The Doctors Are In -- and They’re Booked Solid

As surely as Christmas decorations go up, the phone calls pleading for appointments begin each December as people try to schedule a physical, or blood work or to get that tooth crowned.

While the holiday season means shopping, celebrating, bowl games and bad TV specials, the jingle bells also are a warning to use up medical and dental benefits before the year ends.

It’s just a fact of life for doctors and others whose offices, already crowded with the usual outbreak of cold and flu cases, fill to the brim with these last-minute callers.

“No family doctor in their right mind takes off this time of year,” said Dr. Tim Huston, who has a practice in Laguna Niguel. “Your patients will kill you.”

There are a host of reasons for it: People need to spend the cash remaining in their flexible spending account or lose it; they want to use up annual dental benefits; or maybe they’ve exceeded the deductible on their health insurance and they want to get procedures covered before the new year and a new deductible.

Newport Beach obstetrician/gynecologist Jonathan Wheeler says he works 20% to 25% harder this time of year. Once he had to cram for finals. Now he has to cram in his patients.

He had to close his practice to new patients at the end of last year to catch up with his regular patients.

At Hoag Memorial Hospital Presbyterian in Newport Beach, mammograms are up 25% this month.

And Fountain Valley dentist Steve Underwood figures he will work an extra three or four days this month to accommodate the avalanche of patients. The usual Wednesday off is a dental insurance casualty.

As the calendar pages turn and appointments become more scarce, patients get more desperate.

Doctor can’t fit them in for a complete exam? How about a partial physical in, say, 15 minutes?

Patients who have been putting off arthroscopic surgery to repair that torn meniscus or fix that troublesome rotator cuff suddenly decide it needs to be done -- now!

“I’ve had people ask me if they can make an appointment in January but list it as being done in December,” Huston said. “I tell them, ‘That’s insurance fraud.’ ”

Some dentists, knowing that insurance companies cap benefits, encourage patients to take advantage.

“Your Dental Insurance ... Use It or Lose It,” reads the postcard Long Beach dentist Joel Landers sent to his patients this year and last. “Your dental insurance benefits expire each year if not used. Call today for an appointment before the end of the year. Appointments are going fast.”

Lisa Estrella, Landers’ office manager, said patients start calling in October to find out how much money they would need to spend before they reach the annual limit.

“It gets crazy,” Estrella said.

Judy Stangler, events manager at UCLA’s International Institute, knew she would need oral surgery eventually to repair her receding gums, but she didn’t need it right away. Her dentist called her insurance company to find out how much money she could spend. She scheduled the surgery for Dec. 16.

Many people try to spend any money remaining in their flexible spending accounts. Employees can set aside up to $5,000 before taxes to be spent on medical bills that insurance doesn’t cover. Whatever isn’t spent is turned over to the employer.

“People in my experience still underutilize the advantages of routine medical exams and screenings, so I’m very happy when patients say to me, ‘I have money left over in a flexible account, and I’m coming in,’ ” said Dr. Daniel Bowers, a family practitioner in Beverly Hills.

The flexible accounts are behind the sudden splurge in designer eyewear purchases this time of year, optometrists say.

“People call and say, ‘I have $500 to use in benefits; what should I do?’ ” said Cecelia Patino, who manages the Long Beach optometry office of Darlene Fujimoto.

Larry Akey, spokesman for the Health Insurance Assn. of America in Washington, D.C., said the industry is well aware of the phenomenon and has urged Congress to change the law so a portion of the flexible spending money can be rolled over.

One way to spend it is on a full body scan, which cost about $800. Ernie Nava, a scheduler at HealthView Center for Preventive Medicine in Newport Beach, said about 10% of callers seeking appointments say they are using flexible accounts.

“One woman said, ‘How soon can I get it? Can you get me in this year? Otherwise I won’t be able to use it,’ ” Nava said.

Mental health therapists said although the holidays are a busy time for them, they don’t see patients trying to schedule extra appointments to use up their benefits.

But that gave psychologist Stephen Berger an idea.

“That would be a good way to get an initial start, particularly if you have a reluctant partner [for couples counseling] or a resistant teenager,” Berger said.