Doc: Does your insurer affect wait for an appointment?
Dear Dr. Roach: In a recent column, a person wrote that it took weeks to schedule an appointment with her primary care physician. I have found that it takes months, not weeks, to schedule an appointment with primary care physicians in my area (a large city with two medical schools). I am on Medicare, as are many of my friends. They have said that they have the same problem. Do some medical practices limit the number of appointments available for people on Medicare? My younger friends with regular insurance don’t seem to have this problem.
Dear L.S.: A 2015 study of primary care physicians found that 93 percent accept Medicare, while 94 percent accept private insurance. In a 2018 study, 13 percent of Medicare recipients said there was a small problem finding a new primary care physician, and 14 percent said there was a big one. I suspect there are strong regional differences; however, those with private insurance reported slightly worse results on trying to find a new doctor.
Older, more-established physicians are less likely to have availability in their practice for new patients, so finding a younger physician is more likely to get you seen more quickly. There is always a trade-off between clinical experience and recent training. Hospitals associated with medical schools are likely to have primary care physicians available who take Medicare much more rapidly than you have found.
Medicare has a useful tool for searching for physicians who accept Medicare. You can go to medicare.gov/physiciancompare/ and enter the type of physician you want to see. I think you will be surprised at how many primary care physicians are available very close to you. Waiting months for an appointment doesn’t make sense.
Dear Dr. Roach: I recently read an article on MS. I have a young friend who suffers from it. As the article confirmed, and my young friend can attest to, symptoms receded during pregnancy. My question is: Don’t birth control pills mimic pregnancy because of the hormones used? Have studies been done using hormones to help multiple sclerosis sufferers? Could those hormones possibly help?
Dear F.R.: I love the way you think.
You are exactly right that the symptoms of multiple sclerosis often improve during pregnancy, only to rebound once pregnancy is over. Several studies have now shown that estriol, produced by the placenta in pregnancy, reduces the immune reaction to the brain cells, protecting them. Estriol is relatively safe. However, even though the studies so far are promising, the best use of estrogens (possibly progestins as well) in MS still isn’t clear.
I found five trials currently ongoing on estriol and multiple sclerosis at clinicaltrials.gov.
Dear Dr. Roach: Does putting Neosporin in your nose protect against colds and flu?
Dear D.L.G.: No. Neosporin is a brand-name combination of antibacterial and antifungal antibiotics, very useful for protecting minor wounds and treating superficial infections, but is not effective against cold viruses or flu viruses. It doesn’t filter out the viruses either, which are really, REALLY small, and which may also be transmitted by hands, as well as being airborne.
Some people have noses that get very dry, even to the point of cracking, which may cause an infection in the nostrils, as well as being very uncomfortable. An ointment in the nose acts as a moisture barrier; however, using an antibiotic ointment wouldn’t be my first choice, as the antibiotic is not only unnecessary, but can cause an allergic reaction in some people, so plain petrolatum (Vaseline or equivalent) is my recommendation. Other people like using a nasal saline spray.
Email questions to ToYourGoodHealth@med.cornell.edu.