Critical Doctor Shortage

Critical Doctor Shortage

By Ellen Lenox Smith.

Imagine trying to locate a doctor to only find out there are none with openings and you have serious medical issues that need attending. It is difficult enough to learn to cope with a medical condition you wish would just somehow magically disappear. But to add to this problem, having difficulty locating a doctor to take you on. Some doctors are moving to a new state, retiring or as we are currently experiencing in RI, the serious problem of having doctors move to a new state due to the incredibly low reimbursement rates currently in place in RI. If crossing over the border to the next state provides can a higher compensation for the same services, wouldn’t you, as a doctor, consider the move, too? The dynamic of doctors, understandably seeking reasonable compensation for their highly skilled services, leaves patients left out in the cold with no recourse. And where are you, the patient left?

Ellen Lenox Smith

This is a real problem many are facing more and more across the country. As doctors are getting overwhelmed with rules and regulations that can tie their hands from performing medicine as they prefer, patients are being left in the dust with serious issues trying to find someone to take them on. For example, just last week at a visit to my pulmonologist, I experienced what life was like for him and others as co-workers are leaving and not being replaced. Either they are unable to find someone else to hire, since in many cases like here in RI, they would only make much less salary that they can make elsewhere or in our case, the governor is left to believe that there is no problem to be concerned about this. Yet, the two remaining pulmonologists left in his practice are now being expected to take on the care of the patients that were once treated by four doctors. Through his frustration, it was mentioned that the other doctor’s test results for their patients are still pending conversations due to just plain lack of time to make routine follow up contacts. I saw this dedicated doctor so overwhelmed with his circumstances and at a high frustration level as to what he might do to address this problem, a problem which for his practice has reached crisis proportions.

If we don’t equalize care across the country, we are harming our population. Why should the process of finding a doctor in one geographic area prove relatively simple while in the same process in another area of the country be almost impossible? Then consider someone like me and you with complicated conditions attempting to locate a doctor to take us on. Why would medical professionals want to take on a difficult case over someone who would be much less time consuming to treat, thus more cost effective to care for, most likely? Doctors are not the problem. The quality of any care at all should not depend upon where a patient lives. The system is flawed and, in some areas, broken. Without systemic change, this unfair system of treatment will continue to contribute to patient anxiety and pain.

Consider sending a letter to the editor, writing the governor, making calls to your representatives and senators and whatever else you can think of to express your concern if you, too, are in a state dealing with this crisis.

May Life Be Kind to you,

Ellen Lenox Smith

Author of: It Hurts Like Hell!: I Live With Pain- And Have a Good Life, Anyway, and My Life as a Service Dog!

The information in this column should not be considered as professional medical advice, diagnosis or treatment. It is for informational purposes only and represents the author’s opinions alone. It does not inherently express or reflect the views, opinions and/or positions of National Pain Report.

Ellen Lenox Smith and her husband Stuart live in Rhode Island. They are co-directors for medical cannabis advocacy for the U.S. Pain Foundation, along with Ellen on the board and they both also serve as board members for the Rhode Island Patient Advocacy Coalition. For more information about medical cannabis visit their website.

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Authored by: Ellen Lenox Smith

Ellen Lenox Smith and her husband Stuart live in Rhode Island. They are co-directors for medical cannabis advocacy for the U.S. Pain Foundation, along with Ellen on the board and they both also serve as board members for the Rhode Island Patient Advocacy Coalition. For more information about medical cannabis visit their website.

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Our entire healthcare system is facing critical shortages of all kinds of providers, including primary care, specialist MDs, mental health providers, physical therapists, nurses and many others. The situation is particularly acute for doctors who prescribe opioids because of the legal prosecution of so many. But insurance companies have made life so miserable for so many healthcare providers, requiring unreasonable amounts of documentation of need, reducing and freezing fees, denying reimbursement for services already provided, etc.,that many are leaving their professionals and fewer are entering. Healthcare is the one field I am aware of where experienced professionals, even those with decades of experience and advanced training, get paid the same as brand new providers. Nonphysician mental health providers, physical therapists and chiropractors have not had fee increases in over 40 years, at a time when overall inflation has been well over 300%. This situation takes its toll on availability of care as well as quality of care. To see one aspect of the impact of this situation, see this chart of mental health provider shortages nationwide (a shortage usually means less than 1 psychiatrist per 30,000 people or one mental health provider of any discipline per 9000 people, an incredibly ridiculous standard): All of the providers I have mentioned have critical roles to play in helping pain patients. For more information on the role of nonphysician healthcare providers in alleviating pain, please go to


If I read your letter right it seems like you are advocating for social medicine. If you feel you would have “medical equality” that way I suggest you read/study the countries that have it.

As a patient with many complicated health problems you will find when everyone who works puts 50-70% of their income into a kitty and divides it up you will get the opposite of what you are looking for. Formulary things like shots, broken bones get covered but expensive specialists will have incredibly long lines.

As a digestive disorder patient i have met people from all over the world and they couldn’t be more unhappy. Patients are treated with a one type fits all system which frequently doesn’t work. When they go back to complain of serious pain an problems they are assured they got the best available. If they complain further maybe a surgeon would be willing to undo their surgery.. maybe not.

I really fear for these friends I have met and wish I could adopt all of them so they would be covered here where we get a choice- a chance to get problem doctor’s surgery undone.

I cry for and with them.


Doris Connor

Physicians became so for two reasons. They love helping patients and they made a lot of money doing it. With the government getting involved in patient care, and our physicians and thier families having a life style that they have become accustomed too, what choice do they now have but to follow the money. If they stay put, its thier children that now do without. I cant blame them. I blame the political mess in our country. I am a CPP with a multitude of issues and my PCP would take care of my overall health issues. At times sent me to specialists as needed. Now each Dr. Is limited to what care they can provide so I have to see More specialists who are only interested in one part of me and not the whole. I find they dont communicate with each other and my care and issues are no longer properly addressed. I suffer needlessly because of this mess our government has created. They need to fix the system
Let our physicians do what they were trained for. The health and welfare of thier patients.

I can certainly understand your frustration. I’m in TN, my problem isn’t finding a dr but finding a good one. I had been seeing one now for 3 years, but since I have something wrong with my shoulder I have had the worst care I’ve ever experienced. It keeps me up at night I haven’t had a full night sleep going on 8 months. I guess they feel I don’t deserve to have anymore pain medication than I am already on. It isn’t much, but it’s better than nothing. I wish I could have some sleep and I wish I could clean my house. I feel like a waste, and when I pray at night I pray that god would not let me wake up.

Scott Eustice

Is there still going to be a March on the State capitals on January the 29th? I thought I read about this about a month ago but haven’t seen anything since. This March that I heard about was concerning the problem of pain medication. Can anyone tell me anything about this?


I don’t believe there is a doctor shortage, I believe doctors do not care anymore. Too quick to judge. Everyday pain is a mental strain and I’m tired!

I’ve often thought where on earth would I be without my doctor. He was literally an answer to so many prayers. I thank God for him more then he knows. I’ve often wondered what would I do if he moved, were to retire or something happened to him. I shudder to think. I’ve read so many horror stories from so many chronic pain patients that have been outright abandoned, some treated and talked to worse than animals. To the very point where they’re ready to take their lives because they can’t get anyone to help them, let alone hear them. This is what the “opioid injustice” has created. A friend of mine was trying to find a doctor a couple of years ago. They were relatively new in town. Later I learned that before they were accepted, the doctor’s office had to check to see if this person had ever or was currently taking opioids. It made me shudder, I thought is this what it’s come to? Someone else I knew was trying to find a doctor because they weren’t happy with the one they had. Everywhere they called the first thing they were told was that this particular doctor’s office did not prescribe opioids. Five doctor offices in a row in three different towns. This person just wanted a good doctor, they weren’t trying to obtain opioids! I couldn’t help but wonder what would happen to those in whom would need a doctor and one in which to prescribe opioids. I wish the president could or rather would read all of the horror stories I’ve read or even a portion of them. America needs a serious wake-up call and it’s beyond me as to how it’s going to happen or when. As I’ve said many times, “The land of the free and the home of the brave”…atleast they got the second part right. How incredibly sad, not to mention downright embarrassing.


This is not the forum to start a call - in campaign to start a referendum on reimbursement rates in Rhode Island !
Sorry Ellen , we as a Chronic Pain Community are fighting much larger issues that affect us nationally than Rhode Island’s ; single state issue of less than adequate reimbursement rates for Medicare and Medicaid and possibly private insurance rate payments to physicians.
Dr.s have a right to be paid adequately for their services ; this is actually their fight with the government not ours.
Please don’t use this forum for a private situation that effects where you alone live………
Just one Nurses - Patient’s opinion.
I’m more concerned about health care for all !
Now that’s a fight to engage in!
Sorry, but you asked?

Kris Aaron

Increasingly, older Americans with chronic health issues are relocating to foreign countries. Not only are the costs more affordable (as people who have investigated medical tourism learn) the quality of care is frequently equal to that found in the US.
Plus, pain patients have found that foreign physicians aren’t bound by the same heavy-handed federal restrictions on prescribing opioids. Even some cancer patients have had difficulty obtaining opioids, thanks to the current “opioid hysteria” running wild in the US.
When a nation allows lawmakers and law enforcement agents to set medical practice standards and “play doctor” with people’s lives, relocating to more welcoming countries looks like a viable alternative.

Thomas Kidd

I am after 30+ years, of being mistreated because of something I had no choice in. I have been treated with Methadone for 99% of these years. Methadone makes it possible for me to function on a daily basis and the side-affects are of no concisuence if patient eat as well ballance diet as possible with plenty of fiber. I have been cursed and accused of about everything. I also have Narcolepsy and being reduced or taken off this medicine only causes more complications. I have had a few doctors try to diagnose me with mental illness. People with Narcolepsy have nervous systems very different from the normal person. I am so fed up with these insane recommendations which have no basis in reality. Without Methadone I am basically house bound and depressed. Since this foolish idea started back 2 years ago I have been in pain to the point that I am depressed and suffer mental anguish which no one should be subject to. Trying to talk to my doctor is an exercise in futility. The Pain Clinic which I have been going to for 14 years come June of this year has ignored the fact that I have been a model patient and have not failed one drug screening test. Medical Universities are turning out doctors with little or no compassion and emphany for their patients. It’s insanity for those who suffer from chronic pain to be expected to pay doctors for mistreatment. It’s like going every couple of months to some bullies and paying them to beat you up. I will be 67 years old this July and I am so tired of being mistreated for something I had nothing to do with. Compassion and emphany hasn’t just about vanished from the medical profession but also among those who profess to be God fearing Christian and folks who have never had to deal with chronic pain on a daily basis. I have come to learn that insanity is spreading among the inhabitants of the world at an alarming rate. I can remember when strangers would pity people such as us. When neighbors were concerned about each other. Wake up peopl


I’m truly sorry for the problems encountered in RI. In certain Southern cities, we seem to be drawing doctors to the population explosion going on in places like Nashville. I have no idea what reimbursement rates are like down here (I mostly spend my time and energies on the opioid debacle), but it seems we have plenty of internists and what have you. I have observed a big increase in the services of both Nurse Practitioners and Physicians’ Assistants, so this may help relieve the pressures on the doctors.

Another thing is — and it may very well not be a “thing” today — but I do know there used to be incentives given doctors to help pay for medical school by contracting an agreement to serve so many years in underserved rural locations. Not sure if that was my state (TN) thing or not, but that might be worth checking out.

My very best regards and hope for you a low pain day, FST

The only way to lower and control pain is through a medicine called pain madicine period! Not sure what planet doctors and gov.entities have relocated to but it most certainly isn’t Earth?? I think it’s a planet called the insane asylum really freaky planet good luck.

Gary Raymond

I favor a Constitutional Amendment to separate politicians from medicine. If lawyers can be self-regulating, then doctors can be too. Let’s put a few politicians at the front lines in a war zone then withhold antibiotics and pain medicine.

Bob Roberts

That’s right no relief only PAIN!!!!!!!!+!@