Local doctors question changes in training rules

Monday, June 3, 2002 | 10:51 a.m.

CARSON CITY -- The president of the Clark County Medical Association wants local doctors to have a say in whether training standards are reduced for obstetricians, as proposed by Gov. Kenny Guinn in the face of the medical malpractice crisis.

Dr. Raj Chanderraj said today he will ask the governor's office to have a televised hookup to Las Vegas for Tuesday's meeting of the state Board of Medical Examiners, which is to consider Guinn's proposal. The meeting is in Reno.

Chanderraj said all of the obstetricians in Southern Nevada oppose reducing the licensing requirements because it will mean reduced care.

Reducing standards for obstetricians is a Southern Nevada issue, Chanderraj said, and physicians want a voice.

Guinn said he has not talked with Chanderraj as of this morning.

The governor wants the board to waive the requirement that an obstetrician or gynecologist must have three years of postgraduate education or fellowship training before being admitted to practice. He suggested there be a regulation for one-year residency, five years of practical experience and completion of other licensing requirements.

Some board members said privately outside the meeting that Guinn's proposal presents some problems. The doctors are opposed to reducing the standards; and there are questions about whether the hospitals would use doctors with less training and whether companies would insure them.

Guinn made the suggestion in an attempt to draw more obstetricians to Southern Nevada, which is already underserved and faces the loss of existing physicians because of the medical malpractice crisis.

Malpractice insurance rates have risen dramatically, especially for high-risk specialties such as obstetrics, since the state's largest insurer pulled out of the market. Doctors say they will retire or leave the state because they cannot afford the rate increases.

Guinn said today there are 8,000 to 10,000 pregnant women in Southern Nevada. If the obstetricians leave, as threatened, there would be a crisis.

"It would help tremendously if we get five, 10, 15," more obstetricians, Guinn said today. "I'm looking ahead."

If too many doctors end their practices, Guinn said, the only alternatives are midwives, home delivery or leave the state for medical care.

Chanderraj made a plea to the medical board Saturday to hold some of its meetings in Las Vegas, where the majority of physicians live, but board members expressed resistance, citing increased cost, problems with transporting records and poor attendance at previous Las Vegas meetings.

They also have resisted television hookups, noting a cost of $40,000. Legislative committee meetings routinely are telecast between Carson City and Las Vegas.

The board did not hold a meeting in Las Vegas last year and will not this year. It traditionally meets at its headquarters in Reno.

Board member Donald Baepler of Las Vegas told Chanderraj the public never attended the meetings, which are usually held on Friday and Saturday, when they were held in Las Vegas.

"The doctors tend not to come and sit through the meetings," Baepler said.

"That's true," Chanderraj said. "But recently physicians have seen the squeeze" in malpractice insurance, and have become more active. Doctors showed up in force at a meeting of the state Insurance Division on the malpractice issue, he said. The Carson City meeting was teleconferenced to Las Vegas.

Board member Marlene Kirch said those who complain seldom attend meetings. She said the agendas of the board are posted and the doctors are free to fax or send correspondence to the board.

Other members told Chanderraj could contact the four members from Southern Nevada if they wanted to relay their concerns to the board.