Doctor’s not in

By Marshall Allen

Friday, Sept. 29, 2006 | 7:30 a.m.

One of only two physicians in the Las Vegas Valley who specialize in treating children for diabetes has retired, leaving his young patients facing longer waits between appointments with a nurse practitioner or leaving the state for routine doctor checkups.

Dr. Sterling Tanner, a pediatric endocrinologist, worked at University Medical Center, and administrators there say they are scrambling to replace him. But there's a national shortage of the specialists, and they have no timeline for hiring a replacement.

Dr. Alan Rice, who primarily works at Sunrise Children's Hospital, is the remaining childhood diabetes specialist in Las Vegas, but he is not accepting Tanner's current patients.

In contrast, Phoenix has 10 such specialists and Salt Lake City has four.

Parents of diabetic children complain that the hospital did not do enough to keep Tanner on staff, and did not warn them of his departure. Tanner stopped seeing his 700 diabetes patients Aug. 11.

Jodie Page, mother of a 6-year-old son and 3-year-old daughter, both who suffer from diabetes, called the situation "insane."

"You want the best for your kids and you just don't feel like you have it here with the doctors and the care for diabetes," she said.

Page took her daughter to the UMC Pediatric Diabetes and Endocrinology Clinic to see the nurse practitioner Monday and was told there is still no replacement for Tanner.

"They never notified us, never told us what was going on or what the plans were," Page said. "They haven't done anything at all."

Lynn Scott, UMC's associate administrator over ambulatory services, said that when parents have come in, they've been told of Tanner's departure. She said she has been trying to replace Tanner since she arrived at the hospital in early August.

"Since I have been here, that's been the No. 1 thing on my agenda," Scott said.

Despite the national shortage of such specialists, she said, she has talked to many doctors about coming to Las Vegas, and that one was in the office Wednesday.

Ideally, UMC would hire more than one pediatric endocrinologist, Scott said. But if only one can be found, she said, she will try to enlist others from out of state to provide backup, even if only on a part-time basis.

"I don't ever, as long as I'm here, want to be in a situation where a whole population of people is depending on one physician," Scott said.

Mark Frydman, president of the Las Vegas chapter of the Nevada Diabetes Association for Children and Adults, estimated there are 1,200 young patients with Type 1 diabetes in Las Vegas. Frydman is exploring options for his diabetic son Matthew, 7.

He said he was heartened that UMC wants to expand the clinic beyond just a replacement for Tanner, "but as we stand today there is no other doctor."

Seeing a nurse practitioner is a short-term option, but it may be necessary to leave the state for a doctor's care, Frydman said.

"I'll have no choice unless they provide us with a rational alternative," he said. "I don't know that I can even make an appointment with UMC with anybody. Until there's somebody in there we have no choice but to seek other means."

The national shortage of pediatric specialists is particularly acute in Las Vegas because there is no local medical training for pediatric subspecialties, said Dr. Don Havens of the Clark County Medical Society. Eighty percent of doctors practice within 50 miles of where they are trained, he said.

The shortage of pediatric endocrinologists has been a reality for at least a decade, said Havens, who could not recall having more than three in the valley.

Tanner, 59, said he was forced to retire because the stress of working at UMC was causing complications with his own diabetes. The clinic was losing money and he was told by his supervisors that he needed to see two or three times as many patients, Tanner said.

In the past year, Tanner said, the clinic lost its dietitian, diabetics educator and social worker, leaving him and the nurse practitioner to handle all the complex aspects of patient care.

Meanwhile, the valley's population and number of children being diagnosed with diabetes continue to climb.

"We have a huge city here, and we need somebody to take care of our kids," Tanner said. "It should be the county's prerogative to do it."

Scott, the UMC administrator, said she did not know the background of Tanner's resignation and could not comment on it.