Las Vegas offers glimpse of doctor shortage

Oct. 22 (Bloomberg) — Mary Berg is paying the price for a shortage of U.S. doctors that by most accounts is about to get much worse.

After finding out in 2006 she had a rare and deadly gastrointestinal cancer, the 49-year-old mother of a teenaged daughter found there were no doctors in Nevada who specialized in her type of tumor. Only one cancer center took her insurance. And because the tumor had spread, the need for a liver transplant was a distinct possibility, though no surgeons in the state were qualified to do the procedure.

Frustrated by years of not being able to get proper care, Berg and her husband decided this summer to walk away from their home near Las Vegas, which she says has since gone into foreclosure. They moved their family 300 miles away to Phoenix where she could be close to a specialist and a transplant center. Now, Berg has a team of doctors and nurses focused on her care.

“I get so emotional over it,” says Berg, her voice breaking and her eyes filling with tears as she sits in the living room of her new home, recalling the decision to leave Las Vegas. “We left a lot of friends. We left our house. We left our life.”

In the Las Vegas area, with about 2 million people, patients and doctors said it can take six months to see a primary-care doctor for a simple check-up. For more serious matters, the waits are far longer — more than a year, for example, to get an appointment with a neurologist who specializes in autism.

Waiting weeks

Once a problem limited to rural areas, the doctor shortage is now hitting large population centers such as Las Vegas and Detroit where people are forced to wait weeks or months or travel hundreds of miles for care. Nationwide, there is a shortage of more than 13,000 doctors, according to the Association of American Medical Colleges, a Washington-based nonprofit that represents medical schools.

That shortfall is expected to grow 10-fold to 130,000 doctors within 12 years as the U.S. population ages and 30 million more people are added to insurance rolls under the 2010 health-care law, the medical college association said.

In a bid to address the shortage, the medical community has embraced the greater use of nurse practitioners and physician assistants, who can prescribe medicines and diagnose and treat many illnesses. The number of physician assistants is projected to increase 39% to 108,000 by 2020, according to the Bureau of Labor Statistics. Still, physician assistants can’t replace specialists as regional shortages of all categories of doctors persist.

Drying pipeline

“This is a national problem across the board and it is going to get much worse,” says Christiane Mitchell, director of medical affairs for the AAMC. “We have an aging population and a whole lot of doctors retiring. We need to increase the pipeline of new doctors.”

It’s a problem that Mitchell Forman, a rheumatologist in Las Vegas and dean of Touro University Nevada College of Osteopathic Medicine, is all too familiar with. Forman says it take most patients four months to get an appointment.

“God knows what happens in that four-month period,” he says. If you have a medical problem that requires special expertise, “you’re just going to have to wait.”

“At a time when health-care costs need to be cut, when you need to provide quality services at a reasonable cost, we’re forcing patients to do the worst possible thing — get fragmented care,” says Forman.

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