The news keeps reminding us of challenges in our healthcare system. People brings a story of a 24-year-old with stage 3 cancer, an outlier.
The story is of persistence, perseverance, and heart.
But her comments on access struck me. She was diagnosed slowly because of her age/outlier. The routine tests did not render an adequate diagnosis (“Blood looks great. You’re not anemic. There’s really no concern.”). But as to access specifically:
“This is all like a six-month process, because referrals take forever, especially when you're 24 and healthy."
"There's not a real rush to get you to the doctor."
I’m not a doctor (nor do I play one on TV or stay at the hotel that supposedly makes you smarter). But this seems to be a recurrent story I hear. Particularly in workers’ compensation, there are delays in seeing doctors.
The scenario I hear most often is the leverage complaint. This is essentially about no access to an MD, with systems insisting that patients acquiesce in care with nurse practitioners, physician’s assistants, and similar providers. They are told that when your symptoms warrant it, the doctor will see you.
The next challenge is when the MD makes the referral to a specialist. Delays of 6 months are commonly described. Those lucky enough to get an appointment are frequently complaining that after their initial visit, it is again all nurse practitioners and physician assistants for their follow-up care.
The final complaint is a lack of urgency. Are there methods to expedite care? One primary told me the only urgency system we have is the emergency room. Unless you are bleeding or have chest pains, that adventure can cost hours of delay, discomfort, and too often, disappointment.
If it is not a true emergency, the ER will not get you to a neurologist any faster than the “make an appointment” route. If your symptoms warrant hospitalization, then you may get a more rapid specialist evaluation, but it might or might not lead to care or even follow-up.
I have written about the perceived doctor shortage. Supply and Demand (February 2024); Bid Day 2025 (April 2025). I have written about the investment required to claim “MD.” Opportunity Cost (October 2025).
I acknowledge the economic challenges, the investment challenges, and the societal challenges. But, there is a need for our medical system to render care for the emergency, the acute, the urgent, and the routine. There is room for this to be organized, incentivized, and utilized. Unfortunately, there is little time left in the physician’s day after the crush of patients, paperwork, and compassion.
Who will solve all this? How many will suffer or die before we do? Who will care until they need the system to work for them?
