The state of medical care can make you sick

Why is it consistent medical care is so hard to find in Nevada?

I called my doctor after feeling suddenly ill last Thursday, and was told as of that day he no longer worked at the clinic I go to.

I received no notice that he was leaving, though I am told it was on a sign in the waiting room for the past month that I haven't been sick.

The receptionist said she can't possibly give all patients notice because the doctor had 4,000 patients. What does that say about the quality of medical care I had been receiving?

No mail or e-mail, though the same receptionist said it was in the newspaper. So I go online at www.nevadaappeal.com, but can't find any mention of it.

She strongly implied that I should have seen it in the paper, and suggested if I was really sick I could go to the emergency room at Carson Tahoe.

I thought one reason for having a family doctor was so you didn't have to use the emergency room for non-emergencies, rack up exorbitant bills and get in the way of real emergencies. Silly me.

So I got an appointment with the new doctor for the following week, for which I felt grateful. Most of the time, by the time you get an appointment, you either get well or die.

Not that the new doctor is bad; I'm sure he's fine. It's just that everywhere else I've lived in this country as an adult (Pittsburgh, Greensburg Pa, and Youngstown, Ohio) I had one doctor for the entire time I've lived there. From 1977 to 1992 I went to Dr. Margaret Morton in Pittsburgh, the only one whose name I can remember. I had the same doctor the two years I lived in Greensburg and the same one for the five years I lived in Youngstown.

I have gone through six doctors, whom I won't name, since I moved to Northern Nevada in November 1999. Three of them moved, another dropped me when I lost my health insurance, and another wouldn't give me the kind of treatment I knew was effective, so I dropped her. A sixth was just plain obnoxious.

In fact, the best medical care I have received in Nevada was when I went to the Ross Clinic for severe allergies during a brief time of unemployment. Maybe it's the people who don't get paid who care the most about their patients. They treated me with respect and concern, not like I was one more heifer in a herd of cattle.

I wouldn't mind going back there, but I don't want to take the place of someone who had no insurance or other choices.

It's frustrating to have to repeat your medical history over and over for new doctors every time you turn around.

Some doctors drop patients as soon as they qualify for Medicare, and many don't take Medicaid at all. In this economy, with unemployment a risk for many, how many people are at risk of getting dropped by their physicians?

And why is the problem so pervasive in Nevada? Is it just Nevada?

Some have told me it's because of the transient population of the state, which means doctors no longer take care of their patients throughout the patients' lives, so they don't build a strong relationship with them.

Others have said it is because Nevada doctors pay higher malpractice premiums than elsewhere in the country and tort reform will solve the problem.

I'm sure there's more than one answer, though I haven't found it yet. Maybe I will when I find a real doctor.

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A reader e-mailed me a question this week about the planned Traditions casino and hotel, which will feature a swimming pool. The question was, will the pool be open to local residents?

I have not received an answer from the project manager yet, but in talking to managers at other hotels, the answer will probably be no, because most hotel pools do not have lifeguards and the hotel's insurance only covers guests. But stay tuned.