Thursday, August 11, 2005
Copyright © Las Vegas Review-Journal

Valley hospitals to offer rival plan

Rogers: University system to benefit from competition

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Rather than build an academic medical center, some local hospital officials favor expanding existing hospital programs.

They plan on making that pitch to university system Chancellor Jim Rogers this month.

The proposal is at odds with a blueprint for a Southern Nevada nonprofit academic medical center on the city of Las Vegas' 61-acre Union Park parcel. The university system and city officials have been in negotiations with the University of Pittsburgh Medical Center, also known as UPMC, for months to jointly build and operate the training and research center.

"The hospitals are going to go together for the first time in this and make a joint proposal to us," Rogers said. "We're going to kiss a lot of frogs before we decide which prince we're going to take to the dance."

Ann Lynch, vice president of government and community affairs at Sunrise Hospital and Medical Center, asked Rogers to meet with her and other hospital officials Aug. 23 to discuss their proposal, which she said is not completed. But she emphasized that Nevada already has the medical expertise to strengthen and expand the University of Nevada School of Medicine and does not need outside help.

"Why would we create a nonprofit, secondary center that would just deplete what resources we have?" Lynch said. "That doesn't make any sense."

The Nevada System of Higher Education, the city of Las Vegas and UPMC officials met Aug. 1 and agreed to continue developing a proposal. They also initiated the site planning process for the facility, using some of the $5.5 million the Legislature allocated for planning. All parties characterized the meeting as productive.

Las Vegas Deputy City Manager Betsy Fretwell, who has been part of the negotiations with Pittsburgh, said she had received no word of the local proposal.

"I thought our meetings with the University of Pittsburgh last week were a breakthrough," she said. "We made an agreement to enter into the next planning phase and determine whether a partnership will work."

The issue of who would have ultimate governing control of the proposed center -- local doctors, Pittsburgh officials or both -- has been a sticking point in negotiations with UPMC. Local doctors have argued against the partnership, maintaining area physicians don't need help from an out-of-state medical center to provide care to Las Vegas Valley residents.

The local interest "in doing this is having an alliance where they, in effect, are our partner rather than UPMC," Rogers said. "I think it's just as simple as protecting their own territory, which is very reasonable, and saying anything UPMC can do, we can do together."

UPMC officials declined to comment on Rogers' meeting with the hospital officials.

Rogers said talks with UPMC have been successful, but he said he's open to competitive proposals, particularly if entertaining another offer helps give the university system leverage in future negotiations.

"This is the good old American way of competition. We're going to pit everybody against everybody," he said.

Pride, not money, is behind the local medical community's push to avoid a partnership with an out-of-state organization, Lynch said.

"I think we deserve and have proved over the last 50 years that medically we can step up," she said.

Dr. Benjamin Venger, of the Nevada Neuroscience Institute at Sunrise Hospital, also has courted Rogers to forgo the UPMC partnership. There is no guarantee UPMC would bring the same standard of excellence to Las Vegas that it has to the East Coast, Venger said.

What UPMC wants "first and foremost is a partnership that is financially viable for them," he said. UPMC would duplicate what is already here, he said.

"There is little that we don't already have in Las Vegas," he said. "What we have is actually as good or better than the rest of the country."

But "U.S. News & World Report," the weekly news magazine that annually ranks the most prestigious hospitals, does not include any Nevada hospital in its latest rankings.

Of the 176 medical centers that made the magazine's 2005 edition of "America's Best Hospitals," UPMC earned "Honor Roll" status, one of only 16 medical centers to earn the distinction. In order to make the honor roll, a hospital had to achieve a high ranking in no fewer than six specialties.

UPMC, the world leader in organ transplants, was highly ranked in: ear, nose and throat; orthopedics; respiratory disorders; rheumatology; psychiatry; cancer; neurology and neurosurgery; kidney disease; geriatrics; digestive disorders; and rehabilitation.

Venger also said Las Vegans believe their medical care is as good or better than that found elsewhere. However, a Las Vegas commissioned 2003 study conducted by the Booz Allen Hamilton survey firm found Las Vegans have less confidence in local care than residents of other Western states. The only area in which Las Vegans think their medical care surpasses that in other Western states is in the field of plastic surgery.

For example, 36 percent of Las Vegans thought the cardiac care in Las Vegas is among the best in the United States compared to 69 percent of those in other Western states.

The study also found that about 7,000 people leave Southern Nevada each year in search of health care.

Venger noted the city already has two major medical centers in Sunrise and the University Medical Center that offer some teaching and academic programs. He said they could do more in conjunction with the school of medicine.

Las Vegas Mayor Oscar Goodman repeatedly has said the city needs an academic medical center so residents can receive specialty treatments here such as liver transplants, an area of expertise for UPMC. He declined to comment on the plan by local medical officials, and pointed reporters to a media release announcing the accord with UPMC officials from the Aug. 1 meeting.

Nevada medical school officials have lauded UPMC's ability to bring research, grant dollars, clinical trials and expertise in specialty areas to the community and emphasized the imminent need for an academic medical center to house those activities.

The clinical director of transplantation at UPMC and the physician who performed the first series of living-donor liver transplants in the United States, Dr. Amadeo Marcos, has said he could teach Nevada doctors to do the same and make the state the top center in the West for all organ transplants.

But Lynch doubted liver transplants would ever happen in Las Vegas because there are not enough residents needing them. In addition, Lynch said there are not enough donors here. The less a doctor performs an operation, the less skilled that doctor is, she said, noting complex surgeries are not like riding a bicycle.

"If there is a big demand for heart, lung, liver (transplants) or whatever else, one of the corporations would have done it," she said.

She said residents throughout the state, not just in Las Vegas, are in need of existing services such as OB/GYNs, and pediatric physicians, which the hospitals could help produce. The growth in training positions and mentors for medical school students would be a substantial investment from hospitals, she said.

She pointed to the growth of the valley's medical community in the past 50 years and said it takes time to make people aware of the services available. She said she believes more people come here for medical services now than those who leave.

The Nevada Hospital Association supported the idea of using local resources as opposed to external organizations to further develop the medical school.

"We should be looking at those resources before we look outside the community," said Bill Welch, the association's president.