Husband and wife Drs. Jeffrey Ng and Pamela Greenspon met at the American Medical Student Association as students and continue to champion causes for primary care doctors: he as a physician, she as a pediatrician. Dr. Ng serves as the president of Nevada Academy of Family Physicians and is also a clinical professor at Roseman University College of Medicine. Dr. Greenspon has held posts at the American Academy of Pediatrics Nevada chapter, both as its secretary and treasurer and now as incoming vice president. She has also served as chapter breastfeeding coordinator of AAP and is the lead physician for Walk with a Doc: Kids Time. Here are the highlights of their recent interview with Jessi C. Acuña.
Dr. Ng: Primary care doctors play more gatekeepers now. In order to see a specialist, you have to go through us. Sometimes that creates more headache. The patient feels frustrated they have to see me, but maybe it’s not [the health issue they think they have]. If it is, I will pick up the phone and call the specialists and get the patient in tomorrow. When you call, you may not get in for six weeks.
Dr. Greenspon: It seems like we have more patients than time. Part of it is the primary care field tends to be reimbursed at lower rates than some of the specialty fields, since we don’t do a lot of procedures. Procedures tend to get more reimbursements.
Dr. Ng: You would think that the new electronic records make us more organized—it actually makes it more difficult. It creates more paperwork. I’ve got to read more, and I’ve got to do it in 15 minutes or less. We lost a lot of fun in medicine, because I don’t get the chance to hold your hand and sit there and listen to your story when I’m too busy trying to click on what code [due to government regulations] to enter.
Dr. Ng: A big challenge for doctors is Obamacare—the concept of patients having insurance for the very first time and not really knowing what it is. Patients think, “I paid this premium, I should get everything.” They don’t understand that’s not the way it works. There’s something called a co-pay, a deductible. If you want tests, it’s extra.
Dr. Greenspon: A difference of opinion on the Affordable Care Act: We now have 95 percent of children that have access to healthcare. That helps with getting kids vaccinated, getting their basic preventive care. There are no longer pre-existing condition exclusions, which helps patients who have chronic conditions like diabetes, asthma or cancer.
Dr. Ng: We’re trying to bring back doctors to Vegas. We train them and they leave. Two medical schools are opening up. I’m going to be on the faculty for one. One of our goals is to figure out how to keep doctors in Nevada.
Dr. Greenspon: There’s also a shortage of pediatric specialists. There are two geneticists in the state. It can take months to get in with certain specialties. There aren’t enough providers like psychiatrists or therapists for children. We’re a very underserved state when we look at specialties and primary care providers.