In Business Las Vegas, November 24th, 2006
Physician residents in Valley Hospital’s new program seem bright and enthusiastic, even though they work 10 to 12-hour days and often sleep in tight quarters at work.
They’ve been recruited to a city that desperately needs them. When they complete their training, which takes at least three years, the residents expect to be welcomed with open arms into practices and have plenty of patients to see.
“I’ve made up my mind (to stay in Las Vegas) if things go the way I think they will,” said Darren Wirtz, a Colorado native who is in Valley’s internal medicine program. “There’s nothing but positive energy here.”
That must sound nice to health care leaders struggling to bring in enough doctors to care for the rapidly growing population in Nevada, especially around Las Vegas.
Nevada sits at the bottom of most lists that rank states for the number of medical professionals per capita. Just one example: Nevada was last, according to the American Academy of Family Physicians study last month that looks at the need for family doctors.
This state has 895 family doctors, it said, but it will need 1,599 by 2020, a 79 percent increase. As with most of Nevada’s problems, the shortage is mostly blamed on growth.
“This is not a new issue,” said Bill Welch, head of the Nevada Hospital Association. “The hospitals in the state have had fulltime efforts on this for quite a few years. Historically it’s been a problem for 20 years.”
As of lately, the movement to recruit doctors is ramping up.
Not only will leaders plead with the Legislature for more money again next year, but Valley Hospital has launched a program that will transform it into a teaching hospital.
The first class of residents in family practice, internal medicine, ophthalmology, dermatology and traditional (one-year rotation) programs started this year.
Dr. Dean Milne, its residency program director, is interviewing candidates this fall for 32 open positions. About 100 have applied, many of whom are medical students from Touro University who have been learning hands-on techniques at Valley.
Touro, a private college that recently opened its Henderson campus, is also helping to solve the doctor shortage. Its doctor of osteopathy graduates are being encouraged to take residencies at Valley Hospital, then stay in Las Vegas.
“Too many (prospective doctors) leave and don’t come back,” Milne said. “This is an opportunity to train our sons and daughters in Nevada. It’ll work.”
Valley hopes to grow its program to about 100 residents in the next two years, and it has plans to add fellowships, the programs following residencies that train doctors in specialties like intensive care medicine.
But in two years, it will run into a problem that is being faced at most resident hospitals, Welch said.
The federal government stops subsidizing resident slots — typically $60,000 a year, each — after three years. So any new programs started after three years, such as the new emergency medicine program at University Medical Center, have to be funded entirely by the hospital.
“It’s pretty hard to determine what you’re going to need 10 years down the road,” Welch said. “It’s pretty restrictive.”
UMC, which is run by Clark County, also has major expansion plans. It currently has 210 residents but aims to reach 450 to 500 residents in a decade, said Dr. Jim Lenhart, vice dean of the University of Nevada School of Medicine.
That will take money. Besides normal operating expenses, the school will ask for $14 million more to expand training for medical students and residents, Lenhart said. That would open up spaces for more faculty and more students.
That amount will compete with a larger request for buildings for a Health Sciences Center: $126 million in Las Vegas and $75 million in Reno.
The hospital association would prefer that the training budget have a higher priority.
“It would be wonderful if they could get 100 percent of what they’re asking for,” Welch said. “But there’s a lot of brick and mortars in there.”
Hospitals have offered to share their existing space for training, Welch said. State funding “needs to go into expanding overhead costs to drive residency training,” he said.
More hospitals, such as the nonprofit St. Rose Siena in Henderson and St. Mary’s in Reno, have expressed interest in starting residency programs, Welch said. Those might also need money from the state.
Then, even if a good number of rograms are set, Las Vegas medical eaders might also run into the issue hat many professional recruiters run nto. Will doctors want to stay in Las egas, given the lifestyle?
“I think recruiting will be difficult ut in general it’s difficult for medical chools to recruit,” Lenhart said. “I on’t think it will be any more difficult. People are beginning to see that Las Vegas is an A-OK place to live.”
As for the new residents at Valley ospital, a couple of them said they re not attracted to the Sin City reputation but it does not bother them.
“I think you can lead a normal, ealthy life in Las Vegas,” Wirtz said. It’s diverse enough."
