Smaller practices, in rural areas, can face similar challenges. In Wahoo, Nebraska, “it’s our job to provide the time people need for quality care,” says Aaron Bartek, one of two MS nurse practitioners at the Saunders Medical Center. “What we do every day does make a difference. It’s our role to make patients feel at home, part of our group, and know they can call us for anything.” Having conversations during visits about family life, work, other concerns, “provides value for people coming to our clinic, that they are more than a disease.”Subei points out that “there’s a lot of emotions that our patients go through. You need to be available for patients,” to discuss other issues of concern in addition to their MS care.Patient dialogs with providers vary according to an MS clinic’s location. Some of Gluck’s patients talk about housing challenges, food insecurity, difficulties accessing other doctors, issues reflective of the Montefiore Hospital neighborhood. Only 65% of Montefiore MS Center patients have MS, while 30 percent are dealing with other neurological problems, and the balance are referred to Gluck for assessments. “There are not many neurologists in our area” of New York City, she says.These chats, deemed necessary by physicians as part of their relationships with patients, take additional time in overburdened schedules, adding to stress factors.Moreover, there is a shortage of MS neurologists in the U.S., according to the American Academy of Neurology (AAN). “We have a lot of patients waiting in our community, people who need to be seen, but there is not enough of us,” says Freeman, whose MS center in Austin serves 2,000 patients. She considers capacity another kind of pressure in the realm of MS neurology.Texas is situated in what the National Multiple Sclerosis Society calls the “neurology desert,” where care for many is not close to where they live. To reach the Saunders Medical Center, says Bartek, patients travel for hours to Wahoo, a town of 4,000 people, from across Nebraska, as well as from Colorado, Iowa, Kansas, and South Dakota, to see an MS specialist.Encouraging more medical students to choose MS, to increase the number of MS neurologists in general and specifically in areas of the country that lack accessible care, can alleviate pressures emanating from the MS neurologist deficiency. “We need to be able to extend this workforce” to meet the needs of people living with MS and to “prevent burnout in our physician communities,’’ Freeman says.
