Talk about feeling unwanted.
When I started reporting today’s Refresh cover story – on the quest of helping the unprepared find a medical specialist – I got a small taste of what it’s like to feel like a stranger in a very impersonal land.
Calls to doctor’s offices themselves were pretty similar.
They started with a recorded voice.
No, I wasn’t calling about a prescription.
I wasn't another doctor's office.
Nor did I have a billing question.
Then, oh please no ... I did not need to roll through a staff directory.
My emergency wasn’t so dire I needed to call 911, as many of the recorded voices directed. Thank God.
So I waited on hold, and in one case I was even given a prompt letting me know there were only a couple of callers ahead of me.
When I finally reached a person at one local dermatologist’s office, she was hardly impressed that I was a Buffalo News reporter looking to talk to her boss about tips to find specialists in short supply.
That newspaper name dropping usually works, although, it’s worth noting, not always.
I will say that Carl Paladino has always graciously returned my calls – I’m not kidding – and talked with me for a few minutes.
This woman was no Carl Paladino.
She seemed rushed, put off, unbowed.
Her boss didn’t have time to talk to a reporter, she told me. Never does. Never will.
I can be persistent.
"Can you at least ask?" I said. "Can he refer me to someone else if he doesn’t have time?"
I heard the huff familiar to those I hear from my daughters when I tell them they can’t borrow my car.
After the call, I thought it would be good medicine to name the doctor in this blog piece.
I calmed down and thought better of it, especially since his staffer did give me the name of another doctor who was willing to spend a few minutes on the phone with me to talk about what the Western New doctor shortage means from his perspective.
Like all other physicians I talked with, Dr. Robert Kalb recommended those looking to squeeze onto the appointment books of a specialist in short supply find themselves a good primary doctor – before they get sick.
Those family doctors can separate the truly sick, and in need of immediate attention, from those that a primary doctor may be able to treat, or stabilize, before a specialist is needed, he said.
A primary care doctor called Kalb as we started our interview. I understood, and appreciated, where I rated at that moment. The doctor called me back a few minutes later.
And here’s why Kalb, a dermatologist, and Dr. Ajay Chaudhuri, an endocrinologist, say it can be hard to get in to see a specialist in Western New York:
Many of them are really, really busy.
Kalb works out of the Buffalo Medical Group office on Essjay Road in Williamsville. A physicians assistant helps with his patients. Call yourself for a new patient appointment, without a referral, and be prepared to wait four months.
"We work 45 hours a week and see 150 patients a week," said Kalb, who also is a clinical University at Buffalo professor who teaches dermatology students in his office. He also sees patients at Buffalo General Medical Center a half-day a week.
"Unfortunately, a lot of dermatologists don’t even see new patients," Kalb told me. "Their practices are essentially closed."
Patients have to wait two or three months to see Chaudhuri unless it’s an emergency.
"All of us have some emergency slots" reserved for referrals from primary care doctors or for patients specialists have seen in local hospitals and need follow-up care, Chaudhuri said. "They cannot wait two or three months."
This is a typical day for Chaudhuri, one of three endocrinologists with the Diabetes and Endocrinology Center of Western New York:
"Each one of us sees approximately four or five new patients and 20 or 21 follow-up visits," he says. "After that, we go ahead and see patients in the hospital. In the interim, we’re also taking calls from patients calling in for something. We are reviewing any (medical tests) and calling those patients back."
His workday starts about 8 a.m. and ends about 6:30 p.m. each weekday. He’s also often on-call for hospital work after hours.
"We also work weekends and we do an outpatient clinic one Saturday a month," he said.
And his workplace changes, often day-to-day.
He and his two partners, as well as a physician assistant and a diabetes educator, split time between their center in Williamsville, offices in DeGraff Memorial and Buffalo General hospitals, and with UB MD in the Dent Tower in Amherst. "Then we have teaching and research going on," Chaudhuri said. "It’s demanding but it’s rewarding."
Kalb leads dermatology recruiting efforts for the Buffalo Medical Group.
"Some of major metropolitan areas are saturated with dermatologists because of cosmetic procedures," he said, "but in most areas of the country, there’s a shortage."
As the Bills and Sabres have at times discovered with top players, doctors aren’t always clamoring to come to Buffalo.
"It’s not for a lack of effort," Kalb said, "but t’s tough unless the person has a tie to the Western New York area.
"The reimbursements are relatively low compared to other parts of the country, so it is somewhat tough to recruit people to Western New York. The people who train and have some sort of tie here are the ones you’re more than likely to have come and work in the area.
"It’s been a struggle the last couple of years."
As with other efforts here, slow and steady progress is being made.
Chaudhuri and his partners also are clinical professors with UB, and are helping train two new endocrinologists who will join the practice in September.
That should make Diabetes and Endocrinology Center patients – and the staff – very happy, indeed.
– Refresh Editor Scott Scanlon