What we need to do is turn the procedures on their head--you can demand the insurance company find you an appointment with <any specialty>, they have say 30 days (to the appointment, not to respond). If they don't come up with one you can go out of network and pay no more than you would in network. Exception: If you're in a smaller place and there's only one such doc in town you're expected to go to the bigger city instead. (So you can't have one specialist setting up in an area without any such and charging an arm and a leg.) It's not the insurance company's fault if there are no providers, it is their fault if there are no in-network providers.