Dean of medical school plans to increase professional base

Aaron Clemens

Monday, July 3, 2000 | 11:44 a.m.

We've got a problem, and he wants to solve it.

Robert Miller, dean of the state's only medical school, hopes to fix the chronic shortage of health professionals in Southern Nevada. He took the top job at the University of Nevada School of Medicine six months ago, envisioning a facility that can train future doctors, and possibly dentists, pharmacists and nurses.

In Clark County, the ratio of doctors to residents is more than 42 percent below the national average, while the nurse-to-patient ratio is 13 percent below the average, according to a study done last year for the state Legislature.

Las Vegas is the largest metropolitan area without a research-based academic medical center besides Phoenix, Miller said, but there is one just south of Phoenix in Tucson.

The Clark County-run University Medical Center, where medical students currently train, is not a research facility.

Although a large research-based academic medical center in Nevada would be a large investment, Miller says it's one that likely would pay off. The Texas Medical Center in Houston contributes $10 billion a year in economic activity to the area while serving as the state's medical training facility, he said.

Getting the idea off the ground will require convincing people that the medical school has its financial house in order. Under the previous dean, the school was rocked by financial difficulties stemming largely from poor billing practices.

Miller, a head and neck surgeon formerly second in charge at Tulane University's medical school, has set out to solve the financial problems he inherited. He has hired a chief financial officer for the school, Terry Duffey of the University of Illinois.

Regent Mark Alden, a businessman and chairman of the university Board of Regents' audit committee, thinks the new CFO was an excellent hire. Miller's master's degree in business administration from Tulane also promises that competent business management will be in the medical school's future, Alden said.

The school's clinical teaching program already has made significant progress. It has gone from an annual $2.6 million loss to a $2.4 million gain by simplifying the billing system, David Schapira, senior associate dean, said. The program is funded by fees patients pay for care by physician teachers.

With the balance sheets in the black, Miller can turn his attention to raising the money to build the medical center he envisions.

Alden thinks he can do it. Miller, he predicted, will "raise a lot of money for a Houston-type facility."

Thalia Dondero, chairwoman of the Board of Regents and founder of the Regents Health Care Education Committee, also is optimistic.

"When I look at what we're planning ahead, I'm very excited," she said.

The first significant contribution came from the city of Las Vegas when it agreed to give the medical school 10 acres in its technology park off Tenaya Way and Cheyenne Avenue.

The proposed medical center site in northwest Las Vegas has caused some consternation, however. MountainView Hospital, a competitor of UMC, is already in the technology park.

Suggestions for the Tenaya location have angered UMC Chief Executive Officer Bill Hale.

"They need to do this near UMC, where their patients are," Hale said. "Why would a doctor want to work six hours and drive a half-hour away to do research?"

Ten months ago Hale threatened to ask the Clark County Commission to abandon the hospital's relationship with the medical school and partner with another educational facility.

He never did, and Miller said he has no plans to reduce collaboration with UMC. He has invited Hale to participate in an upcoming strategic planning session with the group that will decide the medical school's future plans.

Miller said UMC won't come out a loser under the plan.

"We want to expand the number of residents by expanding or developing new partnerships," he said.

Schapira said the medical center may not end up at Tenaya and could possibly be part of the current facilities.

"The most important thing is the faculty," he said. He pointed out that the medical school has added a pulmonary medicine department, raised the trauma unit to the highest possible level and added kidney, pancreas and liver transplant capability.

Schapira praised the new internal medicine department chairman for his work to more than double the size of the former staff, which had nearly all resigned after the last dean fired the department chairman.

Miller also pointed out various strengths he noticed in the past six months. Seven graduates will go onto residencies at the prestigious Mayo Clinic and the school has an enviable 100 percent passage rate for the U.S. Medical Licencing Exam over the past three years, he said.

Miller is flexible about future innovations. Technology may allow Las Vegas to develop an academic medical center without one centralized location like Houston's 600 acres, he said. Real time data and video teleconferencing for connecting doctors with each other already have been installed at nine rural sites as well as three in Reno and two in Las Vegas.