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The Numbers Drew Her Here

The new School of Medicine planning dean on changes in health care, access to doctors, and what's needed to improve the health of Southern Nevadans.
People  |  Nov 20, 2014  |  By Cate Weeks
Barbara Atkinson, UNLV School of Medicine Planning Dean. (R. Marsh Starks / UNLV Photo Services)

Dr. Barbara Atkinson was just settling into retirement from the University of Kansas Medical Center when Karen West, dean of UNLV's School of Dental Medicine, called. UNLV was looking for an experienced administrator to launch a much-needed School of Medicine. Atkinson began to skim the materials and soon was absorbed by the reports outlining the region's medical infrastructure needs. The statistics were daunting -- Las Vegas is the largest city without an allopathic medical school -- but she also saw the tremendous opportunity to do what doctors do: help people.

Here the planning dean for the new UNLV School of Medicine explains how she got into medicine and shares her thoughts on the challenges ahead.

I was truly an outlier. I was a housewife until my children went to kindergarten and the only young mother in my medical school class. My own mother and mother-in-law both thought the kids would be ruined. But my father, a biochemist, and husband, a physician, both encouraged me.

I thought I would focus on cancer research but soon found myself wanting to change how things were done. When I was director of the cytopathology lab at the University of Pennsylvania, I thought there should be a better way of diagnosing cancer than just looking in a microscope and deciding it looks like cancer. We tried to do it by research, but when that didn't work, I decided that I could better make a difference as an administrator. So that's where my career took me.

For the most part, I think the doctor/God complex is a bygone.

Doctors used to be so paternalistic. They thought they knew what was best and just did it -- sometimes without really talking to the patient. I think having more women in the profession helped change that. Women are more open to discussions.

It's also a reflection of access to information. Patients are better advocates for themselves. Unfortunately, there's also so much noise in the system.

Look at the anti-vaccination disaster. Kids shouldn't be dying of measles. Adults shouldn't be getting whooping cough. The person who says vaccines caused her kid's autism can get just as much media attention as a doctor with actual expertise and scientific data. The layperson can't always separate the importance of their two statements. And it seems to be human nature that we're more taken by the scary statement than by the reassuring one.

That's a danger for medical students too. They might Google to find answers too. So you have to teach students to think, to find information, assess it, and apply it.

You can't teach students the one right treatment because it changes almost every day. I don't think there's a drug today being used in the same way as when I learned about it in medical school -- except maybe aspirin.

The vision for this school is exactly right.

Building the medical school from scratch allows us to take all the best ideas in medical education and put them together in a new way -- in a way that's right for future doctors and for this region. At established schools, it's hard and time-consuming to unseat some of the methods that are now becoming outmoded.

We won't have many lectures or routine dissections in gross anatomy. We'll have virtual gross anatomy with MRIs and CT scans, the same technology doctors use every day in practice.

Our curriculum will be problem-based. Students will be given a symptom, like a cough, and have to learn what causes it, the mechanics of coughing, the possible treatments. They'll be focused on solving the problem, in much the same way that they'll have to as practicing physicians.

It's a more intensive experience, particularly for faculty. It appeals to the ones who are true teachers at heart, but it's also proven to be more effective for producing good doctors.

I was shocked at the state of medical access here. Nevada ranks No. 45 out of 50 states in the number of doctors per capita here.

Everyone seems to have a story about long wait times and having to go to California or Arizona for their care. The problem is particularly acute in accessing specialists.

One woman told me how she went to Baylor Medical Center for a fairly routine dermatology appointment because she had trouble getting an appointment in a realistic time. You can't get a liver transplant here at all. The transplant surgeons who are here can only harvest livers and send them out, although they do kidney transplants here.

One mother couldn't find a rheumatologist to treat her son with arthritis. There are no pediatric arthritis specialists here. Imagine being that mother. Imagine being that child.

If your financial resources are limited, you just keep waiting.

Las Vegas also has the least number of psychiatrists per capita in the country. This, of course, taxes all of our community resources. It affects criminal justice and social service programs as well as our schools. So mental health and addiction treatments will be a significant area of focus for the school.

Those in the medical community here are just as frustrated as patients. Early major supporters of this new school have been the large physician groups and hospitals that have to recruit medical professionals from out of state. They can't recruit fast enough to fill the extraordinary demand, particularly for specialists.

We'll see some relief almost immediately as faculty come in. They'll bring their practices and begin seeing patients almost immediately. We'll start hiring this spring.

Recruiting them is actually pretty exciting. This appeals to people who want to truly put their stamp on something and use their experience to make a profound difference by building programs. Others are bold and aggressive and recognize the advancements that can be made by bringing extensive research and clinical trials to this population.

There's really not much pushback on building this school -- the need is so apparent. Some people have proposed that the problem could be solved by expanding residencies, but that's just a piece, and it doesn't address the need for more specialists and for the types of research studies and clinical trials that an academic medical school will bring.

Others have said that UNR should just expand, but in my experience distance is prohibitive. When I was at what's now called Drexel University, the Philadelphia and Pittsburgh campuses were 300 miles apart and extremely difficult to manage.

I think having a medical school here will raise aspirations for Southern Nevada's young people. It will make becoming a doctor -- or entering any of the much-needed health care professions -- that much more attainable.

The medical school also will make an extraordinary economic impact in the community. It's a wise investment of resources for a healthier population and for economic diversification. People who travel for care will now spend those dollars here. We'll have a healthier, more productive population. Within 10 years, we will have created 5,300 new jobs and have a $1.2 billion dollar annual economic impact.

And, I hope, we won't be hearing those heart-breaking stories from people who endured pain or whose diseases progressed while they were on long waiting lists.