# Doctors not accepting new patients **URL:** \ **Category:** Factual Questions\ **Created:** [May 17, 2017, 5:01pm UTC](https://boards.straightdope.com/t/doctors-not-accepting-new-patients/786852 "2017-05-17T17:01:06Z")\ **Posts on this page:** 20\ **Page:** 2
**Author:** ![Bijou\_Drains](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bijou_drains/32/2814_2.png) [@Bijou\_Drains](https://boards.straightdope.com/u/Bijou_Drains)\ **Post date:** [May 18, 2017, 11:04am UTC](https://boards.straightdope.com/t/doctors-not-accepting-new-patients/786852/21 "2017-05-18T11:04:20Z")
My Dr. simply asks if your policy is via Obamacare. I guess they could also call the insurance company and ask them too. ---
**Author:** ![Really\_Not\_All\_That\_Bright](https://avatars.discourse-cdn.com/v4/letter/r/e8c25b/32.png) [@Really\_Not\_All\_That\_Bright](https://boards.straightdope.com/u/Really_Not_All_That_Bright)\ **Post date:** [May 18, 2017, 1:38pm UTC](https://boards.straightdope.com/t/doctors-not-accepting-new-patients/786852/22 "2017-05-18T13:38:54Z")
> [@Shmendrik](#): > > Again, medical schools are not the bottleneck. The only effect of opening new American schools will be to reduce the number of foreign graduates practicing here. The number of new practicing physicians is limited by the availability of residency spots. Both are bottlenecks. By and large, foreign doctors aren’t general practitioners, because GPs earn relatively low salaries in the US (and they can complete residencies in Canada if they want to anyway). If you can’t find a cardiologist, it’s because of the residency bottleneck, but if you can’t find a primary care doctor, it’s because of the med school bottleneck. ---
**Author:** ![Kinthalis](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kinthalis/32/16084_2.png) [@Kinthalis](https://boards.straightdope.com/u/Kinthalis)\ **Post date:** [May 18, 2017, 1:45pm UTC](https://boards.straightdope.com/t/doctors-not-accepting-new-patients/786852/23 "2017-05-18T13:45:07Z")
> [@Bijou\_Drains](#): > > My Dr. simply asks if your policy is via Obamacare. I guess they could also call the insurance company and ask them too. This sounds like your doctor is some republican ass-hat and is doing this out of some political agenda, rather than because it posses some sort of issue for him/his staff. ---
**Author:** ![jaycat](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jaycat/32/3015_2.png) [@jaycat](https://boards.straightdope.com/u/jaycat)\ **Post date:** [May 18, 2017, 1:45pm UTC](https://boards.straightdope.com/t/doctors-not-accepting-new-patients/786852/24 "2017-05-18T13:45:45Z")
Try an HMO. ---
**Author:** ![Really\_Not\_All\_That\_Bright](https://avatars.discourse-cdn.com/v4/letter/r/e8c25b/32.png) [@Really\_Not\_All\_That\_Bright](https://boards.straightdope.com/u/Really_Not_All_That_Bright)\ **Post date:** [May 18, 2017, 1:49pm UTC](https://boards.straightdope.com/t/doctors-not-accepting-new-patients/786852/25 "2017-05-18T13:49:50Z")
> [@Kinthalis](#): > > This sounds like your doctor is some republican ass-hat and is doing this out of some political agenda, rather than because it posses some sort of issue for him/his staff. Not necessarily. Because of some of the quirks in the requirements for exchange plans, reimbursement rates can be a bit lower and providers have to fill out more paperwork when submitting bills. There was also a weird rule where patients who were eligible for subsidies had three months to start paying premiums before insurers could drop them - but despite insurers having to “cover” them during this period they could simply refuse to pay providers’ bills if they (the insurer) ultimately dropped the patient for nonpayment. ---
**Author:** ![Evan\_Drake](https://avatars.discourse-cdn.com/v4/letter/e/b487fb/32.png) [@Evan\_Drake](https://boards.straightdope.com/u/Evan_Drake)\ **Post date:** [May 18, 2017, 2:21pm UTC](https://boards.straightdope.com/t/doctors-not-accepting-new-patients/786852/26 "2017-05-18T14:21:11Z")
> [@bob\_2](#): > > I am sure I read in another thread that one of the benefits of a privately funded healthcare system was that one could get an appointment easily at a time to suit them. This was in response to criticism of the NHS where we often have to wait a few days for a non-urgent GP appointment; more if you want a specific doctor. Well, I dunno, never had a problem with the NHS. I have a physio appointment on Monday _re_ my broken arm; I suddenly had the brilliant idea of combining this with some silly glucose blood test they’ve been badgering me about for months ( I’ve rarely seen a doctor in my life, and don’t enjoy some dem sawbones prodding and poking me ), so I just rang up today ( Thursday ) and chose the exact time I wanted for this additional test. Bearing in mind the weekend, this is a couple of days for a non-urgent appointment. And, encore, _waves at Americans_, don’t have to pay a cent. ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [May 18, 2017, 2:41pm UTC](https://boards.straightdope.com/t/doctors-not-accepting-new-patients/786852/27 "2017-05-18T14:41:12Z")
> [@Really\_Not\_All\_That\_Bright](#): > > Both are bottlenecks. By and large, foreign doctors aren’t general practitioners, because GPs earn relatively low salaries in the US (and they can complete residencies in Canada if they want to anyway). If you can’t find a cardiologist, it’s because of the residency bottleneck, but if you can’t find a primary care doctor, it’s because of the med school bottleneck. That’s the first I’ve heard that claim about foreign doctors not going into general practice. Anecdotally it is not what I’ve seen but that aint data. Any reason you believe that? (Mind you agreed that both are bottlenecks.) The usual impression (see for example [this NYT article](http://www.nytimes.com/2013/08/12/business/economy/long-slog-for-foreign-doctors-to-practice-in-us.html)) is that foreign MD are more likely to practice primary care (“… specialties where foreign-trained physicians are most likely to practice, like primary care …”) From that article it seems that in general a foreign physician who is already practicing in a specialty in their home country still needs to do a U.S. residency, along with the American citizen who graduate American medical schools and American citizens who graduate foreign medical schools. > [@](#): > > The biggest challenge is that an immigrant physician must win one of the coveted slots in America’s medical residency system, the step that seems to be the tightest bottleneck. > > That residency, which typically involves grueling 80-hour workweeks, is required even if a doctor previously did a residency in a country with an advanced medical system, like Britain or Japan. The only exception is for doctors who did their residencies in Canada. Information from [the current Match report](http://www.nrmp.org/press-release-nrmp-2017-main-residency-match-report-shows-record-high-31554-positions-filled/): > [@](#): > > Although the number of Match registrants was the most ever, the increase was due primarily to growth in U.S. allopathic medical school seniors (increase of 362) and students/graduates of U.S. osteopathic medical schools (increase of 722). > > The number of U.S. citizen and non-U.S. citizen international medical school students and graduates (IMGs) who submitted program choices declined; however, their match rates of 54.8% and 52.4% respectively were the highest in more than a decade. > > In the six years since implementation of the All In Policy in 2013, the primary care specialties of Internal Medicine, Family Medicine, and Pediatrics have added a combined 2,900 positions, a 25.8 percent increase. > > Since 2012, the number of U.S. allopathic seniors matching to Family Medicine has increased every year from 1,322 to 1,513. Note though that the percent increase in the number of primary care spots available (25.8%) is greater than percent increase of U.S. allopathic seniors matching to Family Medicine (14%). [Specific to Family Practice](http://www.aafp.org/medical-school-residency/program-directors/nrmp.html) (most needed in underserved regions): > [@](#): > > 2017 NRMP Match Highlights > > 3,237 medical students and graduates matched to family medicine residency programs in 2017, the most in family medicine’s history as a specialty. > > Of those matches, 1,530 positions were filled with U.S. Seniors, 810 fewer than the historical peak (2,340 in 1997). > > Family medicine offered 3,378 positions, 118 more than 2016. > > This is the eighth straight year that the family medicine match rate climbed year-over-year. > > Key Takeaway > > The 2017 NRMP Match results continue in the right direction for family medicine. The number of U.S. Seniors matching into family medicine residencies is up 447 over the last eight years. However, neither the production of family medicine residents by U.S. medical schools nor the number of available family medicine residency positions are sufficient to address primary care workforce needs in the U.S. The AAFP is working to remove significant barriers in the educational and practice environments that are stifling growth in family medicine specialty choice among U.S. medical graduates, as well as increase the number of family medicine graduate medical education positions. Substantial increases in the family medicine and primary care workforce will improve the health of Americans and the sustainability of the health care system. [From the Match International Graduate Outcomes Report](http://www.nrmp.org/wp-content/uploads/2016/09/Charting-Outcomes-IMGs-2016.pdf) there were 4,139 applicants who listed Family Medicine as their preferred residency match for 3,238 positions available. Also from that report many more foreign grads have internal medicine residency as their preferred match than do US grads. FWIW. ---
**Author:** ![Okrahoma](https://avatars.discourse-cdn.com/v4/letter/o/90db22/32.png) [@Okrahoma](https://boards.straightdope.com/u/Okrahoma)\ **Post date:** [May 18, 2017, 3:10pm UTC](https://boards.straightdope.com/t/doctors-not-accepting-new-patients/786852/28 "2017-05-18T15:10:51Z")
> [@Bijou\_Drains](#): > > My Dr. takes new patients except for people on Obamacare. I wonder how common that is. AFAIK this is widespread. When I was looking for doctors (both specialists and a GP), and asked whether they accepted BCBS, which was my insurance, the first thing the office asked was whether it was from the ACA exchanges or not. ---
**Author:** ![Slash1972](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/slash1972/32/6461_2.png) [@Slash1972](https://boards.straightdope.com/u/Slash1972)\ **Post date:** [May 18, 2017, 3:15pm UTC](https://boards.straightdope.com/t/doctors-not-accepting-new-patients/786852/29 "2017-05-18T15:15:10Z")
What would be the downside if a person just lied and said “Nope, not from the exchanges”? ---
**Author:** ![Okrahoma](https://avatars.discourse-cdn.com/v4/letter/o/90db22/32.png) [@Okrahoma](https://boards.straightdope.com/u/Okrahoma)\ **Post date:** [May 18, 2017, 3:17pm UTC](https://boards.straightdope.com/t/doctors-not-accepting-new-patients/786852/30 "2017-05-18T15:17:35Z")
> [@Slash1972](#): > > What would be the downside if a person just lied and said “Nope, not from the exchanges”? What’s the point in lying? When they actually put you and your insurance into the system, they will see that it is from the exchanges and tell you they cannot take you as a patient. ---
**Author:** ![MandaJo](https://avatars.discourse-cdn.com/v4/letter/m/ac91a4/32.png) [@MandaJo](https://boards.straightdope.com/u/MandaJo)\ **Post date:** [May 18, 2017, 3:29pm UTC](https://boards.straightdope.com/t/doctors-not-accepting-new-patients/786852/31 "2017-05-18T15:29:13Z")
So what happens to people who finish Med School and don’t match for a residency? ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [May 18, 2017, 4:09pm UTC](https://boards.straightdope.com/t/doctors-not-accepting-new-patients/786852/32 "2017-05-18T16:09:02Z")
> [@MandaJo](#): > > So what happens to people who finish Med School and don’t match for a residency? There’s a scramble to get residents who didn’t match connected with programs that didn’t fill. But without some post med school training, the med school grad can’t get a license. And the vast majority of US states now require at least two years of residency training for licensure instead of one these days. ---
**Author:** ![MandaJo](https://avatars.discourse-cdn.com/v4/letter/m/ac91a4/32.png) [@MandaJo](https://boards.straightdope.com/u/MandaJo)\ **Post date:** [May 18, 2017, 4:48pm UTC](https://boards.straightdope.com/t/doctors-not-accepting-new-patients/786852/33 "2017-05-18T16:48:16Z")
So are there people out there with a quarter-million in med school debt who aren’t ever going to be able to be doctors? You know the old joke about how you call the lowest-ranked member of a med school class “Dr”–is that even true, then? (I mean, I know they have an MD, but if they can’t practice, what can they do?) ---
**Author:** ![Slash1972](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/slash1972/32/6461_2.png) [@Slash1972](https://boards.straightdope.com/u/Slash1972)\ **Post date:** [May 18, 2017, 4:51pm UTC](https://boards.straightdope.com/t/doctors-not-accepting-new-patients/786852/34 "2017-05-18T16:51:20Z")
> [@Okrahoma](#): > > What’s the point in lying? When they actually put you and your insurance into the system, they will see that it is from the exchanges and tell you they cannot take you as a patient. Fair enough. I didn’t realize they could tell HOW you got your insurance (work, exchanges, paid for it yourself) through that system. ---
**Author:** ![ftg](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ftg/32/2801_2.png) [@ftg](https://boards.straightdope.com/u/ftg)\ **Post date:** [May 18, 2017, 4:51pm UTC](https://boards.straightdope.com/t/doctors-not-accepting-new-patients/786852/35 "2017-05-18T16:51:42Z")
> [@MandaJo](#): > > So what happens to people who finish Med School and don’t match for a residency? You can move to [Missouri](https://www.statnews.com/2017/05/15/missouri-doctor-dearth/). ---
**Author:** ![Okrahoma](https://avatars.discourse-cdn.com/v4/letter/o/90db22/32.png) [@Okrahoma](https://boards.straightdope.com/u/Okrahoma)\ **Post date:** [May 18, 2017, 7:26pm UTC](https://boards.straightdope.com/t/doctors-not-accepting-new-patients/786852/36 "2017-05-18T19:26:33Z")
> [@Slash1972](#): > > Fair enough. I didn’t realize they could tell HOW you got your insurance (work, exchanges, paid for it yourself) through that system. The insurance you get (the plan itself) is not exactly the same. It may even have the same exact terms, but it is not the same designation. ---
**Author:** ![Spiderman](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/spiderman/32/230_2.png) [@Spiderman](https://boards.straightdope.com/u/Spiderman)\ **Post date:** [May 18, 2017, 8:38pm UTC](https://boards.straightdope.com/t/doctors-not-accepting-new-patients/786852/37 "2017-05-18T20:38:18Z")
> [@MandaJo](#): > > So are there people out there with a quarter-million in med school debt who aren’t ever going to be able to be doctors? > > You know the old joke about how you call the lowest-ranked member of a med school class “Dr”–is that even true, then? (I mean, I know they have an MD, but if they can’t practice, what can they do?) I know of a MD who works for Big Pharma. I know of someone else (PhD) who works for different Big Pharma; his stepdaughter is starting med school this year. If she wants follow him, would she need to do a residency as she wouldn’t be doing patient care but research? ---
**Author:** ![steatopygia](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/steatopygia/32/3132_2.png) [@steatopygia](https://boards.straightdope.com/u/steatopygia)\ **Post date:** [May 18, 2017, 9:01pm UTC](https://boards.straightdope.com/t/doctors-not-accepting-new-patients/786852/38 "2017-05-18T21:01:28Z")
> [@Spiderman](#): > > I know of a MD who works for Big Pharma. I know of someone else (PhD) who works for different Big Pharma; his stepdaughter is starting med school this year. If she wants follow him, would she need to do a residency as she wouldn’t be doing patient care but research? She could do a “[research residency](http://www.sciencemag.org/careers/2009/04/making-room-research-during-residency)” I know this thread has become a total hijack, but I’m still interested in the question of how come residencies are limited to however many the government will pay for. Anybody? ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [May 18, 2017, 10:48pm UTC](https://boards.straightdope.com/t/doctors-not-accepting-new-patients/786852/39 "2017-05-18T22:48:37Z")
> [@ftg](#): > > You can move to [Missouri](https://www.statnews.com/2017/05/15/missouri-doctor-dearth/). Very interesting arrangement. And better than not being able to practice medicine. But what we really need is more residency spots to enable all medical school graduates to be able to get fully trained to be the best physicians they can be. ---
**Author:** ![Mama\_Zappa](https://avatars.discourse-cdn.com/v4/letter/m/71e660/32.png) [@Mama\_Zappa](https://boards.straightdope.com/u/Mama_Zappa)\ **Post date:** [May 19, 2017, 12:10am UTC](https://boards.straightdope.com/t/doctors-not-accepting-new-patients/786852/40 "2017-05-19T00:10:52Z")
I remember when we moved to the DC area and looked for primary care doctors, there were quite a few that were not accepting new patients (this was in the late 1980s). I don’t know how severe the shortage is here now (if any) but another ugly dynamic is that many primary care doctors are going to the concierge medicine model - where you have to pay anywhere from 1600 dollars a year or more _ **just to be on their list** _. When our now-former primary care doc did this, there were very few non-concierge doctors available within a close drive of our house; the practice we went to next made the same leap a couple years later :mad: I wound up lucking into a doctor at one of the major medical groups that has clinics all over the place; she had literally just moved to this area a couple months before and didn’t have a large patient load yet. So: if you have any large hospital groups near you, see if they have any internal medicine practices affiliated to them. [Previous page](https://boards.straightdope.com/t/doctors-not-accepting-new-patients/786852.md?page=1) [Next page](https://boards.straightdope.com/t/doctors-not-accepting-new-patients/786852.md?page=3)