was the heart because the pain was super intense. MRIs not showing much. It's healed some since I quit running and doing heavy lifting. Running and lifting a lot makes it worse. So now to stay in shape I do bike riding which aggravates me. Basically last ortho he doesn't deal with that stuff and very few doctors in FL do. Said Tampa and see the Rays ortho surgeon who specializes in it. Of course he doesn't take my FL Blue.
If I was living back in St. Louis this wouldn't be an issue because Wash U has a Thoracic Outlet Center that specializes in it at the university. Same with my mom's Congestive Heart Failure. If we were living in Stl still or was up in Tampa going to Tampa General she might be here still.
A lot of the older folks complain about the specialist down here. Millineium Group in SWFL controls everything now. Their cardiology group sucks! Her last cardiologist was clueless and young but at least said go to Tampa. Don't get me started on that group.
I wanted her to get an LVAD but Tampa General was the closest hospital that does that and takes awhile to get an appointment.
With all the older people from Venice to Naples you would think they would do stuff like that at a heart hospital like Healthpark. For all the population we have here they still send people to Tampa for the major stuff.
I’m in Gainesville where one of those medical schools is located. UF did a survey which showed that graduates who already lived in Florida, tended to remain in Florida upon completion of medical school.
The ones who were from out of state tended to leave Florida once they graduated.
UF has identified that there is a shortage of doctors and they are trying to determine what would keep them in Florida. They are also debating whether or not they should skew admission requirements so that in-state residents are given special consideration.
My perspective on working in healthcare in Florida is just what I have had conversations with physicians and residents about so it may not apply to everyone:
1. Florida has a unique combination of high workload and low reimbursement that tends to push specialists and New Docs away from the state. In most states you have a mix of relatively healthy individuals, more complex cases, and geriatrics which to be honest is always complicated.
In Florida, most of your panel (patient list) is Geriatrics with tons of meds that interact and need constant adjustment, lots of follow-ups, collaboration with several other specialists to keep track of what is happening, and lots of Pre-approval paperwork. It's all time-consuming and the reimbursement for all the work is at Medicare levels. And those constant closely scheduled follow-ups clog the schedules as well since all those geriatric complex cases make up the majority of your patient population so it makes it hard to get new patients in.
I would argue that it is harder to be a Primary care or internal Medicine physician in Florida than in just about any other location in the USA due to the complex geriatric cases you carry and see daily AND are from all over the World so you have to know so much more about regional issues across the US or potential issues in countries that your patients are from that may apply to your patient. It is easier to go to a city outside of Florida, get paid more, and have less complex cases.
2. Cost of living increases in Florida, increased debt levels from medical school, lower reimbursement from large Medicare patient panels, and consolidation of practices under large Hospital umbrellas that are managed like cruel dictators have made Florida much less attractive for new graduates to start practicing in Florida.
Even some of the Residents and Fellows I have personally discussed this with in Tampa, FL (Teaching Hospital) and are from a family of physicians with a practice already established are still debating if staying in Florida is a good idea or not. That is not a good sign.
My perspective on working in healthcare in Florida is just what I have had conversations with physicians and residents about so it may not apply to everyone:
1. Florida has a unique combination of high workload and low reimbursement that tends to push specialists and New Docs away from the state. In most states you have a mix of relatively healthy individuals, more complex cases, and geriatrics which to be honest is always complicated.
In Florida, most of your panel (patient list) is Geriatrics with tons of meds that interact and need constant adjustment, lots of follow-ups, collaboration with several other specialists to keep track of what is happening, and lots of Pre-approval paperwork. It's all time-consuming and the reimbursement for all the work is at Medicare levels. And those constant closely scheduled follow-ups clog the schedules as well since all those geriatric complex cases make up the majority of your patient population so it makes it hard to get new patients in.
I would argue that it is harder to be a Primary care or internal Medicine physician in Florida than in just about any other location in the USA due to the complex geriatric cases you carry and see daily AND are from all over the World so you have to know so much more about regional issues across the US or potential issues in countries that your patients are from that may apply to your patient. It is easier to go to a city outside of Florida, get paid more, and have less complex cases.
2. Cost of living increases in Florida, increased debt levels from medical school, lower reimbursement from large Medicare patient panels, and consolidation of practices under large Hospital umbrellas that are managed like cruel dictators have made Florida much less attractive for new graduates to start practicing in Florida.
Even some of the Residents and Fellows I have personally discussed this with in Tampa, FL (Teaching Hospital) and are from a family of physicians with a practice already established are still debating if staying in Florida is a good idea or not. That is not a good sign.
Thank you for explaining what I have been experiencing (as a patient in Florida for years) and why
I've called all the ones listed in my area. Most of them don't call back, but when they do, they are not taking new patients. I've given up.
That's interesting, I'd think there would be fewer people interested in paying the concierge fees to see those doctors than those who don't want to, leaving more openings in the concierge practices. But then, it might be that the concierge docs cap their patient numbers, considering the the idea was to see fewer patients, give the attention and time as needed to their enrolled patients. I've seen listings here for at least 5 concierge docs under the MDVIP label.
I have no interest in joining a concierge practice, so I don't care how many, or few there are in any given area. I get good medical care from the providers with whom I am an established patient.
That's interesting, I'd think there would be fewer people interested in paying the concierge fees to see those doctors than those who don't want to, leaving more openings in the concierge practices. But then, it might be that the concierge docs cap their patient numbers, considering the the idea was to see fewer patients, give the attention and time as needed to their enrolled patients. I've seen listings here for at least 5 concierge docs under the MDVIP label.
I have no interest in joining a concierge practice, so I don't care how many, or few there are in any given area. I get good medical care from the providers with whom I am an established patient.
I think the reason our area is having the issue is twofold - there are enough people with the financial means to afford concierge care AND the doctors do cap the number of patients they have.
Getting to the point of being an established patient is my issue. I called my current doc in January to schedule an appointment...at the end of March. I was very excited about her in the beginning but it's her office staff who are just not up to par in any way. Not to mention that she is often at a satellite office.
So come May I will be trying another practice...and keeping my fingers crossed. My expectations and expected level of service have dropped so low.
My perspective on working in healthcare in Florida is just what I have had conversations with physicians and residents about so it may not apply to everyone:
1. Florida has a unique combination of high workload and low reimbursement that tends to push specialists and New Docs away from the state. In most states you have a mix of relatively healthy individuals, more complex cases, and geriatrics which to be honest is always complicated.
In Florida, most of your panel (patient list) is Geriatrics with tons of meds that interact and need constant adjustment, lots of follow-ups, collaboration with several other specialists to keep track of what is happening, and lots of Pre-approval paperwork. It's all time-consuming and the reimbursement for all the work is at Medicare levels. And those constant closely scheduled follow-ups clog the schedules as well since all those geriatric complex cases make up the majority of your patient population so it makes it hard to get new patients in.
I would argue that it is harder to be a Primary care or internal Medicine physician in Florida than in just about any other location in the USA due to the complex geriatric cases you carry and see daily AND are from all over the World so you have to know so much more about regional issues across the US or potential issues in countries that your patients are from that may apply to your patient. It is easier to go to a city outside of Florida, get paid more, and have less complex cases.
2. Cost of living increases in Florida, increased debt levels from medical school, lower reimbursement from large Medicare patient panels, and consolidation of practices under large Hospital umbrellas that are managed like cruel dictators have made Florida much less attractive for new graduates to start practicing in Florida.
Even some of the Residents and Fellows I have personally discussed this with in Tampa, FL (Teaching Hospital) and are from a family of physicians with a practice already established are still debating if staying in Florida is a good idea or not. That is not a good sign.
Sadly, you're not wrong in what you say here, and I'd add the challenges of ever increasing demands ( with a large share of similarly needy, demanding patients on Medicare) from the throngs of transplants, and snowbirds during season, to that mix. I'm appalled at the lousy Medicare reimbursement rate here, and wonder how the providers can even make it with those rates, having to jump through endless hoops to meet Medicare's often irrelevant "quality measures" or have their poor reimbursements cut further, endless "prior authorizations" and other attempts by insurance companies to deny needed care to their subscribers. More healthcare providers are desparately needed to meet the ever increasing demands for service, but with not much in the way of attracting enough new providers to the area, and having them stay long term, I don't know where we will end up. And I don't know that it's much better anywhere else.
We have family members in healthcare here, and that list of frustrations goes on and on. As I mentioned in previous posts, I'm lucky to have received good healthcare in Florida, although I did my best to avoid it when I was younger. It's increased as I got older, though I try and limit it to the visits, tests, procedures recommended by the docs I see- and those aren't that often, be as prepared as I can be to make the visits meaningful, try not to waste their time, and let them know how much I appreciate their time and attention, maintain a positive attitude. I understand their issues and frustrations, having worked in healthcare myself, and it looks as though it's only gotten worse.
I think the reason our area is having the issue is twofold - there are enough people with the financial means to afford concierge care AND the doctors do cap the number of patients they have.
Getting to the point of being an established patient is my issue. I called my current doc in January to schedule an appointment...at the end of March. I was very excited about her in the beginning but it's her office staff who are just not up to par in any way. Not to mention that she is often at a satellite office.
So come May I will be trying another practice...and keeping my fingers crossed. My expectations and expected level of service have dropped so low.
I think you hit the nail on the head with the problems over becoming established as a patient in a primary practice, and in the practices of specialists you may need to manage chronic issues. It's difficult these days with the ongoing exponential growth in population we've experienced here, increases in seasonal visitors, as they're competing for and overwhelming the available providers with their sheer numbers and demands. So many of them are saying they won't take new patients, and there you are....
But I think as you say the key to good care here ( anywhere really) is to become an established patient in a good practice- tough to do in an area where the population is outgrowing the number of providers. I've been lucky in that I've had the same PCP since we moved here full time in 2013, she's excellent, responsive to the needs of her patients, has an excellent staff. She's been a stellar gatekeeper, referring me to specialists ( even having her staff make the appointments for me when it's been of an urgent nature), and following up as needed. I've also become established with a cardiologist ( 9 yrs), eye doctor ( 11 years), and oncologist as needed, which makes getting any needed care easier and more timely. I find the docs ( and dentists) save spots to schedule appointments for established patients who need them, so depending on the urgency of the problem ( and you don't call them for every little thing) you can be seen fairly soon- I've had same day or next day appointments with my PCP, or a nurse practitioner in the office if she was unavailable.
But this could all change if a provider with which you're established retires, or leaves the area, then you're out there floating with all the newbies looking for providers! My husband's PCP just informed him that he is leaving the area in a couple months, so he'll be looking for a new doctor too.
As for appointments with established providers, around here they seem to schedule the next appointment at the end of each visit, so you don't have to call closer to the time of that next appointment. If you need an appointment for an illness or problem sooner, I guess that could be an issue depending on the provider. I communicate with the. PCP and staff via the patient portal ( not often, only when there is a problem) and they've responded quickly, and I've been able to make appointments as quickly as needed.
Keep looking, I think I see a number of fairly new providers to the area, and others who say they're taking new patients ( webmd searches), with recommendations from friends, neighbors, other providers, checking credentials, etc etc). Hopefully you can find a keeper. Best of luck to you.
Getting to the point of being an established patient is my issue. I called my current doc in January to schedule an appointment...at the end of March. I was very excited about her in the beginning but it's her office staff who are just not up to par in any way. Not to mention that she is often at a satellite office. .
Medical office work along with areas like pharmacy tech, ultrasound tech, phelonotimist, etc. falls in the pay scale of ‘you know, I could work dinner shifts only at Senior Frog’s five nights a week and make way more money’ for those kinds of jobs down here, so a lot of practices have real issues keeping quality people.
Found an interesting chart on best and worst places for senior health care and it’s not surprising to see Minnesota at the top, in part due to easy Mayo Clinic access fro the population centers of the state. Florida is pretty much smack in the middle. The bottom ten are about who you’d usually expect to see there. (Though I think Delaware and DC aren’t getting credit for services available in adjacent areas in other states.)
I'm from a small state, in square mileage. We have several teaching hospitals with some of the best doctors' groups in the country as a result. Florida is a very large state, with fewer teaching hospitals spread out over a much larger chunk of real estate. As a result, the best doctors will be few and far between, both figuratively and literally.
If you want a broad selection of excellent doctors, you need to find the spot with the shortest routes to the most teaching hospitals. Between them, you'll find those excellent doctors in all specialties, in groups and in private practice. No idea if Tampa or Miami have clusters like this, up here in Central Florida we have - Gainesville, and that's pretty much it.
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