This can be an indication of a blockage in the bile duct or loss of liver function. A year is a long time to deal with this. Have you been seen or had any tests done?
By the way, even in major metro areas with great medical systems, Registered Nurse Practitioner or Physicians' Assistants are the first line for most care, even specialty care. If it were otherwise, waits to see specialists or have procedures done would be even longer.
And I will never minimize the good work these primary caregivers provide. One just recently detected a heart blockage that had gone unrecognized as such for over 3 years.