Tim Burke: Timely health care getting harder

Health care is one of the most frustrating and complex issues consumers, businesses and legislators face.

With just three weeks left in this year’s legislative session, Nevada legislators will take up the matter of the Patient Protection Commission promised by Gov. Steve Sisolak.

The commission will be responsible for a top-to-bottom review of health care in Nevada. “It’s my goal that by next legislative session, the PPC will have made a thorough review of our health care system and be able to offer concrete recommendations to the Legislature on what we need to do in Carson City to expand access to quality, affordable health care for all Nevadans,” Sisolak said.

Expanding access to affordable health care coverage is important but for consumers who are fortunate enough to have coverage now, getting in to see a doctor seems to have gotten more complicated and time-consuming. Do you have an issue that needs medical attention but isn’t severe enough to warrant a trip to the emergency room?

Let’s look at what a typical scenario might be for someone with coverage now: you are experiencing some pain in your hip area. You are having a difficult time walking or even getting out a chair without experiencing some major discomfort. After trying various over-the-counter pain medications without much relief, you decide a trip to the doctor is warranted. Good luck with that.

Your first step will be to call the primary care physician that your insurance company has assigned you. Gone are the days of the family physician who takes care of multiple generations of a family. Your coverage didn’t let you choose your physician but since you rarely go to the doctor, you don’t think it’s too big of a deal. You call your doctor’s office and request an appointment.

If you haven’t seen the doctor before, be prepared for an interrogation by the doctor’s office person who answered the phone. Name, date of birth, insurance company, insurance identification number, etc., all before they ask you what your particularly ailment is.

The phone receptionist then tells you, “The first available appointment that we have is in four weeks, does (insert date here) work for you?” You set the appointment, but you say to yourself, “it’s a hip issue, maybe I should just see if I can get into an orthopedic doctor and get it looked at. That should cut down on the wait time.” Sorry, no chance of that happening.

You assume that you can call and make an appointment and after a quick internet search, you find an orthopedic doctor that is close to you. You call the office, “I have some hip pain issues and would like to make an appointment to see the doctor,” you say to the person on the phone at the doctor’s office. “Do you have a referral?” they ask. “No, what is that?” you reply. “It’s the referral we need from your primary care physician before we can see you,” they inform you. So much for eliminating that wait time.

So, you wait. Then after four weeks, the joyous day of your doctor’s appointment with the primary care physician arrives. You arrive excited to meet your new doctor and get your “referral” so that you can finally get your hip pain taken care of. Except you don’t get to actually meet your doctor. You instead get to meet the doctor’s physician assistant (PA) who is kind of a doctor but not actually one.

A physician assistant is a medical professional who operates under a doctor’s supervision. You discuss your hip pain with the PA who then orders X-rays. You are then directed to go to a different medical office where they will take your X-rays and then send them to your doctor for review.

It might take a few weeks but then one day magically, your doctor’s office calls to tell you that your referral to the orthopedic doctor is approved! Excitedly, you call the orthopedic doctor’s office to make your appointment. After they verify that you do indeed have the proper referral documentation to see them, they inform you that it will be four to six weeks before your initial visit. So, you wait again.

It’s not really the fault of the doctors’ offices. It is how our current insurance system is set up. It just doesn’t seem to make a lot of sense to have to wait over three months to get whatever your particular medical issue is looked at while your quality of life is diminished.

The stated goal of the commission is to expand access to quality, affordable health care. Hopefully, when the commission does their “top to bottom” review they can recommend steps to help resolve the issues with the current system before undertaking an expansion. The Governor’s Commission has a very difficult task before it.

Tim Burke is a businessman, philanthropist, educator and Pahrump resident. Contact him at timstakenv@gmail.com