Why can’t Nevada hang on to its health care providers? BY KATIE WAECHTER
T Katie Waechter is CEO of Watch Media Group
he Nevada doctor shortage has been ongoing for decades. If you’ve lived here long enough, you may have heard the running joke, “if you want good health care, go to the airport.” The question is, why? Each year, Nevada gets a little bit bigger in many ways including population growth, business expansion and the addition of sports teams, just to name a few. However, health care continues to struggle to keep up with demand. Mental Health America reports that Nevada ranks 51st nationally in overall mental health and youth mental health. Our doctor numbers are almost as bad. We rank 48th nationally for primary care and 49th for specialist care, according to a 2022 Kaiser Family Foundation report. Shivesh Kumar, MD, MBA, FHM, explained, “I’ve lived here since I was a young professional and seen incredible growth in housing, entertainment, and sports, all of which should be applauded. But that opportunity has not been mirrored by a good medical system. We can do better.”
A quick history
In the early 2000s, there was a significant doctor shortage, medical malpractice insurance rates went wild and liability companies actually moved out of the state. Rudy Manthei, DO, remembers it well. He explained, “The [medical malpractice] awards started getting out of control, and the frequency of claims got out of control, too… those verdicts of enormous amounts drove the frequency way up and basically drove doctors away.” The issue of medical malpractice hit a tip38
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ping point, and the Keep Our Doctors in Nevada (KODIN) initiative was created. As Manthei described, “We created an initiative, we went to the people, and the people voted.” KODIN helped the public understand that medical malpractice laws were needed to stabilize health care in the state. The people voted in 2004, insurance companies stopped fleeing and doctors saw malpractice insurance costs drop.
Not enough residency options
While Nevada medical programs have grown, residency programs have struggled to keep up. Statistically speaking, where doctors do their residency is geographically where they end up practicing—which is bad news because only 15% of UNR’s school of medicine class of 2022 chose Nevada for residency. In Las Vegas, the problem isn’t quite as bad, but close to half of UNLV med school grads are training elsewhere, not because they want to, but because they have to. We lack good opportunities for specialty residency programs. As a direct result, we lack specialty doctors.
Doctors blocked by licensing boards
Board certified physicians moving here face a different challenge. Marc Kahn, MD, MBA, MACP, FRCP, Dean and VP for Health Affairs at UNLV, explained, “Not having a nimble licensing process makes it challenging to get new doctors into the state.” When Dr. Kahn moved to Nevada, he accepted his position in December, applied for his license to practice in Nevada in January, and wasn’t approved until the end of July, seven months later. For one of his colleagues, getting licensed to practice here took over 10 months.