With the possibility and likely probability of 30 million more patients accessing physicians under provisions of the recently-passed health care reform legislation, expect to wait longer to see a doctor when making an appointment, and expect to have less time with the doctor when you get there.
I don’t need a crystal ball to figure this out. The Association of American Medical Colleges estimates a doctor shortage that could reach 150,000 by 2025. At age 76, I don’t expect to share this experience with those readers who are younger than me, but I am concerned.
One of the many things I love about being an American is that we are extremely resourceful. Give us a problem and we’ll find a solution. Some possible solutions to the looming doctor shortage include:
1. Pharmacists taking on some medical oversight responsibilities for people with certain chronic diseases.
2. Better in-home medical care, which combines traditional care and the benefits of today’s advanced technology. This is an approach to medical care that is built around what the patient needs rather than what the medical office or insurance company needs. With this kind of approach, your primary care physician manages your care and stays in charge, even when you see specialists. However, the current shortage of primary care physicians may be a limiting factor in this concept.
3. Using more telephone and email communications. This is occurring more frequently at a physician practices in Portland, Oregon. The medical practice is using this as a way to provide more care to their patients by reserving face-to-face appointments for more seriously ill patients.
4. In Massachusetts, a medical practice offers something called shared medical appointments, where six to 14 patients with similar medical problems are seen at one time.
5. And in Philadelphia, nurses who have earned masters and doctoral degrees and specialized training in the diagnosis and management of health problems provide primary care to patients.
These are just a few innovative solutions some in the medical community are using to deal with the growing physician shortage.

On a scale of one to 10, how much does your doctor annoy you? Are you forced to wait more than 30-minutes past your scheduled appointment? That would be a 10, in my book. Or, have you ever felt that he or she isn’t really concentrating on your problem? That would be another 10.

The truth about those waits is that when doctors are paid by the number of patients they see, they may double-book patients for 10 to 15-minute appointments. That means you often end up in their office for an hour or more.

Here are some suggestions about how to handle doctors who make you wait.

1. Switch doctors. Make an appointment to interview a new doctor and just talk.

2. If your insurance company allows it, ask for a discount. Your time is valuable, too.

3. Post reviews on Internet sites. Doctors hate them!

4. Complain to the doctor and show him or her how angry you are.

5. Ask the doctor how he or she feels about waiting for a medical appointment, or any other appointment for that matter.

If the doctor is a specialist whose practice involves life-threatening emergencies, be prepared to wait without complaint. You would certainly want the doctor to address your own medical crisis with all the time, attention and care possible.

As for not having your doctor’s full attention, ask yourself if you are part of the problem? Have you prepared a concise list of symptoms for the ailment that brought you to the office in the first place? Have you prepared a list of questions? These are some of the things that make doctors gnash their teeth and give patients a 10 on the annoyance scale.

The bottom line here is that there is vast room for improvement on both sides in the dynamic relationship between doctors and patients. Do your part to make that relationship work.

The headline of a recent New York Times article (July 11), “Turn 70. Act Your Grandchild’s Age. Grandma sky-dives. Ringo Starr plays at Radio City. Is this what’s expected in life’s eighth decade?” caught my attention. Not only was it my 76th birthday, but also because I’m committed to a healthy, happy and long life. Now I couldn’t play Radio City on a bet, and I have no intention of jumping out of a perfectly good airplane. Nor am I planning a 1,200-mile trip by bicycle like the one my grandson just completed.

Still, I can rejoice and be inspired that octogenarian Betty White, who at 88 is starring in a new sitcom, or that Clint Eastwood, 80, is still acting and directing films. Kudos to both.

But there are a vast number of older people who fall into the middle of their ability to function healthfully. Some statistics cited in the article are instructive and encouraging. The age range used was 70 to 74. Among the findings was that 76 percent of women and 84 percent of men own their own homes. Surprisingly, only 2 percent of that age group lives in nursing homes. Both women and men experience approximately the same percentage of chronic diseases—over 20 percent had four or more—but their ailments differed. The men surveyed had more heart disease and cancer, while women suffered more from depression and arthritis. Both women and men were nearly equal in their cognitive impairment; 19 percent of women and 18 percent of men experienced mild symptoms, while 7 percent of women and 8 percent of men suffered severe cognitive impairment.

Dr. Robert Butler, who recently died at age 83, was a leading expert on longevity. And he truly lived his work. He worked until three days before his death of acute leukemia. My own husband was 91 when he died. He’d worked at his desk all day before suffering a massive cerebral hemorrhage while we were dining in a restaurant. He died a few hours later. Don’t we all long to have our passing be as easy? He played Tennis until he was 87.

His example on how to age gracefully by staying active and functioning has guided me on my own journey and pursuit of a healthy, happy and long life.