Viva Las Vegas?

[maxpower75]

Hi, I am considering taking a Job in Las Vegas. Could anyone comment on practicing medicine there. There appears to be lots of opportunity for physicians. I thank you in advance.

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[Blade28]

In which field?

 

[maxpower75]

I am a final year Renal fellow, I assume few would have much insight to the practice of Nephrology in LV, however, if anyone has any experience regarding living there, general environment for physicians, etc, I would appreciate it.

Thanks!

 

[Toohotinvegas33]

I lived there for 22 years (grew up there), I think its a nice place to live if you dont have children, and has always had a doctor shortage (dont know about nephro through). Its quick to to get to cali for vacations or southern utah for skiing

 

[docB]

I have found Vegas to be a great place to live however medicine in Vegas is relatively poor. There is a shortage of doctors so there are never any appointments available for weeks. Consequently most primary care is done through the EDs. Med mal is better after the reform act of '04 but it's still a letigious area. And since no one can get anything done outpatient most people start every encounter with a chip on their shoulder. There is a very bad specialist crisis. The EDs and the primaries have real problems getting patients in to see Uro and ENT which are the worst. GI has become a real problem recently. Vegas still refers out particularly tough cases in peds, GI, transplant and so on to either LA or AZ.

As for nephro there is a huge dialysis population in Vegas. That's what you get with lots of diabetes and hypertension an poor primary care. The nephros put everything through the EDs. Catheter or shunt problems, missed 1 day of dialysis, labs from last week that showed something abnormal, it's off to the ED. There's just no room on anyone's schedules to see or do anything so dumping has become the default culture.

 

[Dr McSteamy]

if there's no room for appts on anyone's schedule, that means the doctors must be banking.

so what's dr life like? make money and then blackjack?


what kind of insurance do most people have?
HMO? PPO? medicaid?

clark county, LV doesn't seem like a poor city. they can afford cash visits eh?

 

[docB]

if there's no room for appts on anyone's schedule, that means the doctors must be banking.

so what's dr life like? make money and then blackjack?


what kind of insurance do most people have?
HMO? PPO? medicaid?

clark county, LV doesn't seem like a poor city. they can afford cash visits eh?

Payor mixes are about like everywhere else. Lots of M&M and no pay. High degree of HMO penetration.

I know one guy who plays poker. You can't get to into it or it'll suck you in.

The primary care guys aren't really making that much because even thought they are busy reimbursement for primary care is bad.

 

[Dr McSteamy]

man, the govt needs to step in.
they can't encourage docs to move in if they don't pay well.

and isn't LV becoming the #2 retirement city in the USA? gonna have lots of old folk.

 

[docB]

man, the govt needs to step in.
they can't encourage docs to move in if they don't pay well.

and isn't LV becoming the #2 retirement city in the USA? gonna have lots of old folk.

The govt. couldn't possibly care less about physician job satisfaction. Their goal is to pay out less. And if health care is harder to get they pay less, at least that's what they think. I would argue it's more expensive to have everyone get their care through the ED than at a clinic but they definitely haven't come to me asking for tips on health care policy.

 

[Faebinder]

Oh gimme a break.. legislators can fully slam down the medical board and make them behave themselves but they wont do it.

Nevada is one of the most evil places out there when it comes to licenses. THREE year requirement for both MDs and DO... AMGs and FMGs.... WTF?

I am sure there are many residents in Nevada that would love to moonlight but the state medical board is blocking them and trying to corner the market.

So if they want to boost the number of physicians that will stay there, they can start by reducing their crazy requirements for a license over there.

 

[Toohotinvegas33]

Nevada is one of the most evil places out there when it comes to licenses. THREE year requirement for both MDs and DO... AMGs and FMGs.... WTF?

I am sure there are many residents in Nevada that would love to moonlight but the state medical board is blocking them and trying to corner the market.
.

What is this 3 year thing? Residents are not allowed to moonlight?

 

[Faebinder]

What is this 3 year thing? Residents are not allowed to moonlight?

http://www.fsmb.org/usmle_eliinitial.html

 

[Toohotinvegas33]

thanks

 

[Kubed]

What is this 3 year thing? Residents are not allowed to moonlight?

Yeah, the three year thing sucks. I know a few people who moonlight, but they go out of state to do it.