Wednesday, June 5, 2002 | 11:19 a.m.
CARSON CITY -- Gov. Kenny Guinn's plan to lower the standards for admission of obstetricians in Nevada received a cool reception Tuesday from members of the state Board of Medical Examiners, including one who called it "shortsighted and dangerous."
But the board avoided a showdown with the governor by tossing the issue into the laps of the Clark County Commission to decide if there is a shortage of obstetricians and gynecologists in Southern Nevada.
Dr. Stephen Montoya, a board member and an obstetrician from Las Vegas, said he was "shocked" at the governor's proposal that would "cheapen the profession." Montoya said obstetricians must be highly trained and that the governor does not understand this.
Montoya's statements were the strongest by board members, who said they did not think the plan by Guinn would bring much-needed doctors to Clark County. Montoya said he has talked with four of the major hospitals in Las Vegas, which would not lower their standards to accept physicians to practice with only one year of residency in obstetrics.
The board unanimously decided to write a letter to the Clark County Commission asking whether it considered the area underserved by obstetricians and gynecologists. If the county commission makes that finding, the examiners board will hold another meeting to determine if the standards should be lowered.
Marybell Batjer, chief of staff for Guinn, said she was satisfied with the board's action. She said the numbers will show that Southern Nevada does not have enough baby doctors to take care of the estimated 25,000 births a year. There are 90 to 100 obstetricians in Clark County.
Guinn petitioned the board to reduce the residency training standards from three years to one year in hopes of drawing more baby doctors to Southern Nevada to head off a possible crisis if threats by obstetricians and gynecologists materialize.
Many have said they will give up their practice, retire or move to another state because of the rising medical malpractice premiums. Since January, only two obstetricians have notified the medical examiners board they are giving up their licenses. And 12 have been newly licensed.
Batjer said there are reports that "significant" numbers might leave, and she added the governor doesn't want to wait for a critical situation before taking action.
State Health Administrator Yvonne Sylva told the examiners board, "We don't need pregnant women delivering in ambulances without prenatal care."
Montoya told the Guinn administrators he appreciated the governor's attempt to solve the crisis but said he thinks a special session of the Legislature is the only solution to pass a law limiting court awards against doctors found liable for malpractice.
Batjer said the governor does not want to let unqualified doctors into Nevada. She said the rules were waived for some physicians for rural Nevada and that no incidents were reported there.
Donald Baepler, a board member from Las Vegas, said Nevada has high standards and the board takes great pride in them.
"We're willing to cooperate without comprising the integrity of the profession," he said.
Outside of the meeting, Baepler said he doubted the Clark County Commission would take action in an election year when it is faced with the stiff opposition of obstetricians who oppose reducing the standards.
Dr. Paul Stewart, a board member from Las Vegas, said there is a crisis but he's not sure the suggestion of the governor would help solve the problem. This is a problem of pregnant women getting prenatal care, not one of lowering the standards of the profession, he said.
He suggested that 10,000 to 14,000 women may not receive prenatal care as doctors leave or limit their practice.
"There must be a way to get women access," Stewart said.
State Human Resources Director Mike Willden said the state insures 35 to 40 percent of the births in Nevada with its programs such as Medicaid and Baby Your Baby.
Willden said the Baby Your Baby program, which refers pregnant women to doctors, once had 74 physicians enrolled but that number has dropped to 31 who will take the cases.
"That's a great concern to us," he said.
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