Why is it so hard to see an endocrinologist? I recently saw my primary provider for fatigue and hair loss. We did a couple of blood tests, but things came back inconclusive. From reading Hot Flash, I know an endocrinologist may shed more light, but all of the endocrinologists in my area require an endocrinology diagnosis and referral before accepting a patient (despite my insurance not requiring referrals for specialists). How can one meet with an endocrinologist to investigate indeterminate symptoms?
—Endo-curious
In the U.S. there are only about 9,000 practicing endocrinologists, and there are more than 345 million people. I know not all of those people are clamoring to see an endocrinologist, but that is only about one endocrinologist for every 40,000 people. Many of those endocrinologists are not seeing patients from 9 to 5 Monday through Friday. Many of them dedicate sizable chunks of their time to conducting research and teaching medical students, residents, and fellows.
On top of that, endocrinologists often care for people with common diseases such as Type 2 diabetes (11.6% of the population), hypothyroidism (9.6% of the population), and polycystic ovary syndrome (7% to 10% of women of childbearing age). This means that in general there is a lot of competition for our time.
Endocrinologists and patients are not evenly distributed across the country. New York, where I practice, is chockablock with doctors. There are at least five large academic hospital systems. Wait times for endocrinologists who are in-network with insurance companies are still upward of six months.
What can patients do to access the care an endocrinologist can offer? You can ask your primary care doctor or gynecologist to refer you. Often even without a diagnosis, a referral can get you access to an appointment.
If you can afford to or if you have out-of-network benefits with your insurance, you can consider seeing someone in private practice. While this is likely to be a more costly option, doctors who are not in-network with insurance companies often have shorter wait times and more time to spend with you at the time of your visit. Similarly, you could consider traveling to a larger city where there are more endocrinologists and thus more access. Many of my patients travel from other states and even other countries to see me.
You might also consider seeing a dermatologist rather than an endocrinologist. Some dermatologists specialize in hair loss and can be an excellent option for getting the care you are seeking.
The takeaway: There are a limited number of endocrinologists practicing in the U.S., so getting an appointment with one can be tricky, but a referral from your primary care doctor or gynecologist may help.
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