How Long To Get A Consult?

Specialties NP

Published

Specializes in Adult Primary Care.

For those of you in primary care, how long does it usually take your patients to get an appointment with a specialist? For me the quickest are surgical and cardiology and the longest are psychiatry and dermatology.

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Specializes in Adult Internal Medicine.

Psychiatry is a major problem right now for my practice; we are seeing patients discharged from in-patient psych with an appointment scheduled 4-6 months out. If you have money or good commercial insurance it's not as bad, but if you are on state medicaid then it may be 6 months.

Other specialists are 1-2 weeks (derm maybe 3-4 weeks unless urgent) unless I call in a favor and in most cases a personal phone call will get a patient in same-day or the next.

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Specializes in Nephrology, Cardiology, ER, ICU.

I work heart failure and cards is of course easy (lol).

Derm is impossible in our area - they all requirement payment in full up front which can be $250-500. They do not accept Medicaid. The nearest derm that will accept Medicaid is in Chicago a distance of 200 miles!!!!!!

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Specializes in Psychiatric and Mental Health NP (PMHNP).

I practice in a rural clinic and this is my biggest frustration. All specialists are in a town 50 miles away and the wait for nonurgent (and sometimes urgent) cases is 4 weeks or longer. On top of that, I have to order all the right tests and have them done before the specialist appointment, or the specialist will refuse to see the patient! Of course, I don't get to talk to the specialist, I just have a very brief generic list for each major specialty, so there is guesswork involved. The wait to see a psychiatrist is 6 weeks or longer. I just had a patient with constant recurrent seizures EVERY DAY that started abruptly and it took 4 weeks to get him in to see a neurologist! We just got an email stating that all the urologists in this town are basically not going to see anyone for anything except new onset cancer; a urologist had recently retired and the remaining urologists stated they will not take his patients, even his cancer patients! The wait to see specialists in Sacramento or San Francisco is even longer, except for life-threatening emergencies. *arrrrrgggh*

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Sad, but nothing new, and we have allowed it by our policies in this country.

I work as a Psych NP in LTC for a national company, who handles all the billing, and pays me even before reimbursement comes in.

That being said, every week there is at least one letter in my mailbox from managed Medicaid.

I used to open them, but they were all the same. "We are denying your claim because x, y, z......"

If I were independent, I couldn't possibly afford to accept Medicaid. I would have to hire somebody just to handle all the billing rejections.

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I'm rural, but we have weirdly good access to derm due to a derm NP opening a practice in the area. Psych is impossible, as it is in so many areas, but getting a patient in to endo takes almost as long as pysch.

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