By Diana Diamond
Is PAMF running amok?Uploaded: Aug 25, 2021
I don't want to write this, but problems at the Palo Alto Medical Foundation are still increasing. For years I have been a very happy patient at their Palo Alto clinic. Parking was always available, employees were courteous, nurses were efficient and the physicians were not only knowledgeable and caring, but they took time to talk to me.
But things have changed. PAMF is a partner of the Sutter Health family of providers. Rumors and anonymous conversations I've had with staff and physicians at PAMF suggest that Sutter has further implemented its bottom-line financial philosophy -- i.e., make more money. Hence, appointments are often limited to 15 minutes -- and, upon occcation,40 minutes is allowed. How can a physician undertake a reasonably thorough analysis of a problem in 15 minutes, particularly when a patient (like me) comes in with two or three issues to discuss? Note: the physicians are still great, and are trying their best within these forced constraints.
I now have a new problem, perhaps experienced by some of you. My long-time GP is retiring from PAMF, as happened to me once before. So, this time I tried some advanced planning. My GP's nurse provided the name of a physicians there nurses respected. I saw him; he seemed competent and bright. I asked if I could become his patient. "I am not taking any new patients," he replied.
So, I called PAMF's support team, and talked to a pleasant, caring woman. I need a new GP, I said, explaining that a few of my problems were complex and I didn't want someone just out of med school internship. She understood, and said she first would search for doctors taking new patients.
But I am NOT a NEW PATIENT, I declared. I've been coming here for decades.
But you are a new patient now, she replied, because your doctor is retiring.
Just because he's leaving, doesn't mean I should be a new patient, I declared.
Oh yes, it does, she stated. And unfortunately, none of our physicians in Palo Alto are accepting any new patients. I'll look in Redwood City, she offered. Seconds later, she told me that no Redwood City PAMF physicians are accepting new patients. Nor at the Los Alto facility either.
"I'll try Mountain View," she offered. "The Mountain View site is on El Camino, close to Sunnyvale. And it looks like we are in luck! Two physicians there may take you. Let's see, Dr. M's first available appointment is Oct. 28 at 9 a.m. Nothing earlier and his next opening is Nov8. That's all there is."
I told her I have driving difficulties. "Maybe you can take Uber." I g felt I had to accept the appointment.
Then someone on the line asked if I "agree that you will be in California that date," and cancellation rules. It seems like the lawyers have had their input. Do I have to assure them eight weeks in advance that I will be in this state that day?
So here goes my rant. How can a big medical facility, Sutter Health and PAMF, have no openings for any new patients? And why does a well-established patient suddenly become a "new" patient in their system to then suddenly hear no doctors are accepting new patients nearby. In other words, no need to apply. Where is the advanced planning?
My retiring GP told me 12 physicians in Palo Alto are all leaving around the same time, so many patients will be having similar problems. Didn't PAMF officials know a long time ago that these physicians were getting older and would retire? He said PAMF would "assign" a doctor, but I'm suspicious the person will be new to PAMF and with limited years of practice.
What are we patients supposed to do? Self-diagnose? Heal ourselves? Some have serious problems and need attention. The team member who helped me said she didn't know what I or others could do, except call back monthly to find see is any doctor is taking new patients.
Can I call or email you, I asked? No, she said, there are many team members and she has no individual number. Nor can she call me back if an opening comes up. It's against the rules.
That's a crazy circular system.
My neighbor had similar problems trying to get a new physician. It took her a couple of months, and that was nearly two years ago.
Second problem is that some of the newer phsicians seem too textbook-trained. Constipation? Try MetamuciL. Sore throat? Two Tylenol four times a day. Pain when walking? Use Ibuprofen.
Another friend described his uncle's experience at PAMF. "My uncle said he felt like he was just a cog in a machine -- the doctor was treating him anonymously, not as ME as a real person."
Then there's the long wait in some departments to get an appointment. "The doctor is now taking appointments for late November or early December," I was told recently. I replied i had pain. "November or December?" was the reply.
I have a few easy suggestions for PAMF that could help a bit -- but getting more physicians is their immediate priority.
Suggestions: It would be nice if, when I checked in, the appointment desk could guestimate how long a wait I have. The other day, at one office, I had to wait 1-1/2 hours to see my doctor -- a visit that lasted five minutes. "Sorry for the wait," she said, "We had to squeeze you in." But I had made that appointment six weeks ago. Another symbol of overload of patients, compared to the number of physicians.
That wait, however, t is the exception to the rule -- most departments try hard to see a patient with 15 or 20 minutes after arrival.
Stanford Health Care has some similar issues, but my focus to day is on PAMF. I want it to get better -- to get back the way it was about four or five years ago.
The irony of all this is that I knew then that I was lucky to be living next to two of the best health facilities in the state -- PAMF and Stanford. They still can be, I strongly believe that.