Nevada’s questionable reputation for health care has taken another big hit.
A report in July by the Commonwealth Fund, a healthcare advocacy center, laid out the specifics for Nevadan women. And it’s not good:
- 44th in the rate of infants born with congenital syphilis
- 49th for women 18-64 who reported being in fair or poor health
- 45th in the percentage of women without health insurance
- 50th for women 18-44 who couldn’t see a needed doctor because of the cost
- 46th in the country for the number of OB-GYNs per 100,000 people
For just doctors overall, the state ranks 45th for physicians per 100,000 people, and 49th for primary care physicians and general surgeons.
While the data is new, the reality of these sobering statistics has been plaguing the local healthcare industry for years.
Dr. Rebecca Lee is an assistant professor in the department of gynecologic surgery and obstetrics at UNLV’s Kirk Kerkorian School of Medicine. She said there are noticeable differences between Nevada’s healthcare landscape for women, and those of other states higher on the Commonwealth Fund’s rankings.
“I’ve only been (in Las Vegas) for two years,” she said, “and it was very eye opening to me to see the differences here. I trained in Ohio where pregnant ladies are immediately eligible to be on Medicaid as soon as their pregnancy test is positive. And then when I got here to Nevada, it seemed a lot more difficult for patients to get any kind of insurance coverage. … A lot of our patients that I see through triage in the hospital seem to be underinsured, if not just uninsured.”
Experts blame Nevada’s ranking as 48th overall in the study (out of all 50 states and the District of Colombia) on the state’s perennial healthcare worker shortages.
Dr. Joseph Adashek is the director of the division of maternal-fetal medicine at both Summerlin Hospital Medical Center and Southern Hills Hospital, and also on faculty at Touro University Nevada and UNLV. In his experience, there’s not a robust interest among prospective med students in obstetrics and gynecology.
“I think they see that the lifestyle is not the best,” he said. “The few that do want to go in, really want to go in. … It’s hard to recruit people to come here, when, to be honest, you can't really pay them what you'd like to pay them, where they could stay somewhere else and do better financially. It is hard to get people to want to move here to work harder and make less money.”
And while the situation is concerning in urban areas of the state, Nevada’s less-densely populated counties are perhaps in even worse shape.
“I would say half of the rural counties in Nevada are considered maternal care deserts,” said Dr. John Packham, the associate dean of statewide initiatives at UNR. “That is to say, there are no birthing hospitals or OB/GYN physicians practicing there. So, the problem’s probably more acute in rural areas.”
Packham is one of the co-authors of a chartbook, published by UNR’s Nevada Health Workforce Research Center, on healthcare availability disparities around the state.
It turns out, Nevada had only 110 OB/GYNs in 2021. Of those, 106 of them were in Las Vegas, and just four practiced elsewhere throughout the state.
Importantly, though, Packham said solutions to our low obstetrician and gynecologist population are not out of reach.
“In the short- to medium-term: stretching the existing OB/GYN workforce when it comes to reproductive health services,” he noted. “There are some promising models that include child birthing centers — that is to say, centers that provide perinatal care including labor and delivery — using more of a midwife or wellness approach. … I think, even more promising, and it's a long-term strategy to deal with these issues, is the expansion of residency and fellowship programs in obstetrics and gynecology. (UNR has) two programs down south: one with UNLV and one with HCA Sunrise. We're trying to launch one up here in northern Nevada, between UNR School of Medicine and Renown Health. That will take a couple of years, but those will put an important dent in these shortages and help us in the long-term.”
Guests: Dr. John Packham, associate dean of statewide initiatives, UNR; Dr. Joseph Adashek, director of the division of maternal-fetal medicine, Summerlin Hospital Medical Center and Southern Hills Hospital; Dr. Rebecca Lee, assistant professor, department of gynecologic surgery and obstetrics, UNLV's Kirk Kerkorian School of Medicine
