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Tuesday, Sept. 29, 2009 | 2 a.m.
Dr. Ron Kline says local providers had chance with brain institute.
Mayor Oscar Goodman is impatient with local medical community.
Sun Archives
- The city's budding love affair with the Cleveland Clinic (9-24-2009)
- Medical community embraces alliance (2-18-2009)
- Ruvo’s dream becomes real (2-17-2009)
- Ruvo's mission is bold, driven by love (2-17-2009)
- Gehry's design elevates awareness of Alzheimer's disease, research (2-17-2009)
- In Cleveland, patients are priority (2-17-2009)
- Aiming to revolutionize dementia research (1-7-2009)
- Brain institute thinking big (12-24-2008)
Sun Coverage
Lou Ruvo Brain Institute
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Local medical providers who grouse about the Cleveland Clinic’s burgeoning presence in Las Vegas should remember: They had their chance.
That’s the history lesson offered by Dr. Ronald Kline, president of the Nevada State Medical Association, the state’s largest organization of doctors.
Before Cleveland Clinic came to Las Vegas, the University of Nevada School of Medicine was going to run the then-named Lou Ruvo Brain Institute. That deal fell through after four years, opening the door for the Cleveland Clinic, which in February took over the clinical and research operations of what is now named the Cleveland Clinic Lou Ruvo Center for Brain Health.
Cleveland Clinic is now looking to expand its operations in downtown Las Vegas’ Symphony Park, possibly aided by a land donation from the city. The Cleveland Clinic’s expansion from outpatient treatment for brain disorders to other types of treatment would likely cut into the paying business of local doctors and hospitals.
Some doctors are grumbling about the Cleveland Clinic’s motives. One local doctor who did not want to be named said, in so many words, that no one should think that the Cleveland Clinic’s arrival here is about fixing local health care shortcomings. It’s all about money, he said.
“They’re in a dying Midwestern city. It’s like a bad ‘Star Trek’ episode where people on a dying planet are trying to get off.”
The Cleveland Clinic is one of the nation’s largest hospitals and boasts a top-10 ranking by U.S. News & World Report in multiple specialties. President Barack Obama has praised the Cleveland Clinic as a model because of its high-quality and cost-effective care.
The local medical community has defended its turf from outsiders in the past.
In 2003, the Cleveland Clinic explored opening a hospital in Las Vegas. The University of Pittsburgh looked into starting a teaching hospital here in 2006. Both proposals were opposed by local medical providers.
Las Vegas Mayor Oscar Goodman, an outspoken Cleveland Clinic fan, said the dissent was rooted in doctors and hospitals trying to protect their profits. Now when local doctors tell the mayor they don’t want Cleveland Clinic expanding he tells them to “drop dead.”
Kline is a bit more constructive, suggesting that the critics — he was among those who opposed the Pittsburgh proposal — should remember their past shortcomings.
In 2004 businessman and philanthropist Larry Ruvo joined forces with the University of Nevada School of Medicine, which was to run the medical operations of the brain clinic.
What followed was a clash of cultures.
Ruvo thinks big. The businessman wants to make Las Vegas the worldwide epicenter for innovations in Alzheimer’s care and research. His father, Lou, died of the disease, and he is determined to change the way the medical community addresses brain disorders.
Ruvo enlisted world-renowned architect Frank Gehry to design an iconic building to serve as the Brain Institute’s headquarters. The $100 million building, under construction in Symphony Park, would have essentially been given to the school of medicine.
But the partnership broke down in 2008. A source familiar with the situation said the school lacked the leadership, money and vision to help the joint endeavor thrive.
Dr. John McDonald, the school’s dean at the time and now vice president of health sciences at the University of Nevada, Reno, said it came down to the medical school not being able to satisfy the Ruvo team’s requirements.
“We’re a small school with limited resources,” McDonald said. “It would have been very difficult to undertake the support of the center in a way they had anticipated.”
Cleveland Clinic is a $4.8 billion institution. In contrast, the University of Nevada School of Medicine has a budget of about $150 million, McDonald said.
“We’re a pea compared to their cantaloupe,” McDonald said, adding that he’s delighted by the new partnership.
Kline said the medical community opposed the Pittsburgh proposal because local doctors wanted a chance to prove themselves, showing that they could build a world-class institution like their out-of-state counterparts. After the Pittsburgh option failed, Kline helped lead an advisory committee of local hospitals, medical schools and doctors that explored developing a homegrown academic medical center. He said that once the outside threats went away, the group’s intensity fizzled.
Kline said he knows of no organized opposition to the Cleveland Clinic in Las Vegas, and hopes that if the clinic does grow it competes on a level playing field. Other groups won’t get free land, he pointed out.
But the local medical providers who don’t want the Cleveland Clinic growing in Las Vegas should remember the failed partnership with the school of medicine.
“Larry Ruvo wanted to hand the medical school a $100 million building and they couldn’t agree about how to run it,” Kline said, adding that he doesn’t know who was at fault in the breakup. “If the school of medicine runs (the Lou Ruvo Brain Institute) then there’s no Cleveland Clinic here.”
Sun researcher Rebecca Clifford contributed to this story.
RE: "They're in a dying Midwestern city. It's like a bad Star Trek episode where people on a dying planet are dying to get off."
Rochester, Minnesota is home to Mayo Clinic, no doubt another sleepy, "dying Midwestern city" with only about 65,000 people residing there. Cold winters, 21 below in January, certainly a boring place with no 24-7-365 entertainment. It must be a terrible place to focus on healthcare delivery day to day!
Without 24-7-365 climate, desert golf, world class entertainment weekly, luxury auto dealers, and the escort industry, yes, everyone must surely be dying in those places in the Midwest which have access to world class, branded healthcare.
Gaming Industry bundling and overdevelopment, lack of economic diversification, financial entrapment (i.e. loose mortgage lending), real estate speculation in residential property, poor leadership-expertise in the public sector (where should I start there, just indictments?) put Nevada into a Texas-80's deep recession.
The way out is (1) time, (2) commitment to economic diversity and the related growth in a skilled population that comes with that, (3) restructuring jobs growth into a more equitable private-public ratio, (4) restructuring the tax structure (which does not have to mean great big increases for residents), (5) stronger homestead restrictions on borrowing against home equity, (6) a non-resident tax on residential property ownership, (7) the Gaming Commission actually understanding the penthouse finance practiced by license holders, and (8) electing a Governor who is a pragmatic, progressive centrist.
As to healthcare and the dying Midwest, Texas is rightfully part of the Midwest, and in 2008 created 71 percent of all new US jobs. Why? 368 banks folded in Texas in the late 80s. The answer was commitment to diversity, both job and immigration, and higher education. Texas is getting the jobs because universities and graduates are performing.
Texans would welcome Cleveland Clinic's presence in the Lone Star State with open arms, a state already rich with other provider options.
Note to Doctors in Clark County who do not want Cleveland Clinic, or any reputable, branded healthcare provider in their profit zone: Brains are the new jobs in the US economy to come. The more brains you have around you, the better off you will be.
Big Kudos to Mayor Goodman for working efficiently and quietly to plub a big hole in Nevada, a hole that has been a money pit for a few doctors, but a dark place for many Nevada patients over the years.
atta boy oscar...
screw the money grubbing whore doctors...
just look at their pathetic response to the hepatitis epidemic...
pathetic...
absolutely pathetic...
you are the man oscar...
conversely...
the medical board is a failure...
the medical board is a complete and total failure...
louis ling is a failure...
louis ling is a complete and total failure...
tony clark was a failure...
tony clark was a complete and total failure...
district attorney david roger is a failure...
district attorney david roger is a complete and total failure...
attorney general catherine cortez masto is a failure...
attorney general catherine cortez masto is a complete and total failure...
monkey boy gibbons is a failure...
monkey boy gibbons is a compete and total failure...
the citizens of nevada are not safe...
our public officials are failures...
complete and total failures...
except of course for oscar!!!
There is an excellent read in the Sunday, September 27-09 Dallas Morning News about Dr. Bill Walton, a PCP for 30 years in Dallas, Texas with 3500 patients who is closing his practice to take a salary position three hours south at Scott-White, a referral hospital with several clinics around the state.
Google: Dallas Morning News, Bill Walton, Scott-White
Healthcare reform in Congress is absolutely mandatory for cost restructuring and insuring a supply of future doctors, especially PCPS.
Rural areas in Nevada (that can justify a doctor being there) particularly need salaried PCP(S) who work for branded, referral providers, so they have security to practice medicine right, and can direct-expedite their patient to the next step in diagnosis-treatment through direct communication to the referral system they work for.
That makes sense for the future of healthcare in America.
A billion thank you to Larry Ruvo and Mayor Goodman, men of vision, for working so hard to improve health care in Las Vegas. To hell with the clueless, incompetent, money hungry snake charmers that are doctors in name only!
As a native Ohioan, I know that everyone who lives in Ohio would choose to go to the Cleveland Clinic for all of their medical needs if possible. They are an exceptional hospital with a talented medical staff. We would be lucky to have a piece of them out here. I definitely wouldn't be defending a hospital in Nevada if the roles were reversed.
Thanks Oscar just maybe Las Vegans and Nevadans can get quality heath care without leaving the state.
Yes, Oscar Goodman's efforts to bring the Cleveland Clinic to Las Vegas are wonderful. The practical question is whether the Nevada medical community will only allow the brand name and the management style to function, while the Nevada branch of the clinic is staffed by doctors currently licensed to practice in Nevada.
The reason I ask that political question is that past articles in both the LVRJ and Sun have repeatedly stated that Nevada has a slow, complex licensing process for physicians, which many physicians who want to move to Nevada believe is designed to keep them out, and keep competition down.
I have no way to judge whether that is true, except by analogy. For at least 35 years, Florida has had laws and bar association fees expressly designed to keep experienced lawyers from moving to Florida. The Florida bar associations' big fear is that accomplished lawyers in their 40's and 50's will decide to move to the warmer climate and steal their volume of clients. In Florida, if you don't joint the bar association directly out of law school, becoming a Florida lawyer immediately after graduating, there are huge economic and regulatory barriers to joining the Florida bar in later years.
The reality in Cleveland is that it is beyond being a dying metropolitan area. Shaker Heights, once the Summerlin or Beverly Hills of the region, is now beset with foreclosures, abandoned houses, home prices in the toilet, crime increases and to put it politely "population change". My assumption is that many competent physicians from the Cleveland area would love to move anywhere else. Going to a community which has a Cleveland Clinic in it would be icing on the cake.
Here in Las Vegas, there are some wonderful, well educated, intellectual physicians who are the equal of anyone at prominent hospitals across the country. There are, at least, an equal number of mediocre quacks, half of whom speak English so poorly that most of us cannot understand them. I often wonder how the quacks pass Nevada's medical licensing process.
The medical community here in Las Vegas should wish that we be flooded with excellent doctors from Ohio, allowing the community to expect and receive a better standard of care, and pushing the mumbling quacks across the state line to somewhere else.
Thank goodness someone in the university system knows that just because someone offers you a "gift" doesn't mean you have to accept it. Without adequate resources to sustain such a venture, the School of Medicine (and thus the state) might have been saddled with another white elephant that the taxpayers would have to bail out. Do the math!! And, satisfying the wishes of wealthy Las Vegan's, albiet with good hearts and intentions, doesn't always benefit the masses. Self actualization comes at a cost to many..one only needs to look a the NSHE system former leadership.
Actually, I've often heard that for physicians, Nevada is a "last chance state." Doctors sanctioned or stripped of their medical license elsewhere, are able to "reappear" as licensed physicians in Nevada. I'll stipulate that I am not repeating what I know to be fact, only what I've "heard." Others with more knowledge about this, please weigh in, either way.
I have found in my own personal experience, the quality of health care to be very poor, here in Las Vegas. I absolutely applaud the Mayor for his second and third efforts on this hugely important thrust -both for the welfare of Valley residents, as well as for the economic contributions it will bring. And kudos to Ron Kline for telling it how it is.
Some of you may remember hearing about the sleazy ambulance chasers and doctors in Vegas colluding to scam on insurance, even as they were seriously paralyzing patients with un-necessary operations. Read this update from last month if you really want to get ANGRY:
http://money.cnn.com/2009/08/18/news/eco...
The Cleveland Clinic had a bad reputation in the 20's and 30's. The Cleveland school children had rhymes about the clinic.
Why doesn't a casino have a healthy food buffet? Probably go BK.