Your mother suffers a stroke and needs some help relearning how to live in her own home, so her doctor refers her to an occupational therapist. You call to make an appointment, and they say they don’t have any immediately available.
Can we pencil you in for an appointment sometime next year?
That’s what was happening to patients who were being referred to the occupational- and physical-therapy clinics at San Francisco General Hospital this spring. At the time, the wait for a physical-therapy appointment was 110 days, and for an occupational-therapy appointment, it was 258 days — the better part of nine months.
In the past few months, the hospital has hired more therapists in one of several steps it’s taken to whittle down the waiting list. As of last week, the wait for a physical-therapy appointment was 52 days, while occupational-therapy patients waited 32 days, according to hospital spokeswoman Rachael Kagan.
But despite the advances, the hospital clinic is still in violation of a state mandate.
As of Jan. 17, new regulations by the state Department of Managed Health Care went into effect requiring that patients see a specialist within 15 days of receiving a referral. However, hospitals won’t actually have to report how quickly they’re processing those referrals until next year, according to Tangerine Brigham of the Department of Public Health.
It’s not clear what the consequences will be for hospitals not in compliance.
General Hospital’s clinic sees about 800 patients a month. The clinic sees virtually everyone who goes to a public or nonprofit health clinic, then the doctor there refers them to a physical or occupational therapist for treatment.
The clinic’s patients are often on public insurance plans or are uninsured; many lack the resources or insurance to go to private clinics that can see them faster.
This scenario is far from ideal for patients in need of therapy, according to several practitioners. Dr. Katie Jordan, associate chair of clinical occupational therapy at the University of Southern California, said patients’ conditions can deteriorate if they wait too long for therapy.
“That’s the worst-case scenario that an occupational therapist could imagine, if a person got worse in the course of waiting to see them,” Jordan said.
Jordan said her clinic sometimes has a wait list of a week or 10 days, but any longer than that and they recruit more therapists.
Without proper guidance from a practitioner, patients are in danger of having the situation become worse.
San Francisco physical therapist Jerry Durham said he’s familiar with the clinicians at the hospital and they provide high-quality work. But time makes a difference.
“If you’re waiting two months for an appointment, it’s almost like having an open sore on your arm and you continue to poke it for two months because someone didn’t tell you to stop,” he said.
Wait list for outpatient physical-therapy services at San Francisco General Hospital
Wait list for outpatient occupational-therapy services at San Francisco General Hospital
Patients seen by clinic each month: 800