There is a shortage of Dermatologists in North Dakota. To get an appointment with a Dermatologist in the state capitol of Bismarck, there is a five to six month wait.
On January 25, 2018 I noticed that I had a new mole on my right shoulder. This mole was different than the other mole that I have had on my shoulder for the past thirty-two years, because this new mole appeared so suddenly, was dark in color, and it had a rough unhealthy looking surface.
From the television commercials that I have seen, and from reading about skin growths on the internet, I believed that this was very likely a melanoma. A melanoma can be benign or malignant, meaning noncancerous or cancerous. You need to have one checked right away, especially if it is dark in color, or has an irregular shape and appearance.
On February 2, I began searching for a Dermatologist in Dickinson, North Dakota and I found that there isn’t one. This is kind of bad, because Dickinson has a population of about 25,000 people, and it is the largest town in southwest North Dakota.
I found that the nearest Dermatologists were in the state capitol of Bismarck, 100 miles to the east of Dickinson. In Bismarck, there is the Mid Dakota Clinic of Dermatology with three Dermatologists, and two Nurse Practitioners. I thought to myself, “Good, this is exactly what I was looking for.”
I telephoned the Mid Dakota Clinic of Dermatology, and I requested an appointment with Mark Ebertz, MD. I was told, “Mark Ebertz is not accepting any new patients, you can choose to make an appointment with either of the two Nurse Practitioners, or one other MD, but their next available appointment is in August.”
I thought to myself, “February, March, April, May, June, July…that’s six months before I can even see a Dermatologist, and I need to get this melanoma mole looked at and removed right away!”
The administrative person at the Mid Dakota Clinic of Dermatology was not rude in any way, but I was very angry, and I ended the telephone call with her. I could not believe the absurdity of having a melanoma, and a Dermatology clinic wanting you to wait six months for an appointment. What kind of skin problem could a person have, that they could figure on waiting for six months to receive any kind of treatment?
I was very, very angry. I write and write about this, but I don’t think that I ever truly convince people how backwards North Dakota is. I thought about this for few minutes at the time, before continuing to try to find a Dermatologist in North Dakota.
I still want to give a big Fuck You!, to the Mid Dakota Clinic of Dermatology. I hope that Dr. Mark Ebertz has some kind of life threatening emergency, where he needs the police, fire department, or paramedics to show up, and they tell him, “We are kind of busy, we aren’t accepting new calls at this time.” Or anything that he needs done, everyone tells him, we can’t help you for six months.
I went on to telephone Sanford Health. I telephoned the Sanford Health in Dickinson, and they told me that they did not have a Dermatologist in Dickinson, to call the Sanford Health in Bismarck. I telephoned the Sanford Health in Bismarck, their Dermatology Clinic, and I was told that the earliest appointment that this particular clinic had was in April, but I could try calling their other Dermatology Clinic. At the second Sanford Health Dermatology Clinic, the next available appointment was in September.
I called an older relative of mine who had had a skin growth surgically removed from his shoulder, to ask him about it, how much did this cost? He said to me, “You can’t wait this long, you need to get this taken care of right away, it sounds like you are going to have to go to a different state to have this done.”
I looked up on the internet, a Dermatologist that I had seen in Idaho seven or eight years ago. This Dermatologist surgically removed a small carcinoma from under my eye for about $140, which required stitches. This was not a big deal for him, or difficult for him, and he did a very good job, not leaving any scar.
I telephoned his office in Idaho, and he had appointments available each week in February. I explained that I was working in North Dakota, and I could not get this taken care of in North Dakota. I explained that it was a twelve to fourteen hour drive one way to get there, I would have to drive there to get this melanoma removed, and then drive right back to North Dakota to return to work on time.
I e-mailed to the Dermatologist in Idaho, three photographs of my melanoma mole. I followed up with a phone call to the Dermatologist administrator, saying that I didn’t want a biopsy, and that I was not looking for a preliminary visit prior to surgery, that I needed to get this melanoma mole surgically removed, and then drive right back to North Dakota. The expected cost was $300 to $800, depending on how much they had to cut out.
I am not looking forward to this twelve to fourteen hour drive to Idaho, and the twelve to fourteen hour drive back to Dickinson, North Dakota. The gasoline cost alone will be $350. The weather this month has consistently been below 0 degrees Fahrenheit. I know that the interstates will be snowy and icy the whole way. If my vehicle breaks down, especially at night, I will be in a very dangerous situation, due to the extreme cold weather.
Dickinson58601 
You do NOT know that this is a melanoma (unless I didn’t read carefully) so take a breath. It does sound highly suspicious and you are very correct to take it seriously. Do not waste time and money driving to Idaho. Most certainly there is an MD over at St. A or Sanford who will be able to cut it out and send it to the lab. Hopefully it is benign (and there’s a good chance it is). If it isn’t, then you can go see the dermatologist in Idaho. I agree it is lousy there aren’t more doctors in ND, but I don’t want to argue with you about any of that right now because I know you are worried about your health.
P.s. I had a melanoma. I definitely understand.
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S,
I have had a couple of moles, and a couple of carcinomas in the past. I had this Dermatologist in Idaho look at everything, he seemed very competent, he removed two growths, and he did not charge me very much money. I would have liked to see him as soon as possible this time, for this melanoma mole, but he is so far away.
I just can not afford to waste any more time trying to see a medical doctor in North Dakota. I have been through this before, trying to get medical and dental treatment in North Dakota, and what would be a completely normal thing to do in another state, is nearly impossible to accomplish in Dickinson, such as seeing a dentist, optometrist, or dermatologist. Sanford Health in Dickinson does not even have a Dermatologist, there is no Dermatologist in Dickinson.
I will write a blog post about this in the near future, my former landlord, had one preliminary medical appointment after another at Sanford Health and St. Alexius in Dickinson prior to a surgery. He had about six preliminary visits and tests, totaling about $5,000 to $6,000. Then they gave him a run around to avoid the surgery that he needed, no one actually wanted to perform this surgery. This has been going on for more than one year, and still no surgery.
I am not about to get involved with this preliminary, preliminary, preliminary medical appointments procedure at the clinics in Dickinson where you get billed again, and again, and again, so that they can pay for their administrators, medical staff, facility, and overhead, yet nothing gets done, like they did to my former landlord. Go and read the Google customer reviews for the St. Alexius Hospital in Dickinson, it’s the same thing.
Also, I am going to write about how the Sanford Health clinic in Dickinson keeps saying to people, “…when you see your primary care physician..,” They may as well be saying, “…when you see someone who gives a shit…” or “…when you see someone who knows what they are doing…” For many or most people in Dickinson, especially people who do not have health insurance, they seek medical treatment only when they are sick or injured, the only place that they can quickly get medical treatment is at the emergency room or the Sanford Health clinic, they have no “primary care physician”, they only seek medical treatment in an emergency.
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While all that may be the case, you can still get this thing removed and analyzed so that you can decide what to do next. Maybe you’ll be lucky and it’s nothing. Years after my melanoma I developed a weird spot that turned out to be nothing major at all, though you can bet I was already planning for the worst. It turned out to be nothing and hopefully yours is nothing major as well.
Just go get somebody to remove it. They may not have the finesse of someone who does that regularly (like a derm. or a surgeon), but virtually all of them have to learn to excise a mole and can do that for you.
Of course I agree that it’s not optimal. You can’t do anything about that right now, but you CAN put your mind at ease. Just go in making it clear you’re there to have a mole removed and examined.
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S,
It is one week to my appointment in Idaho where my mole will be surgically cut out by a Dermatologist. From previous experience, I doubt that I could get an appointment anywhere in North Dakota to be seen within a week, and no matter how strongly I explained and emphasized to an administrator that I needed to get this mole removed, I would show up to an appointment in North Dakota and it would be a “preliminary visit”, then they would schedule me for my next appointment four weeks from then or later.
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Let us know how it goes. I pray it is nothing big.
Regarding the medical is Dickinson, I’ve had good experiences and bad. I agree that oftentimes it seems disorganized at St. A (I have not experienced that at Sanford, but have not been there more than a couple times and those were satisfactory). The most annoying experience for me at St. A was the check-in process. Last time I was there was…early 2017, early Spring. I stood at the little sign, the one that reminds you to stand back for others’ privacy or something like that. I waited to be summoned over, because all the women working had their heads down or were working with somebody else. The one on the far end, that would be the cubby on the end, the north wasn’t working with anybody, but had her head down apparently doing something. She mumbled something I couldn’t hear, as I was standing where I was supposed to wait, courteously. Then she yelled something to me, apparently annoyed that I didn’t realize she was mumbling to ME (with her head down). I walked over and asked her the question I had and found it humorous that she had some kind of b.s. customer service award in a frame next to where she was sitting. She was not an impressive person, not by a mile. I don’t remember her name, but she was on the young side, certainly under 35. I think it is difficult to find and keep good people who’ll work hard and also have nice social skills.
Again, good luck with your mole.
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