Friday, Sept. 9, 2005 | 5:56 a.m.
Jon Ralston hosts the news discussion program Face to Face on Las Vegas ONE and publishes the Ralston Report. He can be reached at (702) 870-7997 or at [email protected].
WEEKEND EDITION
Sept. 10-11, 2005
If there is such a thing as a triple oxymoron, the phrase "academic medical center" fits the definition when it is used in Las Vegas.
The word "academic" rarely crops up in stories about Southern Nevada, despite the herculean efforts of UNLV's Carol Harter and others. The thought of the city being talked about vis a vis medical care or research would be laughable to most, despite the progress created by the likes of Nevada Cancer Institute visionary Heather Murren and others. And the valley as the center of anything other than an escape for all manner of sinners is a conceit that surely would draw derision outside of Nevada, despite the hopes of many cultural paladins such as performing arts advocate Don Snyder.
But now, thanks to Mayor Oscar Goodman starting the debate and last week's local hospital proposal fueling it, an academic medical center has become potentially less oxymoronic.
The idea has come a long way from a mayoral musing, partly based on his son, the doctor, coming home from the East Coast, to two internationally known facilities considering the possibility (Cleveland Clinic and University of Pittsburgh) to the Nevada Hospital Association presenting Chancellor Jim Rogers on Friday with a bombshell that includes $45 million in annual funding. What's equally significant is that the colloquy now has crystallized the sectional feud over the state's medical school that has made northerners as territorial as ever and southerners as covetous as ever of a facility that more than ever seems based in the wrong part of the state.
The hospitals generally are not sympathetic figures and their motives may be as self-serving as His Honor's or the out-of-state companies. The local hospitals (and the doctors who work there) also do not fit well into the victim's costume, mewling as they have been about the outsiders coming into their oligarchic world where record profits is hardly an oxymoronic phrase.
But their proposal is real, no matter their motivation, and includes the so-far quiescent medical school as a key component of any academic medical center.
"Before we can expect to recruit the quantity and quality of faculty that become the backbone of this effort we must collectively elevate the role of the University of Nevada School of Medicine in the daily application of health care in this state as well as quickly promote its successes to funding partners and prospects in the public, private and non-profit sectors," the hospital proposal says.
One reading of this is a call to Harter, UNR President John Lilley and even Rogers to decide if they really are committed to an academic medical center with a truly academic component. That is, are they willing to commit to a medical school, which inexplicably and sadly has stayed on the sidelines, becoming a full player in this endeavor?
For the School of Medicine, this is a call to be part of the solution or to stay out of the game. And whether it's in Las Vegas, where it should be, or Reno, where it is, the medical school cannot let this challenge go unanswered.
The fiscal component here, too, cannot be ignored. The hospital proposal's $45 million would pay for a tripling in residency, intern and fellowship slots, expanded programs in a variety of research areas and a health science center on the med school's Shadow Lane campus.
This is nothing short of brilliant, substantively (that's a lot of money) and, especially, politically.
Goodman and the city have followed the same roundheels development philosophy with the academic medical suitors as they have with others who want to come downtown -- if you come, we will lie down for you. No tax incentive is too high, no deal is too sweetheart.
No wonder Pittsburgh is so interested -- the city's memorandum of understanding would promise hundreds of millions and make Pittsburgh contribute ... nothing. Such a deal.
But when Rogers, to his credit, stepped in and labeled rape what the city considers consensual sex, that gave the local folks their opportunity.
Goodman and the outsiders had been counting on the stigma Nevada's medical community has operated under for so long (Where do you go if you get sick in Las Vegas? The airport!). But strides have been made, albeit quietly, by Murren, Larry Ruvo's Alzheimer's clinic and the slow migration of expert physicians in various specialties, many of whom are here despite the much-ballyhooed medical malpractice crisis.
Now that the hospitals have volunteered to pony up $45 million -- did I mention those record profits? -- they have put Pittsburgh and local officials in a bind. How do Rogers and Goodman accept any offer from Pittsburgh, with no money attached, when they have the hospitals willing to fork over $45 million. And how do the Pittsburgh folks, who have expected the city (that means taxpayers) to write them a blank check, now refuse to find their checkbooks?
It will be interesting to see how the North-South aspect of this plays out, especially since the hospital association is dominated by Southern Nevada members.
Some Renoites will be paranoid that this is yet another example of southerners trying to suck money and prestige from the North and they will besiege their political protectors for aid and comfort. But even if they are right, why shouldn't Las Vegas, which has the largest hospitals, be the locus of academic medical research?
If Goodman deserves credit for starting the discussion, the hospitals merit kudos for all but ensuring an academic medical center becomes a reality.
This is a classic case of the motivations of everyone involved becoming secondary to the goal. And no matter how self-interested all of the parties are here, they may make this triple oxymoron a reality.
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