UMC shift to teaching focus to be explored

Clark County and higher-education leaders said Wednesday they will explore turning the troubled University Medical Center into a full-fledged research and teaching hospital, with the hope of drawing more private funding and more paying patients.

Former Chancellor Jim Rogers will spearhead the effort at the request of Clark County Commission Chairman Rory Reid.

The details at this point are lacking, but Rogers is going to study the issue for 90 days before giving a report to Reid and other commissioners. Even if a plan is approved, it could be years before it's implemented.

"The thing is out there, saying, 'Try me. Try me,' " Rogers said Wednesday at a news conference called by Reid.

Rogers pointed to Maryland's Johns Hopkins Medicine as a system that was able to rescue a financially strapped public hospital in Baltimore as an example of what he hopes could happen with UMC.

Both Rogers and Reid said that if UMC achieved a fraction of Johns Hopkins' success, it would solve the county hospital's financial problems and improve medical care in Nevada.

The Johns Hopkins system, which includes the Johns Hopkins University School of Medicine and its four hospitals, generates about $10 billion a year in economic activity in the state of Maryland.

In Baltimore, Bayview Medical Hospital, according to Johns Hopkins' spokesman Gary Stephenson, was losing "big money for the city."

Johns Hopkins took over about 20 years ago, renamed it Johns Hopkins Bayview Medical Center, and "it is now in the black," Stephenson said.

"We re-engineered and retooled it, altering the patient base," he said. "No longer is it just a charity hospital. The quality of medicine makes it a place that many people want to use."

Rogers said he is going to consult with experts across the country, including officials at Johns Hopkins.

Rogers, who said it is critical that UMC more closely align with the University of Nevada School of Medicine, concedes he has no idea how UMC could end up like Johns Hopkins Bayview.

"I'm not sophisticated enough at this point," he said.

Nevada's School of Medicine, the nation's smallest, only admits 62 students a year and does not provide training in critical specialities, including cardiology and radiology.

One thing that is clear, Rogers said, is that the medical school, which is also hurting financially, can't acquire UMC.

"It's a couple of poor kids getting together with huge deficits," Rogers said.

Wednesday's half-hour presentation in the commission chambers made by Reid, Rogers, current Chancellor Dan Klaich, Board of Regents chairman James Dean Leavitt and County Commissioner Steve Sisolak provided no details on how UMC could be made financially viable. Neither did one-on-one interviews with the five public figures in commission chambers.

That didn't trouble Rogers.

"We're at the point right now where there's more questions than answers," he said.

Reid, a Democratic gubernatorial candidate, denied taking the lead on overhauling UMC as a political maneuver. Gov. Jim Gibbons recently used the financially strapped hospital to deride Reid's fiscal leadership.

"For Jim Gibbons to accuse someone of not running something well is kind of like Alice in Wonderland," Reid said.

UMC has been plagued with heavy financial losses, in large part because the facility is required as a public hospital to treat poor and uninsured patients.

The hospital lost $82 million last year and received a total of $140 million in taxpayer subsidies.

Although some teaching occurs at UMC, Reid said, it can't be deemed a true teaching hospital unless academia is at its core and there's a public-private partnership.

At Johns Hopkins hospitals, as well as at most academic medical centers or teaching hospitals, Stephenson said, only medical school faculty members care for patients. They also teach and do research.

Stephenson said it is critical to an academic medical center's success that all members of the staff have the same core mission and values.

"There is a potential for a clash in cultures" if private physicians also practice at an academic medical center, he said.

At UMC, both private physicians and School of Medicine faculty members care for patients, but academic physicians are in the distinct minority, according to Dr. Maurizio Trevisan, executive vice chancellor and CEO of the University of Nevada Health Sciences System.

For UMC to have only Nevada School of Medicine faculty members practicing there, the medical school would have to hire at least 150 new doctors, according to Dr. Ole Thienhaus, dean of the School of Medicine.

"The medical school would have to get much larger than it is," Thienhaus said.

Rogers promised Wednesday that anything he suggested to help UMC would not cost taxpayers any more money.

The idea of a "teaching hospital" bringing new dollars to Southern Nevada's public hospital is nothing new.

In the mid 1980s, the Clark County Commission changed the name of the hospital from Southern Nevada Memorial Hospital to University Medical Center as a "marketing tool" to help acquire new patients.

Hospital administrator Richard Coughlin at the time said the hospital had about 50 of its graduates serving residencies at the hospital and brought in about 35 medical students a year for training.

"We are a teaching hospital," he told the Review-Journal in 1986.

Thalia Dondero, a retired county commissioner, said Wednesday that the commission at the time believed it was a way for the public to learn that the state's medical school taught medical students there.

"And we hoped we could get more residents (advanced medical students) there too," she said.

Trevisan said the medical school currently partners with UMC to offer residencies at the hospital where new doctors can learn the specialities of emergency medicine, family medicine, internal medicine, OB-GYN, pediatrics, psychiatry and surgery/plastic surgery.

But there are no residencies in some of the most critical areas, including cardiology, urology, and neurology.

Rogers said he would to love to increase the specialties available at UMC, so it would become a place where people would come from across the country for medical procedures.

The School of Medicine also rotates students through the hospital as part of its teaching, Trevisan said.

When combined with hospitals, medical schools tend to attract large donations, Rogers said, adding that "donors go with winners."

One example is the Keck School of Medicine, which partners with the Los Angeles County-USC Medical Center. The medical school received a $100 million donation in 1999 from the Keck Foundation in return for adding the Keck name to the school.

If UMC were to convert to an academic medical center model, it could still become nonprofit or private or remain in the county's hands, Reid said.

Teaching hospitals throughout the country vary in ownership, Reid added.

Contact reporter Scott Wyland at swyland@reviewjournal.com or 702-455-4519. Contact reporter Paul Harasim at pharasim@reviewjournal.com or 702-387-2908.