Want to see a doctor? Be patient

Michelle Swafford

Monday, Oct. 10, 2005 | 8:36 a.m.

For example, a study by the Southern Nevada Medical Industry Coalition reported t' ractitioners per 100,000, compared with a national ratio of 29.3.

Some other comparisons included:

Southern Nevada had 1.48 dermatologists per 100,000, compared with 2.5 per 100,00.

Southern Nevada, 6.48 OB/GYNs; 11.4 nationally.

Southern Nevada, 1.48 orthopedists; 6.5 nationally.

Southern Nevada, 9.93 pediatricians; 13.1 nationally.

Southern Nevada, 1.97 urologists; 3.1 nationally.

Southern Nevada, 4.69 psychiatrists; 12 nationally.

That's considered a short wait to see an orthopedic surgeon at the Bone & Joint Institute, where waits average about a month.

And once the 33-year-old arrived for his appointment, he waited some more.

"The first time I waited an hour," Lybbert said. "After that it wasn't more than 10 to 15 minutes."

He said he's accustomed to long waits at doctors' offices, especially for orthopedists.

A shortage of specialists results in long waits for appointments in the Las Vegas Valley and around the nation.

Compounding the valley's problem is a steady influx of new residents looking for doctors.

At the end of 2003, which is the most recent data available, Nevada ranked No. 47 out of the 50 states and Washington, D.C., with 172 physicians per 100,000 residents, according to the American Medical Association.

That compares with the national average of 235 physicians per 100,000 people; only Mississippi, Iowa, Idaho and Oklahoma fared worse than Nevada.

Valley patients say that while they do not like waiting to see a doctor, the delays vary and most say they understand why they have to wait.

Las Vegas resident Karen Proctor said doctors' wait times may have increased since she moved here 14 years ago, but "it's kind of a hit and miss type of thing.

"I look at it that this is the way it is and I know doctors are trying real hard and it's growing ..." she said.

"People are busy and you don't want to spend half of your day at the doctor's office but I think the doctors are doing the best they can. People forget the scope of it and you may have to wait, but you'll be seen."

To compensate for the long wait times, Dr. Michael Crovetti, Lybbert's orthopedic surgeon in Henderson, added doctors so patients wait less.

He said new patients wait an average of three to five weeks for an appointment. Crovetti's challenge is to get his patients to accept the new doctors and feel that their care is comparable to his, he said.

"When patients are referred over, because it's my practice, they want to see me and I'm trying to change wait times (and) to say everyone here is great," he said. "Once they get to the office they have to wait as well and we tell them that when we book the appointment; otherwise it'd be six months."

Insurance factors affect wait times as well.

Dr. Don Havins, executive director of the Clark County Medical Society and an ophthalmologist, said because some insurers have smaller doctors' networks than others, patients face tougher competition for appointment times.

Wait times vary by specialty.

Proctor said she does not have trouble obtaining an OB/GYN appointment, but the visits take at least two hours once she is at the doctor's office. In contrast, she said it only takes a week to get a dermatologist appointment and those visits require only a few minutes in the waiting room.

At the end of September she made an appointment with a gastroenterologist and was told the earliest appointment was Oct. 19, Proctor said.

Dr. Miriam Bettencourt, a Henderson dermatologist, said she has implemented a variety of practices to make her clinic more accessible to new patients, who wait up to two weeks for nonemergencies.

To make her practice run more efficiently and speed up wait times, she keeps a few appointments open each day for emergencies and hired a physicians' assistant to treat minor conditions.

"If we go by the book and don't open up the schedule, you won't be able to get in for three months," she said, adding that some of her new patients have come from dermatologists who had three-month waits.

"We have a very transient population. We need to make our schedule open to new patients because people come and go."

Dr. Warren Volker, an OB/GYN in northwest Las Vegas and the chief of obstetrics at Summerlin Hospital, said his practice stays so busy he has only a few slots for new patients.

"Most of our patients will make their appointments six months to a year in advance just to make sure, but I'm usually booked three to four months out," he said.

But as important as time is to doctors and patients, all of the doctors interviewed said patients should not choose a physician based solely on wait times.

"I would not go to (just) any doctor because you can get in," Volker said. "That's a big mistake."

Patients need to let their doctors know when time is of the essence, said Las Vegas resident Marianne Viola.

"If it's urgent, they do it in a day or two," she said. "If it's routine, it's about a week. Most of my doctors know when I need to see them to get me."

Michelle Swafford is a business writer for the Sun and its sister newspaper, In Business Las Vegas. She can be reached by e-mail at swafford@lasvegassun.com or at (702) 259-2326.