There's an interesting column in the New York Times today about the business of physician referrals. The physician author worries about the financial incentives generated by the dynamic in which specialists rely on primary care physicians to keep their schedules full.
Here in Philadelphia, at least, that concern seems almost laughable. Studies have established (and we have discussed) the long wait times to see a doctor here. And in the time it has taken me to write this post, I've been sitting on hold with a dermatologist's office--the same office that I've been calling for two months to try to schedule an appointment. At least with some specialties, the dynamic has so reversed itself that patients look to their internists to help them jump the queue to get in to see a specialist.
There's a lot of talk about the shortage of primary care, but what's with the shortage of specialist appointments?