Spokane has imbalance of medical specialists
“There is a health-care crisis here in Spokane.” Those were the words uttered by my heart transplant nurse-coordinator as she was trying to schedule an appointment for me with a specialty physician. Although having a heart transplant and other serious medical issues categorizes my health at times as “life-threatening,” it remains difficult to expedite an appointment.
Spokane is suffering from a lack of, or overload of several specialty doctors. While there are a handful of endocrinologists, there are quite a few cardiologists. Where you may have no trouble finding a family physician, try getting an appointment with a neurologist or hematologist. When a health crisis arises beyond that of basic medical care, getting help can be frustrating and sometimes futile, as many doctors are not taking new patients.
According to the Center for Disease Control, there are an average of 27 doctors for every 10,000 people in the United States. In Washington state the average is 26 and in Idaho the average is 17. The average in larger cities is much higher, with New York averaging 37 doctors per 10,000 people, and Washington, D.C., averaging as high as 74 doctors per 10,000. The dramatic difference of health care in varying geographical areas can mean the difference between quality of life for some and life or death for others.
The New York Times reported in July 2006 that “… In the past 20 years, as the number of doctors per capita grew by more than 50 percent, … most of the new ones settled in areas where the supply was already above average – places like Florida or New York – rather than in regions that lack doctors, like the rural South.”
Still, patient satisfaction, as reported in the same article, is no better when there are higher doctor-to-patient per capita ratios. “Studies of individual hospitals have likewise shown that while the doctor-patient ratio varies widely from place to place, more doctors do not mean better care,” the newspaper reported.
While we realize the need for more physicians, are other factors affecting patient satisfaction? According to The American Academy of Family Physicians, “Among 11 industrialized nations studied recently, the United States ranked … lowest in terms of patient satisfaction … and highest in terms of cost …”
Why is patient satisfaction so low? Why do more doctors choose larger cities over rural areas? What is Spokane missing? According to www.citizen.org, “Like anyone else, doctors want to live where they can earn high incomes, enjoy cultural and leisure activities, and send their children to good schools. Doctors migrate to states on lists of “Best Places to Live:” Forty of the top 100 cities with “strong arts, cultural programs and higher education” were in the 10 states with the highest per capita number of doctors.”
After six years of heart disease, 59 inpatient hospital stays, dozens of doctor appointments and procedures, two open-heart surgeries, a heart transplant, and numerous complications, I can say, firsthand, part of the problem lies with a decline in compassion and genuine care. Although doctors are mandated to uphold the Hippocratic Oath, the modern-day interpretation of it has dwindled from its original purpose.
I believe an integral part of it has been forgotten, “I will remember that there is art to medicine as well as science, and that warmth, sympathy and understanding may outweigh the surgeon’s knife or the chemist’s drug.”
As a patient, I do my best to remember doctors are people and people do fail. But when health care is merely a source of income and practicing health care is seldom based on helping others, I cannot help but have a disenchanted opinion.