ST. GEORGE – Since Southern Utah’s only rheumatologist retired in October, several hundred patients are unable to see a local doctor for what can be a life-threatening illness.
Rheumatologist Dr. John McCormick retired in October, and now local patients have to travel to Salt Lake City for care – if they can find an opening, local arthritis advocate Sarah Cloud said.
The term ‘arthritis’ encompasses dozens of medical conditions that range from mild to disabling to life-threatening, and includes several autoimmune disorders.
Cloud lives in Hurricane and is a platinum ambassador for the Arthritis Foundation and the mother of an adult son who has the disease.
“Dr. McCormick was the only rheumatologist south of Provo,” Cloud said. “He was covering the entire half of the state.”
“He had over 500 patients that he was seeing. There were another 300 on the wait list, and that didn’t include those of us who weren’t able to get on his wait list,” Cloud said.
Local patients had less than a month’s notice that McCormick’s clinic was closing and were told they’d have to transfer to other rheumatologists.
“So it has created anywhere from a six-month to a nine-month waiting list for rheumatologists in Salt Lake City,” Cloud said.
Many insurance companies will not pay for doctor visits across state lines, including SelectHealth, which the Clouds get through an employer.
But waiting that long to see a doctor can cause permanent damage, Cloud said. While her own son is doing well for now, others are not so lucky.
Cloud’s son was covered by Arches Health Plan and seeing a Las Vegas rheumatologist, but Arches was dissolved in October of 2015. The move left 20 of Utah’s 29 counties with only one insurer, according to the Deseret News.
“He’s actually been on a patient wait list for Salt Lake since January of last year,” Cloud said. Right now, the Cloud’s family doctor is seeing Chris. However, the doctor is not familiar with arthritic disorders nor the “biologic” medicines that are often prescribed to treat them.
McCormick practiced at an Intermountain Healthcare clinic and Intermountain is trying to recruit a rheumatologist, Dixie Regional Medical Center spokeswoman Terri Draper said in an emailed response to questions.
“We are aware of this need and want very much to meet it,” Draper said. “We wish we had better news regarding local rheumatology options for patients.”
“With the aging of America, rheumatologists are in very high demand everywhere. We have been and still are actively recruiting for them, as are most hospitals in the country,” Draper said.
Intermountain is exploring the possibility of telemedicine consultations with rheumatologists, Draper said, and staff is doing everything they can to recruit one.
In the meantime, the situation has been very difficult for arthritis sufferers.
“It’s forcing people to either go to Salt Lake or go without care,” Cloud said.
Cloud could take her son to Las Vegas to see an out-of-network doctor, but that would cost $300 cash up front.
“We’re already in a disease class that’s expensive,” she said, adding medications for autoimmune arthritis are outrageously expensive as well.
“My other concern is that I do know adult patients here that because of the severity of their arthritis cannot actually make the trip to Salt Lake.”
Cloud personally knows people who are becoming housebound because of lack of treatment – and lack of options, she said.
And while seeing a general practitioner works for milder cases, it is very complicated to get the class of medications severe patients need when a family doctor is trying to prescribe it.
“Generally, you need to have an internist, a gastroenterologist or a rheumatologist to actually prescribe these medications,” Cloud said. “Insurance will deny it because it’s not the right type of doctor requesting it.”
In addition, family doctors are hesitant to prescribe the medications, many of which come with a “black box” warning label because of the serious and even life-threatening risks associated with the medicines.
“So that leaves you with a group of patients who don’t have a doctor to oversee their care, but they also don’t have a doctor to oversee their medications. And you have to have a doctor’s approval every time you get these medications.”
Patients also have to be closely monitored when on anti-rheumatic biologics such as Enbrel, which involves regular doctor visits.
- Arthritis Foundation website
- Arthritis Foundation Utah Web page
- Arthritis Foundation advocacy information web page