...since my current primary care physician is in South Nashua, 20 miles away now. Dartmouth Hitchcock has a family practice facility right here in Merrimack, and my podiatrist is already part of the Dartmouth Hitchcock system. On top of that, it turns out one of the doctors at the Merrimack family practice center is an osteopath, which might well mean I'd be able to find more effective care for my back problems. (I think half the reason chiropractic treatment is viewed with such suspicion in the US is because it's so hard to find a chiropractor who isn't, frankly, a complete quack.)
Well, so much for the theory. The practice is that the osteopath isn't accepting new patients, and the only doctor there who IS accepting new patients is currently booking appointments in early January. This suggests that the facility is so overloaded going there might be a bad idea anyway. I wouldn't be able to get any of my referrals transferred until after a new-patient appointment, and then there'd be the queue lead for the specialists, so the upshot of it seems to be that if I switch to a PCP at Dartmouth Hitchcock Merrimack, it's going to be five to six months before I can get any care from any of my specialists again. (And frankly, I think I need to get my right knee cleaned up the same as the left knee as soon as I can. The crunching noises are starting to get really unsettling.)
It's at times like this that I reflect on how screwed-up the US medical care system is. The whole "all your referrals reset if you change doctors" thing is a pain, and when it's so hard to find a doctor who's accepting new patients and isn't totally swamped, what do you do?
Half the problem, I suspect, is the number of doctors who've retired or gone into other lines of work because they can't afford malpractice insurance rates driven by frivolous malpractice suits (parents suing their obstetrician because their child was born with a congenital defect, for instance¹). Unfortunately, that's not going to change as long as the perception of a career in law as a get-rich-quick license endures.
This country needs twice as many doctors and engineers, and a quarter as many lawyers.
[1] This isn't a hypothetical example. I've read of several cases in which a child was born with what was unquestionably a congenital defect, but the parents sued the obstetrician anyway, and the obstetrician's medical insurance settled out of court because "We all know this is a congenital defect and there's not a thing you could have done to prevent it, but the instant a jury sees those photos, we've lost the case."