Older, sicker Americans waiting longer to get into crowded hospitals

An endocrinologist is a doctor specializing in hormone-related diseases, such as, in my case, diabetes. When first diagnosed in late September 2024, I got a crash course in the huge demand for that profession’s services. The first endocrinologist I approached wouldn’t see me for a year. The second wouldn’t see me at all; he was refusing all new patients.

Figuring I would have to engage another gear if I didn’t want to sit around, doing nothing, waiting to go blind, I grabbed my notebook and decided, if I couldn’t meet with an endocrinologist as a patient, I’d find out what I needed to know by writing a column. Diabetes affects 40 million Americans; it isn’t as if it’s a personal affliction.

That third endocrinologist not only spoke with me immediately — barred doors fly open for publicity — but put me in touch with a colleague who, either through a sea change in my luck or, I suspect, some kind of secret doctor-to-doctor dog whistle, took me under her wing as a patient.

If this strikes you are morally squishy — the journalist pushing to the head of the line — I worried about that, too. But I didn’t misrepresent anything; the column ran in the paper.

Besides, with health care, you have to be a strong advocate for yourself. Faced with the prospect of letting my condition go unchecked while I hunted with increasingly numb fingers for an endocrinologist with an open slot, I did what I could. At that point, if meeting Morgan Finley in a Cicero motel room and handing over an envelope of cash would have gotten me an appointment, well, I certainly would have considered it.

I thickly assumed this was a problem inherent to endocrinology. Getting diabetes is easy — I just woke up one morning with Type 1. Medical school is hard. Of course, there’s a shortage. Now it turns out I was encountering, not a diabetes-specific bottleneck, but a generalized, widespread condition.

This week, The Economist published a story with the musical title, “Hospitals are stuck in a deadly doom loop.” Turns out the 2020 COVID crisis not only killed millions worldwide and shut down society, but it also “did lasting damage to health-care systems.”

Where? Everywhere, all over the world. What’s been damaged? In a nutshell, everything.

“From admission to discharge, hospital care is now harder to access, takes longer and is of worse quality,” the magazine reports. “The resulting toll includes avoidable deaths. Almost everyone is affected: across 18 rich democracies, satisfaction with health-care quality fell sharply after the pandemic and remains well below the pre-pandemic norm.”

Getting an appointment takes forever. As does getting admitted after showing up in the emergency room. Last year, one in 10 patients visiting an emergency room in England had to wait 12 hours or longer before being shown a room.

And in Chicago, an NBC News Channel 5 report found that Chicago has longer wait times to see a doctor than most American cities — a month to see a primary care doctor. For specialty care, like neurologists, up to five months.

Hospitalstats.org cited wait times at Northwestern Memorial Hospital, between showing up at the ER and being admitted, as approaching six hours; members of the Service Employees International Union held a protest of long wait times and short-staffing outside the Northwestern ER in January. Rush and University of Illinois hospitals both have wait times of over five hours (while the fastest, St. Joseph, Loretto and Thorek, have under three hours).

Before the pandemic, about 64% of American hospital beds were occupied. Now it’s 75%, and in places as high as 88%, there’s no room at the inn.

Why? It’s a mystery. The Economist calls it a “productivity puzzle.” Hospitals in general have more resources — more money, more staff. But are doing worse.

One factor is older, sicker patients who delayed getting treatment, because they can’t get into hospitals, so are even older and sicker when they do.

Another suspect is burnout.

“Pandemic-era stresses increased churn as doctors and nurses resigned, or retired early,” The Economist wrote. “Health-care workers today are less experienced and perhaps less productive.”

I’ve seen my endocrinologist twice over a year and a half. After the first appointment, she gave that secret dog whistle, and I got a second appointment in six months. In the meantime, I saw a nurse practitioner. After the second appointment, the endocrinologist said, “I’d like to see you in three or four months.” Knowing better, I told her she’d better alert her front desk, or there wouldn’t be a vacancy.

When I went to schedule my return, the receptionist slotted me in to the next available opening, 364 days in the future.