Vermont faces shortage of endocrinologists

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(Host) Forty-thousand Vermonters suffer from diabetes. About a third of them have the disease and don’t even know it. With obesity rates rising, health experts say the number of diabetics will grow exponentially in the years to come. But Vermont and rest of the nation face a growing shortage of endocrinologists, the doctors trained to treat the disease. VPR’s Nina Keck reports:

(Keck) Rutland physician Phillip Lapp says he’s one of only eight practicing endocrinologists in the state.

(Lapp) “There is a program affiliated with the hospital in Burlington, there is a solo endocrinologist in Bennington and there’s me, and that’s it for the state of Vermont for this specialty.”

(Keck) Vermont has only one pediatric endocrinologist, which Lapp says is worrisome, since diabetes is affecting more and more children. The Rutland physician says he gets patients from as far away as New York and the Northeast Kingdom and though his staff works hard, he says scheduling can be frustrating.

(Lapp) “Where we used to be able to see a new patient within a month or maybe two, now it may take four months or more for a new patient to get an appointment.”

(Keck) Recruiting a partner has been difficult. Despite demand, Lapp says there aren’t that many doctors going into endocrinology – a subspecialty that deals with the body’s glands, hormones, metabolism, growth and reproduction. While it’s a complex field, he says it doesn’t pay as well as many other specialties.

(Lapp) “In talking with colleagues in eastern New York State and other parts of New England who have been recruiting longer than myself, they’re having a real hard time finding qualified applicants.”

(Keck) Lapp says physician assistants and nurse practitioners are helping to fill the gap, but he expects the shortage to get worse.

Robin Edelman is Diabetes Program Administrator at the Vermont Department of Health. With so few specialists, she says primary care physicians need to do more to screen for pre-diabetes. Edelman says those high risk patients can then be taught how to avoid or delay the onset of the disease.

But nutritional counseling is time consuming and primary care doctors point out that insurance companies rarely pay for it for someone who does not have full blown diabetes.

Edelman says the important thing for people to understand is that even small lifestyle changes can make a bid difference in fighting the disease.

(Edelman) “If you’re say 200 pounds, and you lose just ten pounds. That’s five percent of your current body weight. That’s not a huge amount to lose. That can be protective to delay or prevent diabetes.”

(Keck) Change is never easy, she admits, but it’ll be much easier than facing the consequences if we don’t.

(Edelman) “We’re just not used to seeing young children with heart attacks in our emergency room. We’re not prepared with the number of dialysis machines to deal with failing kidneys of younger people. So we are not quite really prepared for the numbers of complications that will ensue as a result of this epidemic.”

(Keck) Rutland physician Phillip Lapp says that while he’s frustrated by epidemic nature of the disease, diabetics should feel hopeful.

(Lapp) “The good news is there are a lot more tools in the tool box. So we do a much better job helping people take care of their diabetes than we did 10 years ago.”

(Keck) And he says patient outcomes are better as well. For Vermont Public Radio, I’m Nina Keck in Rutland.

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