Late-year rush jams doctors’ offices

Karen Bouffard
The Detroit News

Instead of holiday time off, lots of Metro Detroit health care professionals are working overtime to cope with their busiest end-of-year rush in recent memory.

They blame a combination of factors from an active flu season, to new incentives for consumers to squeeze in preventive services, to the addition of hundreds of thousands to the private insurance and Medicaid rolls.

“Demand is right through the roof right now,” said Paul Szilagyi, vice president of primary care and medical centers for Henry Ford Medical Group, which includes more than 1,100 doctors employed by the Detroit-based Henry Ford Health System. “We’re getting an end-of-the-year blip that’s bigger than anybody anticipated.

“Everything is coming together at the same time; it’s like a perfect storm.”

Michigan Department of Community Health spokeswoman Jennifer Smith said the flu is definitely going around, though it’s too soon to say how the season will shape up compared with other years.

“We have seen a rapid onset to this year’s flu season; however, we expect to see these increases within each year because it is a seasonal illness,” Smith said.

Dr. Jamie Taweel, a family practice physician with the Detroit Medical Center, agreed the flu has been a problem.

“This end of year has been way busier and non-stop ...,” Taweel said. “People are coming in left and right with the flu.”

Insurance coverage also contributes to an annual spike in appointments before the end of the year, noted Helen Stojic, director of corporate affairs for Blue Cross Blue Shield of Michigan and Blue Care Network. Optometrists, dentists and other health care professionals also report upticks in appointments this time of year as people try to spend money earmarked for health care that won’t roll over to the new year.

“Because some individuals have a new deductible in January, they could be looking to have a service performed this year if they have already met their deductible,” Stojic said.

But for some consumers, changes in policies under the federal Affordable Care Act have increased pressure to get appointments and procedures done by the end of the year.

Richard Grucz, a family physician and medical director at Oakwood Health Center in Canton Township, said more consumers are enrolled in plans that come with a high annual deductible in exchange for lower monthly premiums. A deductible is a fixed dollar amount during the benefit period that an insured individual must pay before the insurer starts to make payments for covered medical services.

“There used to be a small minority of our patients who had high-deductible insurance,” Grucz said. “Most of these insurances through the ACA have high deductibles. There’s a much larger percentage of the population that has that type of insurance now.

“It’s actually dramatic the number of patients who have come in the last couple of days saying, ‘I’ve already paid my deductible this year, and I need you to schedule this appointment before my deductible goes back up on Jan. 1.’ ”

Another trend is that an increasing number of health insurance policies offer discounts for getting preventive services, such as an annual physical. It’s part of a national effort to reduce health care costs by providing preventive care and chronic disease management.

“It’s a good thing because we pick up diseases by doing this ... but if they aren’t used to this, they wait until the end of the year,” Henry Ford’s Szilagyi said. “It’s ‘Don’t wait until (patients) become train wrecks; have these problems identified sooner so they can get treatment.”

This year’s frenzy of appointments may also have been boosted by newly insured Michiganians. As of Tuesday, 509,777 residents had signed up for the state’s expanded Medicaid health care program for low-income residents, the Healthy Michigan Plan.

Since coverage started on April 1, the Healthy Michigan Plan has provided more than 315,000 primary and preventive care visits, including 22,900 mammograms and 10,900 colonoscopies, according to the Michigan Department of Community Health.

Beaumont Health System Call Center Manager Emily Hein said call center volumes are higher than during the same time period last year — and they’ve been higher all year.

“We’re not sure if it’s due to more people being insured, but we certainly believe that is a factor,” Hein said Tuesday.

Dr. Shaun Jayakar, a family medicine specialist with St. John Hospital in Detroit, said expanded Medicaid patients have added to the usual number of patients trying to squeeze in appointments by the end of the year.

“My primary care practice accepts all forms of Medicaid and has substantially grown with the additional people now insured under the (Affordable Care Act) through the Healthy Michigan plan,” Jayakar said. “This has definitely contributed to the year-end rush to get in to see the doctor.”