Las Vegas Sun

March 28, 2024

Report: Shortage of doctors still a problem in Nevada

CARSON CITY -- A record 538 doctors were admitted to practice in Nevada last year but that still isn't keeping keeping pace with the population growth, the state Board of Medical Examiners said.

In its annual report released last week, the board says the current ratio of 161 physicians for every 100,000 population is "well below the national average," said Tony Clark, the board's executive director.

"In some states, there are 200 per 100,000," he said referring to the ratio of doctors to the population.

The 538 doctors who obtained their Nevada medical licenses last year include individuals who live in other states, according to the board. The number of licenses also does not reflect the number of doctors who are actually practicing medicine, a statistic the medical board does not track.

The U.S. Census Bureau reported that in 2002, Nevada was 47th in the nation with 174 active and inactive physicians per 100,000 population. Idaho was last at 161 doctors, California was 15th with 252 doctors and Massachusetts was tops with 427 physicians for each 100,000 residents. According to the Census, the national average is 256 physicians per 100,000 population.

The Census ratio is different -- and more relevant -- than the one reported by the medical examiners board because the board counts only the 3,879 actively licensed Nevada physicians, not the 898 doctors in 2004 who were inactive or retired.

Larry Matheis, executive director of the Nevada State Medical Association, said high medical malpractice insurance rates had held back the growth of the physician ranks in Nevada. Because of the high rates, physicians declined to come to the state after completing medical school or residency, Matheis said.

But, Matheis also said, "even before the (malpractice) crisis, we were not keeping up."

According to the state board's figures there were 411 newly licensed doctors in 2000 and that fell to 383 in 2001 and then to 335 in 2002. But then it bounced back in 2003 to 422.

Gov. Kenny Guinn convened a special session of the Legislature in August 2002 to grapple with the malpractice problem. Lawmakers adopted several changes, including a $350,000 cap on pain and suffering in medical malpractice cases.

The hope was that by capping judgments, insurance companies would be able to forecast their costs and lower their rates for medical malpractice insurance.

Doctors were also successful in defeating two measures on the 2004 election ballot that they said would have renewed the upward spiral of medical malpractice insurance rates. One question would have allowed a person to recover unlimited damages in a court trial and the other would have changed insurance rates.

Matheis said the Legislature was "very responsive to us" and the voters backed the doctors on the ballot questions.

Dr. John McDonald, dean of the University of Nevada Medical School, said Tuesday the Legislature "gave us a fantastic opportunity to accelerate the production of physicians." The Legislature accepted Guinn's recommendation to increase the number of residency slots by 16 this first year of the biennium and by 32 the second year of the biennium, he said.

There are now 220 residents training in Nevada at hospitals.

"We have the smallest number of trainees of any state with a medical school," McDonald said.

He said Nevada has nine residents in training per 100,000 population. Other states with medical schools have two and three times that number, he said.

Residencies are important to Nevada, McDonald said, because 70 percent of those rookie physicians stay in the state after completing their training. In contrast, the four-year medical school graduates 52 students a year but only 40 percent practice in Nevada.

These residents will be trained in Las Vegas and Reno in such fields as family medicine, internal medicine, obstetrics and psychiatry. And the school is starting a program in child psychiatry.

There are generally less doctors in the West than in other parts of the country, McDonald said. And adding to the problem is the fact that physicians are retiring earlier, McDonald said.

McDonald said the Legislature also allowed for money to be spent on increasing enrollment at the medical school. The medical school budget will go from $23 million in 2004 to $33 million in 2007, the dean said.

Matheis is in Chicago this week attending the national conference of the American Medical Association. He said he is there partly to spread the word that the problems with medical malpractice insurance have simmered down -- and that physicians might consider Nevada a good place to set up shop.

While there have been improvements in numbers, there are still critical shortages in some specialties. This is especially true in Las Vegas, Matheis said. There are many young families and also a lot of senior citizens moving into Clark County.

"In Southern Nevada there is a need for obstetrics and pediatric care," Matheis said. There is also a shortage of surgeons, he said.

McDonald agreed. "We don't have the specialties we need," he said, adding that the residency program will be focused on filling those ranks.

The dean also praised the more than $800,000 in the state budget in the 2007 fiscal year to help staff the Lou Ruvo Center for Alzheimer's Care and Research in Las Vegas.

McDonald said he intends to hire the best physicians to make this a world-class center.

"People want to live where there is good medical care," the dean said.

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