Tribune/Debra Reid - Three family physicians, including Dr. Chris Patin, are accepting new patients at the Northern Nevada Medical Group in Spanish Springs. Susan Robinson attended Tuesday's open house.
“I think the need is huge and it’s nicer,” Inman said. “Patients like not having the long drive and going 25 minutes to see the doctor.”
Local physicians, community members and the Sparks Chamber of Commerce on Tuesday celebrated the Northern Nevada Medical Group’s Ion Drive office grand opening with a ribbon cutting ceremony. The location opened July 1.
But the three doctors, including Inman, Cynthia Brown and Chris Patin, who now work in family medicine at the Ion office, already have started seeing how the services at that location are providing relief a little closer to home and how indicative it is of the importance of offering primary medical care close to outlying residential areas like Spanish Springs.
“There is a huge need,” Inman said. “People will get a headache, take some Advil, but then it comes back. They’re more likely to not seek care if they have poor access. The doctor is 20 miles away. They’re more likely to treat it at home and potentially ignore a more serious problem.”
Patient visits to the primary physician’s office are quickly becoming stunted by a number of factors, including an increase in the physician-to-patient ratio. According to the American Medical Association (AMA), as of December 2007, the ratio of doctors to patients in Nevada is 218 to 100,000, with one physician to approximately 459 individuals. These figures include all general practice physicians and specialists.
Larry Matheis, executive director of the Nevada State Medical Association, added that in 2008 Nevada was 47th in the nation for its physician-to-patient ratio, largely a product of growth in southern Nevada but with a similar trend in the northern part of the state.
Primary care includes internal and family medicine, general practice, obstetrics and gynecology and pediatrics. They are typically the first doctors patients consult before seeing a specialist. With the region’s population growth driving the physician-to-patient ratios in favor of patients, it becomes more difficult for fewer doctors to see more patients in need of primary care.
John Packham, director of health policy research at the University of Nevada, Reno School of Medicine, is a statistician and economist who will soon put out a report on the physician workforce in Nevada using AMA data.
According to his findings, there is some good news about Nevada’s production of doctors.
“One of the things we can say is good news, despite our medical school and residency programs producing a relatively small number of physicians, is that Nevada has been able to recruit and retain primary doctors to the state, but we have been treading water in terms of doctors per 100,000 population,” Packham said.
In the area of family medicine in Nevada, Packham explained, the number of doctors has grown as the population has risen, but the state still only has 20 physicians per 100,000 patients, whereas the United States on average has 27.9 doctors per 100,000 patients.
In obstetrics and gynecology, there are 11.1 doctors per 100,000 patients; nationally, there are 14.1 to 100,000. Pediatricians in Nevada have a ratio of 14.7 per 100,000 versus 24.7 per 100,000 across the country.
The numbers confirm a serious deficit for primary care doctors in the state.
“Basically, we are significantly below our need for primary care physicians,” Matheis said. “It’s a national issue and in states with rapid growth, it’s a runaway issue.”
“There is a considerable amount of unmet need for medical care in Nevada and we’re not getting any younger,” Packham added, referring to the Silver State’s population growing older and needing more medical care.
Locally, Mark Crawford, CEO of Northern Nevada Medical Group, said Sparks and Reno have a deficit of 40 to 50 physicians. Spanish Springs, though incorporated into Sparks, has even fewer options for primary care, so its location at 5070 Ion Drive, where there are no other health clinics, made it an ideal place for doctors to come in and serve more patients.
“The ultimate objective here is to provide geographically good locations so customers in Sparks can have access to physicians on a wider-spread basis,” Crawford said. “Generally, it’s population (we consider for establishing an office). … We have a few offices in Sparks, but we didn’t want to encroach on them.”
Inman, who helped form the NNMG, said in addition to accessibility, prevention is crucial to preventing hospitalization and medical costs to residents.
“Communities with primary care have fewer emergency room visits and lower hospitalization rates because people will come in and see a doctor and take care of it before it snowballs into something more serious,” Inman said.
Primary care doctors often make referrals to specialists if a problem has gone untreated for too long and is outside their purview. This can also affect the specialists and their schedules, Packham said.
Even a visit to the pediatrician is difficult these days.
If a parent wants to bring a child in to see a specialist, Packham said, “you might have to wait until Christmas to get an appointment. … If you have kids and you’re trying to find a pediatrician in Reno, it’s nearly impossible to get on a list.”
The economy’s impact on families also has taken a toll in that some people won’t go to the doctor to avoid making a co-pay for the visit, said Nancy Strayer, a consultant who works with the NNMG in matters of billing, for which some offices offer a payment plan.
“People who need a colonoscopy, people who need a mammogram aren’t going because it’s preventative,” Strayer said. “With primary care, people are sick, they’re going to have to go, but all the preventative stuff, we’re really seeing a drop-off in that. If your kid’s sick, you’re going to go to the (primary) doctor, you’re going to pay the co-pay, you’re going to pay for the medicine, you’re going to find a way. But more of the specialized care, elective surgeries, if someone needs knee surgery – ‘Well, I’ll just find a way to deal with the pain’ – you find a lot more of that because of insurance.”
Billing supervisor Mandy Meyer said NNMG offers payment ranges with different options, as well as discounts for self-paying patients.
The NNMG hopes its new office will help prevent some of these larger health issues by providing more staff by the end of the year. Currently, in addition to the three family medicine doctors, the Spanish Springs office has one intervention and cardiology specialist. By the end of the year, Crawford said the office wants to have five general medicine physicians and three specialists.
Patin said the establishment of a new clinic takes a dedicated team working together to help meet patient needs.
“In my point of view, it takes keeping your patients happy and meeting their health care needs (and) being available,” Patin said. “I think this is a great time to be a primary physician because medicine is going to play a big role in cost savings.”
Tribune editor Nathan Orme contributed to this article.
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