Las Vegas needs a medical school

By John Hudak

Sunday, Nov. 2, 2014 | 2 a.m.

I’m giving my space today to one of my friends at the Brookings Institution, for his insights on the importance of establishing a second medical school in Nevada. With the election on Tuesday and having celebrated the state’s 150th birthday on Friday, this is a weekend when we are contemplating the future of Nevada. Health care is certainly a vital issue to be addressed. —Brian Greenspun

Any discussion about the need for a medical school at UNLV should include the financial implications — not the cost of the facility but how it will generate private and federal money that will benefit the region.

The reality: the state’s one existing medical school, at UNR, is underperforming almost every other public flagship medical school in the United States, by a variety of metrics. As a result, the state is woefully underperforming in many areas, ranking near the bottom nationally in physicians per capita as well as in the receipt of National Institutes of Health (NIH) and other federal health care funds. The more doctors a state prepares, the more money it can get. Some states have more than two medical schools, and they effectively cash in all the more.

On this topic, The Lincy Institute asked me to prepare and deliver a report on the funding benefits of establishing an allopathic medical school at UNLV based on my research into how the federal government distributes grants to states and institution. At the September event “Valuing a UNLV Medical School,” I explained the benefits included boosting private and federal funding to the state and enhancing markets in both medical education and practice.

My research — and other research presented at the event ­— found a UNLV Medical School would generate tens of millions of dollars per year in federal aid that instead is going elsewhere. Nevada needs to access these funds by placing a qualified institution in its most populous region.

Some questions and discussions after the talk exposed a concern: UNR may worry a second medical school — one in Las Vegas — will draw resources away from the senior institution. Such concerns are misplaced and based on a gross misunderstanding of medical education and health care markets. Having a single medical school, for instance, limits the capacity to train all the doctors Nevada needs. A UNLV medical school will address this shortfall.

Besides producing more doctors for Nevada, a UNLV medical school would be able to develop partnerships with other medical schools, research universities, foundations and philanthropic and nonprofit organizations—something the University of Central Florida, for example, has done effectively under the leadership of Dean Deborah German.

A UNLV medical school will be able to grow the health care market by increasing the number of specialties in a state sorely underserved in certain areas of medicine. It will make Las Vegas a more appealing destination for businesses and their families, and provide more and easier ways for Nevadans to access quality health care.

Working in concert, UNR and UNLV can craft a strategy that offers complementary, rather than competitive, specializations and services to benefit the entire state.

Moreover, having a second medical school doesn’t mean having to share federal funds but actually serves as a catalyst in generating more funding for Nevada. That’s because some federal funding is allocated according to the training capacity of a state, much in the same way transportation funding often depends on how many roads a state has.

Boosting the capacity of the state — in terms of number of students being trained, number of beds at hospitals, number of physicians — will improve the state’s ability to draw larger flows of federal funds. UNLV will not be taking from UNR; on the contrary, it will be Nevada taking its share of federal funds currently being distributed to other states.

There surely will be times when the two medical schools compete for the same funding. But overall, new medical schools can help existing medical schools, and irrational fears about intrastate competition between institutions should be kept on football fields and basketball courts and out of doctor’s offices and operating rooms.

In other words, a medical school in Las Vegas shouldn’t be viewed as a threat but as an asset in serving, as Gov. Brian Sandoval calls us, “One Nevada.” Our medical shortcomings are the One Problem that threatens the health and welfare of One Nevada.

Twenty-five states have multiple medical schools, and it is time for Nevada to join those ranks. Since 2000, nine states have opened additional medical schools; Florida alone opened four. Michigan opened three between 2011 and 2013. The existing institutions in those states do not suffer; they do not close their doors; in many cases they are strengthened.

Research by Tripp-Umbach, commissioned by the Lincy Institute, illustrates that a new medical school at UNLV will help the University of Nevada School of Medicine create jobs, generate revenue and attract research dollars.

Nevada is facing a health care crisis. Its population is growing and the number of medical professionals is not keeping up. The state is falling embarrassingly short in the receipt of many types of federal health care funds.

The prescription for steering Nevada out of this crisis is a multipart, long-term strategy. Using the opening of a new UNLV medical school as part of the strategy to boost the whole state’s ability to meet the health care needs of its residents is an important start.

John Hudak, Ph.D., is a fellow in the Center for Effective Public Management at the Brookings Institution and managing editor of FixGov blog.