CHEYENNE – Having access to doctors and specialists is an important part of maintaining a healthy life. For women, health care often extends beyond the annual primary care visits.
Women’s wellness tends to require more specialized care, due to health care needs such as mammograms and pap smears, which are regular tests to maintain a woman’s health.
To accomplish these needs, sometimes it means going to an obstetrician-gynecologist, or an OB-GYN.
“The big part of it is, women’s bodies change over their whole life,” said Anthony Schirer, executive director of Cheyenne Ob/Gyn. “There’s different phases, from things like birth control, child bearing and menopause. Each one of those stages have their own health concerns.”
In Wyoming, there are currently 34 board-certified OB-GYNs, according to the American College of Obstetricians and Gynecologists (ACOG). Though in a Health Professional Shortage Area survey conducted in 2017, there were 36 OB-GYNs that responded to the survey, and only 23.3 of the specialists for full-time equivalent, according to the Wyoming Department of Health.
This means of the 36 doctors that responded to the survey, many of them don’t work full time, Kim Deti, Wyoming Department of Health spokeswoman, said in an email.
Wyoming is considered a frontier state when it comes to health care, said Gail Wilson, registered nurse and family planning director at the Cheyenne-Laramie County Health Department. This means, in general, access to health care is limited in the state.
“Women’s wellness is just more complicated,” she said.
Deti said it’s also important to note these surveys only count the doctors who respond and only include outpatient providers. This means the survey doesn’t count any providers practicing in an inpatient setting, such as a hospitalist.
Across Wyoming, there’s pretty limited access to health care. But in the Cheyenne area, access is better because it’s a more populated, Wilson said. She mentioned that despite the limited number of providers – since there’s fewer doctors, there’s fewer appointment opportunities – it’s important to let women know what is available to them.
She said the City-County Health Department provides Title 10 services, which is health care at reduced costs as part of federal funding for no-income or low-income people.
“The importance for recognizing or being able to detect a pregnancy as early as possible in the pregnancy is for the healthiest outcomes for both the mother and the child,” Wilson said. “Access to prenatal care through the OB clinic is extremely important; that goes into the health of the entire family.”
Using U.S. Census Bureau estimates that in 2016, the number of OB-GYNs per 10,000 women age 16 years or older was 2.7 (down from 3.1 in 2008) and per 10,000 women ages 15 to 44, which is considered reproductive age, was 5.5, according to ACOG. From 2008, this was down 3.1 practitioners per 10,000 women 16 or older and down 6.2 practitioners for women of reproductive age.
This means the number of OB-GYNs is continuing to decline, and especially in the Mountain West, women are considered more at risk for health-care shortages.
Schirer said in his experience there could probably be eight OB-GYNs in Cheyenne to service the community. On the other hand, he said, a hospital might do a survey and say there’s a need for 12.
“It really does depend on how busy a physician wants to be,” he said.
He said he knows of some physicians who want to see 35 to 40 people a day, and others want to see fewer. It really depends on how much an OB-GYN wants to work.
In Wyoming, there were about 3,318 women per OB-GYN in 2015. There was also a -2% to 2% growth range for in-demand women’s health-care services.
“Approximately one half (49%) of the 3,143 U.S. counties lacked a single OB-GYN, mostly because these counties lacked a hospital with maternity services,” according to ACOG. “More than 10 million women (8.2% of all women) in the United States lived in those predominantly rural counties, located especially in the Central and Mountain West regions, and commonly designated Health Professional Shortage Areas.”
For the City-County Health Department, providers usually see local people, but Nikki Armstrong, a family nurse practitioner with a certified doctorate in nursing practice, said she does see people coming to Cheyenne from Rock Springs.
Looking at a map of Wyoming, Schirer drew about a 75-mile radius around the towns in Wyoming that had an OB-GYN. He said the only area where the circles don’t overlap is in the Riverton area in central Wyoming.
Even then, this access depends a lot on how far people are willing to drive, he said.
His clinic mostly sees local people, but he knows of patients that drive from Colorado, even Nebraska, to come to the clinic because that’s their personal preference, he said.
“Both men and women have a responsibility in their family situation to be able to encourage healthy lifestyles, and our clinic, as well as many others, promote the healthiest outcomes,” Wilson said. “It just becomes a ripple effect in the whole family.”