Will UMC Add Another U?

Touro University wants to partner with the budget-challenged hospital. So, what’s the downside?

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Imagine if the area around University Medical Center were built out to contain medical research facilities, med-school classrooms, more doctors’ offices and medical specialty centers. Imagine that any person could go to that corridor around Charleston Boulevard and Shadow Lane to receive all types of medical care—a continuum of care—and that medical professionals ranging from emergency-room doctors to cancer researchers or nutrition experts could network in close proximity.

Add to that medical students from around the nation coming here to learn their profession—and then staying in Las Vegas to practice. Maybe it’s a lofty idea in a community that has actually talked about closing down its only public hospital, UMC, because of budget problems. But Clark County commissioners—who oversee the long-ailing hospital—have held onto that vision of an academic health science center for years. Other cities have thrived with this model of collaborative health care and attracted millions in public and private research and education grants. Commissioners’ recent frustration with officials at the University of Nevada, Reno School of Medicine’s level of activity in Southern Nevada—deemed not enough—has brought the vision to light again: Why can’t Nevada have an academic health science center in its most populated city?

“Somebody needs to take the bull by the horns, step up and commit to doing it,” says Commissioner Steve Sisolak. “You would think it would be the [University of Nevada] School of Medicine. They should be the hub.” The University of Nevada School of Medicine was chartered in 1969 to serve the entire state, but its classrooms are housed at the University of Nevada, Reno. As Southern Nevada has wildly outpaced Reno in growth, Las Vegas leaders have frequently called for the school to focus more on Clark County. The medical school does have physician residents at UMC, but commissioners want the school to build research facilities and classrooms here, have the dean live here rather than in Reno (which has never been the case) and expand the UMC residency program.

Short of that, the county is looking for another medical school to step up.

Touro University Nevada, a private medical school that is part of the New York-based Touro College system, has expressed interest, and commissioners are listening. Touro executives gave a presentation at the commission meeting earlier this summer, touting their enrollment and growth potential—some 1,500 students are enrolled in either its College of Osteopathic Medicine or College of Health and Human Services. Touro’s Henderson campus is anything but splashy, but the name is well known nationally, and the network includes a Bay Area osteopathy school and the New York College of Medicine. Touro already has a medical residency program with Valley Hospital, and wants to develop one with UMC in hopes of attracting more medical students and professionals.

“We want to develop that in this community. It would attract specialty positions, who do research which improves overall quality of care in a community,” says Dr. Michael Harter, Touro University senior provost and CEO. “It also provides us with different opportunities for students to train. And we think it could also have a long-term beneficial effect on UMC’s financial situation.” Touro would fund a UMC residency program in part through federal grants, Harter said. Right now, School of Medicine residents serving at UMC are funded in part by the medical school, which is primarily funded by the state, and in part by UMC, which is primarily funded by the county.

“Touro costs the state of Nevada nothing. And we don’t plan to ask for any money from the state,” adds Dr. Mitchell Forman, dean of Touro’s College of Osteopathic Medicine. The economic times are ripe for such a public-private venture to further develop UMC as an academic health science center, Sisolak says. “We have a lot of public-private partnerships, and we’re developing more as the economy is struggling,” he says.

County commissioners and Touro officials still want the School of Medicine to be a partner in expanding medical training, and subsequently services, in Las Vegas. “There’s room for both schools,” Sisolak says. But officials at the School of Medicine are tight-lipped about the possibility of Touro developing a residency program with UMC. “The School of Medicine has a very good partnership with UMC,” says Dr. Miriam Bar-on, associate dean for graduate medical education. UMC is its primary teaching hospital, with some 170 residents serving there. The school has just hired a new dean, Thomas Schwenk, who has yet to weigh in on the commissioners’ desire for the school to invest more heavily in Southern Nevada. But when he selected Washoe County as his primary residence, as his predecessors did, it irritated commissioners.

There’s another issue with Touro partnering with UMC for a residency program, says Bar-on: Touro trains physicians to be doctors of osteopathy, or D.O.s, while the School of Medicine trains physicians to be medical doctors—M.D.s. The two degrees are legally equivalent—state licensing boards recognize both as physicians, and D.O.s practice throughout the nation, as do M.D.s.

The difference is in the type of training: Basically, osteopathic training focuses more on holistic or “whole patient” care, while the allopathic training M.D.s undergo is based on traditional biomedical problem-solving. Another difference is that the two are accredited by different boards, and Bar-On says that students trained as M.D.s cannot participate in residency programs for D.O.s. UMC would, then, need two separate residency programs.

Historically, the M.D. has been the preeminent medical degree in the U.S., while D.O.s were regarded as second-tier. “D.O.s weren’t considered equal, but now that’s not the case,” says Harter, noting that Forman, a D.O., is the president of the Clark County Medical Society.

“That’s a fight in the medical community,” Sisolak says. “There’s room for both.”

Meanwhile, Bar-on says the School of Medicine is committed to the residency program at UMC, and has plans to expand it, but that the new dean needs time to adjust. Despite what seems like parochial bickering, all sides claim to see the need for a better and more collaborative approach to medical care in Southern Nevada. An academic health science center with multiple disciplines, research and training opportunities would draw more doctors here and translate into better health care for Las Vegans.

“So many people go out of state for medical care, and for a state our size, that just shouldn’t happen,” Sisolak says. “ We’ve [waged] this war too long, and we need to bring everybody together.”