My biggest headache is the fact that no doctor has taken charge of my mother's care and she has nearly a dozen. Except for shared records unless we fax or bring the updated chart information to each specialist and sometimes the generalist, one doesn't know from the next what medication she is taking, whether she was recently in the hospital, etc. Its a kind of hands off policy. Even with doctors in the same umbrella organization. Similarly there are limited hours with many doctors. And the doctors on call almost categorically have had the same policy...won't consider a change in medication when its seems to be warranted over the weekend or in general, even for a non-life-threatening emergency the refrain is to go to the ER. Why bother with anyone on call? Is this true in large cities as well as smaller ones (in this case the greater area is 300,000 but the community itself is half that). I also find that the doctors won't take the time to consult the family when there are shades of nuance and my mother can't always speak for herself because she doesn't remember everything (what her normal bp is to function well different from the standard for instance). The local hospitals have inadequate charting and each visit requires the same review of medication even though she might have been there within a few weeks and the older meds aren't even listed. No one reads the chart well in the ER and again defer to the hospitalist or primary care doc. Is this because there are inadequate number of doctors? I don't recall the ER being like this in the past? Or is it because they don't want to be responsible for anything that might come back to them? Same hospital has no social work care after hours. Nurses and aides are stretched beyond adequate care often with too many patients.