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By Scott Scanlon // Refresh editor

The message we often get when it comes to navigating the ever more complex world of medical care is that we need to seize control of our health and wellness by blazing our way through the system like a hearty American pioneer.

But here's one part of health care where rugged independence will do little to serve you: finding a doctor in short supply in Western New York.

“We're certainly proponents in having people actively engaged in taking responsibility for their health care … but I think it's unrealistic to expect a patient to know how to navigate to various specialists or even understand what's the most appropriate specialty area for a given issue,” says Dr. Michael J. Edbauer, chief medical officer of Catholic Medical Partners.

The last thing you need when you feel like garbage – and fear that ache or pain is the beginning of something really bad – is to pick up the phone and start cold-calling doctors' offices. You may find you're getting the cold shoulder by front-end office staff, if you can even get a live person on the phone after a flurry of voicemail instructions.

Such treatment is often a reflection of the demand on specialists in short supply in Buffalo Niagara. Primary care, internal medicine, emergency and psychiatric doctors are among them, according to a recent report by the Healthcare Association of New York. Local health care administrators dispute some of that, but agree there is a shortage of psychiatrists, endocrinologists, dermatologists and rheumatologists in the region.

If you need one of these docs, rather than forage on your own, consider these tips:

1.It is about who you know: A primary care doctor should head that list. If you don't have one, get one. Now.

“Your primary care physician is to some extent like a broker for specialty care,” says Dr. Thomas Rosenthal, a family physician in Buffalo for 35 years. “We'll make multiple referrals to a dermatologist, for instance, so we know how their office works, how they schedule people, but also from a more crass business perspective, the dermatologist doesn't want to lose our referrals. It's not one referral, it's multiple referrals, so they will tend to try to make the primary care office happy by accommodating a patient with an urgent problem.”

What's more, primary care doctors are trained to treat many of the medical conditions that specialists do, so they can start treatment right away, say Rosenthal and Dr. Andrew Symons, who practices at UB Family Medicine in the Town of Tonawanda.

“I know how to leverage care in the community when my patients need it,” says Symons, “if I can't directly provide it.”

2.Find a good IPA: We don't mean beer, but an “Independent Practice Association,” or something similar. These collections of aligned medical professionals act as cooperatives, and are designed as a group to provide overarching medical care. Patients plugged into one of these teams often find it easier to see a specialist. Catholic Medical Partners is one such group and combines the power of all the region's Catholic hospitals and more than 900 affiliated doctors. The Optimum Physician Alliance (Rosenthal is chief medical executive), UB MD and Buffalo Medical Group are others.

Buffalo Medical Group, a physician- owned group, comprises a team of 106 doctors, including 31 primary care physicians, many of whom work in three core offices in Buffalo, Orchard Park and Williamsville. “At times, a primary care patient can be walked down the hall to a specialist,” says Joe Martone, group spokesman.

3.Think insurance: If you have health insurance, the company that provides it often is a good source to line up a primary care doctor and team of professionals. “Most health plans have very robust digital directories that list all the doctors in the network by speciality, by primary, and will usually do a geo search by ZIP code,” says Julie Snyder, BlueCross BlueShield of WNY spokeswoman. Independent Health has a program called the Primary Connection. Info on how to plug into the system is on your insurance card.

Those without insurance can access care online at chsbuffalo.org or by phone at 447-6205, Catholic Health's Edbauer says, because part of the system's mission is to assure everyone gets adequate medical care.

4.Go online: Many doctor groups have online programs – Buffalo Medical Group calls theirs MyBMGChart – that allow patients to schedule appointments and email doctors directly with questions or concerns.

5.Get a Plan B: If you can't get in quickly, make a “placeholder” appointment with a specialist and get on a waiting list for cancellations. Ask if a nurse practitioner or physician's assistant might be able to see you faster than the doctor.

6.Be patient: Dr. Raghu Ram is chief medical officer for BlueCross BlueShield of WNY. He also is in private practice.

When the family doctor talks to his patients at Primary Care of Western New York in Kenmore and Williamsville, he understands their desire to see a specialist quickly. When he makes a referral, he tells his patients to call these doctors directly, and let him know if they can't get an appointment within four weeks. If they can't, he will intervene. He also talks to patients about how they can handle a health condition in the meantime, and about signs to look for that suggest things may be getting worse.

“People should be patient patients,” he said, “and understand how urgent their needs are.”

email: refresh@buffnews.com

Related: Once you're at the doctor, make the limited face time count. Page 10

On the Web: Two specialists talk about their typical work week. Visit the Refresh Buffalo blog at BuffaloNews.com