UNR School of Medicine expanding to better serve the community – and Nevada | nnbusinessview.com

UNR School of Medicine expanding to better serve the community – and Nevada

Sally Roberts | sroberts@nnbw.biz

RENO, Nev. — Despite increases in the number of licensed health professionals in the Silver State in recent years, the faster pace of population growth has kept health service availability "treading water," a recent report concludes.

Nevada ranks 48th in the U.S. in the number of physicians per capita, according to the 2017 UNR Med Health Policy Report. For primary care physicians, it ranks 50th.

"The only specialty that meets benchmarks (for the number of doctors per capita) is plastic surgery," John Packham, associate dean for the Office of Statewide Initiatives at the UNR School of Medicine, told the NNBW. "We're so far behind that we have to expand dramatically just to catch up."

With new families moving into the area, the need for additional pediatricians, obstetric-gynecology specialists and primary care physicians is particularly critical.

And it's not just about health services, says UNR School of Medicine Dean Thomas L. Schwenk, M.D., considering the school of medicine receives $40 million in state funds and generates an economic impact of $200 million.

"The state gets a five-to-one return on investment," he told the NNBW.

Recommended Stories For You

In 2017, health care employees made up 11 percent of Nevada's total workforce. Each of the 5,000 physicians in the state generate an additional 55,000 to 56,000 jobs in diverse industries and contribute $2 million to the economy.

"It's a ripple effect," Packham said.

The UNR School of Medicine is working to enlarge those ripples, Packham and Schwenk said, by increasing the number of medical professionals in Northern Nevada and adding new programs.

It starts with recruitment

Currently, one quarter of actively practicing physicians in Northern Nevada are UNR Medical School alumni, according to the university. More School of Medicine grads will result in more health care professionals in the region.

To increase the chances a newly minted doctor, nurse or technician will stick around, the School of Medicine focuses its recruitment within the state.

Ninety percent of current medical students are residents of Nevada, or have strong connections to Nevada, such as a parent who's an alumni, or who have relatives in the area, Schwenk said.

"Our goal is to find students interested in Nevada — in staying in Nevada or to come back (after residency)," he said.

Eighty percent of those who both attend medical school and complete their residency in the state are likely to practice in Nevada, according to the university, compared to 40 percent who only attend medical school and 60 percent who only complete residency in the state.

"There is no shortage of local young residents who want to do training in Nevada and we've got data showing that they stay," Packham said.

Expansion of residency programs

The UNR School of Medicine has embarked on a plan to increase its programs to serve both its medical students and the community.

UNR's Graduate Medical Education support program began three years ago partnering with Renown Health and the Veterans Administration Sierra Nevada Health Care System to expand residency programs in Northern Nevada.

This year, residencies are expanding in the fields of family medicine, internal medicine, psychiatry and rural training. Plans also are under way to expand programs in pediatrics — with 2019 as the target to open the program — followed by neurology.

UNR Med also offers specialty residency tracks in rural and primary care to serve Nevada's rural communities.

"There are 158 health care providers in rural Nevada with boots on the ground in 17 counties," said Packham, who coordinates rural medical care for the School of Medicine, adding that some rural hospitals need help just keeping their doors open, he said.

Among the biggest additions ready to start is a new PA (physician assistant) program, a type of medical profession that is greatly expanding and helps fill the gap in general care.

Schwenk said UNR Med received 800 applications for the 24 positions open in the PA program, which begins in July.

Making changes in medicine

Clinical research is also increasing, with an expansion of its clinical residency program. Current research is looking for causes and treatments for muscular dystrophy, gastrointestinal and cardiac disorders, HIV, infertility, cancer and infectious diseases.

Clinical research is a major enterprise, explained Schwenk.

"That's how you make changes in medicine," he said. "A high quality research experience teaches students how to think."

What won't be added is a medical campus or hospital, an expensive feature that has become less of an option for medical schools nationwide.

The Nevada schools of medicine are structured so that partnerships with hospitals in the community take the place of university medical centers.

UNR partners with the Renown and VA hospitals in particular, but also has students working at the other hospitals and medical facilities in the region.

UNLV Med is also expanding its programs and partnerships with area hospitals, but in different specialties.

The two medical schools have very complementary programs, Schwenk said.

"It's so much greater with two schools of medicine (in the state)," Packham said.

UNR School of Medicine: changing for the modern age

The UNR School of Medicine in 2019 will celebrate 50 years as a community-based medical school.

Since the Nevada State Legislature established the school, it has grown and evolved to serve the state’s growing population and economy, and the past decade has seen tremendous change in operations.

When Thomas L. Schwenk, M.D., became dean of the Nevada School of Medicine in 2011, the state had one school of medicine divided between two campuses. A series of interim deans created a lack of cohesion and mission, he said.

There was tension between north and south, Schwenk told the NNBW: “There was no permanent person in place to be the catalyst for these (changes).”

“What is the role of public medicine in general, and how do we serve the entire state?” Schwenk asked, reframing the question from how to divide the campuses into how to meet the needs of Nevada.

The discussions initially resulted in full medical campuses at both UNR and UNLV, while still framed as one school.

With the state growing rapidly, the legislature created a second school. The UNLV School of Medicine began taking students as a separate school in 2017.

Untangling the finances between the two campuses was one of the biggest challenges and took time, Schwenk said.

Each serves the entire state with complimentary programs.

Nevada “needs two medical schools,” he said. “Not each serving each part of the state but both serving the entire state.”