They’re not MDs but they’d DO

By Marshall Allen

Monday, Oct. 23, 2006 | 7:34 a.m.

Last week thousands of doctors and medical students were visiting Las Vegas.

Now if we could only get them to stay.

The were in town for the annual convention of the American Osteopathic Association: 3,000 physicians and hundreds of medical students, enjoying the sights and lights and discussing issues involving their specialty. Doctors of osteopathy, DOs, are like medical doctors but holistically approach the body's interconnected system of bones, muscles and nerves.

Officials from Valley Hospital Medical Center thought it would be a good opportunity to set up a recruiting booth and entice doctors and medical school graduates to relocate to Las Vegas. Valley Hospital has the area's newest residency program, where new doctors receive hands-on training under the supervision of attending physicians.

Reactions to the recruiters were mixed, and help tell the story of why it's difficult to attract doctors to Las Vegas.

Las Vegas is not "one of the health care meccas," said a doctor from a rural North Carolina town who also said he has no intention of moving here.

Said another, referring to two trappings of Las Vegas he'd rather avoid: "It's too hot and my wife likes to gamble."

The responses given to Valley Hospital recruiters suggest reasons why Las Vegas has one of the most severe doctor shortages in the nation. The region's population explosion has outpaced the growth of the medical community, and bolstering the ranks of doctors would go far in improving medical care. Patients frequently can't see their physicians in a timely manner and are sloughed off to more expensive urgent care centers and emergency rooms. Or, they have so little face time with physicians that their health care suffers.

In addition to luring veteran doctors from elsewhere, the region's doctor pool can be enlarged by expanding schools of medicine and bringing newly graduated medical students here for their residency programs - and hoping they'll stay. Nevada lags on both fronts.

Increasing the size of medical schools is a matter of funding and political will.

The University of Nevada School of Medicine is the smallest in the country with classes of 52 students. Dr. Jim Lenhart, the school's vice dean, said the state contributes $28 million a year toward medical education, compared to the $55 million annual investments made by both Arizona and New Mexico.

Lenhart believes the situation will improve with the University of Nevada's proposed $300 million Health Sciences Center. Among other things, it would include exponentially increasing the size of the school of medicine's student body.

Nevada has 190 medical residents - fewer per capita than any other state in the nation with a medical school. Bill Welch, president and CEO of the Nevada Hospital Association, said the number should grow to 450 to keep up with the state's growth, making Valley Hospital's program a welcomed addition. Medical students attending last week's convention seemed open to serving a residency in Las Vegas.

Among them: four third-year students from Touro University College of Osteopathic Medicine in Henderson - the state's newest medical school - who said they were interested in Valley Hospital's residency program and could see practicing here as well. One of them, Matthew Ledford, a 26-year-old from Orange County, Calif., said it shouldn't be a problem establishing a practice, given the doctor shortage.

But there is a catch to expanding the number of residencies. The positions are 70 percent funded by Medicare. But after a program is three years old, Medicare caps the number of funded residents at that level, and hospitals bear the cost of future expansion.

Thus, Dr. Dean Milne, Valley Hospital's director of medical education, is racing the clock to fill the hospital's new program, which has 26 residents in its first year. He wants at least 90, which would make it the largest Doctor of Osteopathy residency in the western United States.

Milne expects the residency program to fill easily, and said he is more concerned with bringing established doctors to Valley Hospital to improve the ratio to patients and work as attending physicians to the residents. He said the hospital's biggest selling points are the city's growth, strong economy and the residency program.

The barrier to recruiting is often Las Vegas itself, he said.

But one man's barrier is another's tease. Dr. Brooks Betts was among the osteopaths who picked up information from Valley Hospital's booth. He's 54, belongs to a money-losing doctors' group in Pennsylvania, and likes Las Vegas' climate and golf courses.