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Easy Rx for shortage of doctors in Las Vegas?

From him you can learn about Sjogren’s syndrome, the autoimmune disorder that caused tennis star Venus Williams to pull out of the recent U.S. Open.

And from him you get a better sense of why Southern Nevada continues to have a shortage of doctors.

This is also true about Dr. Mitchell Forman, the founding dean of the Touro University College of Osteopathic Medicine: No visit with him ever seems to be complete without a discussion of the guitar.

In fact, this 65-year-old rheumatologist who helped found the UNLV Classical Guitar Series is apt to pull out his Martin acoustic, as he did in his office the other day, and start strumming.

“I play well enough to have captured a wife 41 years ago, ” Forman said.

If he wore a wide-brimmed black hat to go with his full beard and penchant for dark suits, he’d look right at home working in the Diamond District of his native New York City.

A former vice president and clinician at the University of North Texas Health Science Center, Forman jumped at the chance in 2004 — “what an opportunity” — to help found Touro, which welcomes students of all faiths but acknowledges its Orthodox Jewish roots by keeping a kosher campus and closing on Jewish holidays.

He’s a man in a hurry, already having served a term as president of the Clark County Medical Society, where he gained a reputation as being outspoken. When Sunrise Hospital officials refused in 2010 to answer questions about two nurses allegedly involved in misconduct in the hospital’s neonatal unit, Forman said he wished hospitals would be more transparent.

“It’s perfectly natural for people to have questions that need answering,” he said. “People want to feel safe. We ask electricians questions, why not hospitals?”

The only thing that bothered him about his move to Nevada was having to stop working as a clinician for two years as he opened the school in Henderson.

“I really missed working as a rheumatologist,” he said. “That’s my first love.”

He hopes the recent announcement by Williams that she suffers from Sjogren’s syndrome educates people about a disorder in which white blood cells target the body’s moisture-producing glands. Its hallmark symptoms are dry eyes and dry mouth, but many patients also experience extreme fatigue and joint pain.

Sjogren’s affects as many as 4 million Americans, 90 percent of them women. It’s diagnosed by testing the eyes and mouth, as well as using blood tests to check autoimmunity.

It often takes a person years to get the right diagnosis because symptoms may be mistaken for depression or menopause. Dry eyes are often treated by eye doctors who don’t ask about dry mouth and fatigue.

“This is a disease that in its severest form can be treated by immunosuppresants, but we have to get the right diagnosis,” he said. “Fortunately, dry eyes in Nevada probably are far more likely to be caused by the climate than by Sjoren’s.”

Forman is quick to diagnose why Nevada has a shortage of doctors, ranking 48th among states, with just 218 physicians per 100,000 residents — “we don’t have enough hospitals partnering with our medical schools to offer graduate medical education.”

Two years after Touro opened its doors to 78 students — it now graduates 135 yearly — Forman forged a profitable relationship with Valley Hospital. There are now seven graduate programs there, including residencies in family and internal medicine, dermatology and neurology.

Yet even when you combine the dozen students who complete residencies this year from Valley-Touro with those who complete residencies in Southern Nevada largely through University Medical Center and the University of Nevada School of Medicine, the overall number is just slightly more than 60 per year, not enough to make a major dent in Nevada’s physician shortage.

“I’ve talked to all the hospitals here about offering more residencies,” Forman said. “And they’ll say their corporate offices are unsure about the economic environment here. I think that’s a lot of baloney. Valley’s successful. Statistics show that where medical students do their residencies is mainly where they’ll stay. If you train them, you retain them. Too many have to leave Las Vegas for residencies. This just boils down to the commitment our hospital systems want to make to the community.”

Paul Harasim is the medical reporter for the Las Vegas Review-Journal. His column appears Mondays. Harasim can be reached at pharasim@reviewjournal.com or 702-387-2908.

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