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Alzheimer's Association seeks to change Oklahoma recruiting law

Daily Oklahoman - 2/2/2019

Feb. 02--Oklahoma City -- The Alzheimer's Association thinks it has a solution to the long wait Oklahoma families endure to find out why their loved ones' minds are changing: Use state incentives to lure a neurologist.

The law authorizing the incentives poses at least two challenges, however. It's only been used primary care providers, and it requires that they set up in rural areas -- a tough sell for a specialist.

Access to neurology care is a challenge in both rural and urban areas of Oklahoma, said Randle Lee, director of advocacy for the Oklahoma branch of the Alzheimer's Association. He hopes that bringing another neurologist into the state would speed up appointments, allowing patients with Alzheimer's and other neurological conditions to get a faster diagnosis.

"Our families kept telling us through our support group system ... that it takes nine to 12 months to see a neurologist," he said.

Diagnosing dementia is largely a process of ruling out other explanations, like depression, a head injury or malnutrition.

Primary care doctors can make a diagnosis with the right training, but a neurologist could use more advanced tests and brain imaging to confirm it, Lee said. While there are no effective treatments for Alzheimer's disease, diagnosing it earlier gives patients a better chance to help plan their care and make legal arrangements, he said.

"A lot of them don't know all the resources," he said.

The Alzheimer's Association is pushing Senate Bill 437, which Lee said would fund loan repayment through the Physician Manpower Training Commission for one neurologist for five years as part of a pilot project. The bill's current language only refers to using telemedicine to let a neurologist already working in the state see rural patients.

Richard Evans, executive director of the Physician Manpower Training Commission, said he supports some sort of pilot program, but lawmakers would have to change statutes to allow it to recruit a neurologist. Currently, the law limits it to primary care providers, obstetricians and providers specializing in geriatrics or emergency medicine.

The commission offers up to $160,000 toward repaying student loans for doctors willing to work in rural areas. The focus has always been on rural areas because many doctors prefer communities with more entertainment options and employment opportunities for their spouses, Evans said.

"PMTC offering financial support to an urban specialist is a major departure from our current rural and primary care focus," he said in an email.

Lee said he hopes the commission will be satisfied if the neurologist agreed to work with rural patients through telemedicine, because the incentives may not be enough to attract a specialist to a small town.

"Our issue then becomes, OK, is a neurologist going to move to Woodward?" he said. "Using (telemedicine), we still get to serve the rural areas."

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