Medical school could lose its insurance

Jennifer Knight

Monday, March 25, 2002 | 10:58 a.m.

Nevada's only medical school will lose its malpractice insurance July 1, and if replacement coverage is not found, the medical care of thousands of patients treated by faculty and residents could cease, university officials said.

"We're talking about thousands of patients," said Stephen McFarlane, dean of the University of Nevada School of Medicine, which operates both in Reno and Las Vegas. "It is very serious. This could close down the medical school if we don't find a solution to this."

The medical school is insured by the St. Paul Cos., which sparked the current malpractice crisis in Nevada when it announced it would stop offering medical coverage this year as policies expire. St. Paul covered 40 percent of the state's doctors.

School officials are exploring including the school's teachers and students in the state's emergency coverage, due to go into effect April 15, or covering them as county employees, as trauma doctors at University Medical Center recently were.

Lawsuits filed against doctors working for the county or the state are capped at $50,000 an incident.

Doctors working full time and part time for the university's medical school as well as residents qualify for the same immunity, but volunteer physicians would not be covered, Lisa Davis, chief operations officer for the medical school said.

Officials also are pricing policies with other companies and estimate premiums, now $1.23 million a year, could rise up to 200 percent.

The loss of insurance at the medical school -- and the possibility of losing the services of its faculty and residents -- illustrates the integral role the school has quietly assumed in the state's health care,

"There's a second-tier crisis that is just coming now and it's going to be the hospitals and the medical school, and the effects of that on the community will be great," Larry Matheis, executive director of the Nevada State Medical Association, said.

The school has branches all over the state, most notably at the University Medical Center in Las Vegas, where residents gain clinical and practical experience. University medical school faculty and residents also serve indigent patients, women's outpatient clinics, rural areas and numerous other segments of the population, Davis said.

"It's staggering how many areas we serve," Davis said. "There are very few parts of the population that we don't touch."

In Las Vegas alone 500,000 patient encounters are handled each year by the medical school. Another 125,000 are handled annually in Reno. Encounters can include follow-up visits by the same patient.

Since all hospitals and patient health insurance policies require doctors to carry malpractice insurance, those who are not covered would not be able to serve patients, Davis said.

The resulting patient load would either shift onto remaining doctors or would cease altogether, she said.

The medical school's malpractice insurance currently covers 250 full-time faculty, 150 part-time faculty and 192 medical residents, 125 of whom are in Las Vegas.

But the lion's share of practical experience provided to doctors-in-training is done by 1,100 doctors who volunteer their time and open their practices to teach residents. All cases related to work for the medical school are covered by the university's insurance.

"The problem for us is no one will be covered and we have great concerns that we will not have volunteers taking our residents and students," Davis said. "If coverage goes away, what would be their motivation to take our students?"

If none of the solutions pans out, the repercussions would be hard to imagine, Matheis said.

"It would be tragic for Nevada if the school of medicine would have to cut back on their involvement in the community," Matheis said. "I'm not even prepared to contemplate that it might not exist. It's got to be a part of the future of our state."