Unless we are extraordinarily lucky, we spend more time in the healthcare world as we grow older.  And I don’t think it’s just me who finds that negotiating with the medical world has become a lot more complicated.

Let me say up front that I am astounded by and grateful for the many medical breakthroughs that have occurred in my lifetime. I and my loved ones have benefitted from them.

But now it takes a near-miracle to see your primary care doctor rather than a physician’s assistant or nurse practitioner.  There are many reasons for this.  For one thing, there aren’t enough general practitioners, partially because specialties offer a much higher income.  Another reason is a high physician burnout rate .  Two of my doctors have quit practicing medicine, one because of stress leading to mental illness; the other by being exhausted by the managed healthcare system patient load with its burdensome paperwork.

I have been dealing with some specialists about a few health issues and wrote to my primary care doctor asking him to weigh in on my plan. Weeks later, I got an offer for an appointment, and we met last week.  He was open to my feedback about my dissatisfaction with the system, and he explained a few things that are changing.  Most importantly, he is relying more on his nurse practitioners and physician assistants. This allows him to carry an even larger patient load because someone else deals with the everyday runny noses.

There is a cartoon in a recent New Yorker magazine that is so true.  In it, a receptionist in a medical department is handing a clipboard containing a questionnaire to a patient checking in. Three other seated waiting patients are also filling out forms. The receptionist says to the patient, “Please fill out these medical forms, which are identical to the ones you filled out earlier online, and have the exact same questions your doctor will ask you later in the exam room.”

I did not find it funny.