Nevadans frequently face difficulty getting seen by physicians in a timely manner. The difficulty is even greater for those trying to see specialists. Nevada has several factors working against it - an aging physician workforce, a high number of inactive physicians (those not practicing), and the scarcity of residency positions in Nevada's medical schools (something that is decided by Medicare’s Graduate Medical Expense [GME] funding).
We are going to focus on the number of residents. However, we encourage you to read the editorial posted on Cureus by Do K, Do J, Kawana E, et al. (July 15, 2023) Nevada’s Healthcare Crisis: A Severe Shortage of Physicians and Residency Positions. Cureus 15(7): e41700. doi:10.7759/cureus.41700 for a deeper dive into physician shortages.
Current status of physician availability in Nevada:
Nevada ranks 48th in the nation in primary care physicians per capita
Nevada ranks 49th in the nation in surgeons per capita
One million people in Nevada live in an area with a shortage of physicians
All 17 of Nevada’s counties have some populations in areas that are federally designated as Health Professional Shortage Areas due to low ratio of doctors to residents
In March 2023, approximately 43,000 medical graduates nationwide learned where they were to train for their residency, and in what field of medicine. However, there were only 40,375 residency positions available. This means that approximately 2,600 applicants had to wait an entire year to reapply.
As of July 2023, Nevada had around 404 residency positions funded by the Center for Medicare and Medicaid Services (CMS). However, some say that Nevada has a limited number of residency spots compared to other states, such as New York, which has 25 times as many funded slots per 100,000 people. This can lead to medical school graduates leaving the state to complete their residencies elsewhere, and studies show that up to 50% of physicians may end up living within 100 miles of where they completed their residency.
In the past two residency match cycles, only 14.6% and 36.2% of the residency positions in Nevada were filled by UNR and UNLV medical students, respectively.
Background:
In 1997, Congress imposed a cap on the number of Medicare-funded residency slots for medical school graduates. This had the effect of fixing the geographical distribution of funding for residency training across the United States.
Despite the tremendous need for mental and physical healthcare, Congress has expanded funding for residency only once in almost 25 years. Several bills have been introduced to combat the problem yet remain unheard in Congress.
3/14/2013: Senators Bill Nelson (D-FL), Chuck Schumer (D-NY) and Harry Reid of Nevada introduced the Resident Physician Shortage Reduction Act of 2015 (S.577). The bill was referred to the Senate Committee on Finance and never got a hearing. The House's counterpart bill (H.R.1180) was sponsored by Rep. Joseph Crowley (D-NY) and co-sponsored by Nevada Representatives Dina Titus and Steven Horsford. The bill was referred to the House Subcommittee on Health and never got a hearing.
4/30/2015: Senators Bill Nelson, Chuck Schumer, and Harry Reid of Nevada again introduced the Resident Physician Shortage Reduction Act of 2015 (S.1148). The bill was referred to the Senate Committee on Finance and never got a hearing. The House's counterpart bill was introduced by Rep. Joseph Crowley (H.R.2124). Like its predecessor, it was referred to the House Subcommittee on Health and never got a hearing.
6/7/2017: Sen. Bill Nelson again introduced the Resident Physician Shortage Reduction Act of 2017 (S.1301). Then-Nevada Senator Dean Heller signed on as a sponsor. The bill was referred to the Senate Committee on Finance and never got a hearing. The House's counterpart bill was introduced by Rep. Joseph Crowley (H.R.2267). Like its predecessor, it was referred to the House Subcommittee on Health and never got a hearing.
2/6/2019: Sen. Robert Menendez (D-NJ) introduced the The Resident Physician Shortage Reduction Act of 2019 (S.348). Senator Jacky Rosen was a sponsor. It was referred to the Senate Committee on Finance where it has sat ever since. The House's counterpart bill was H.R.1763, sponsored by Rep. Terri Sewell (D-AL). Like its predecessor, it was referred to the House Subcommittee on Health and never got a hearing.
3/18/2021: A bipartisan group of senators introduced the Resident Physician Shortage Reduction Act of 2021 (S. 834). Senator Jacky Rosen was a co-sponsor. It, too, was referred to the Senate Committee on Finance where it has sat ever since. The House's counterpart bill was H.R.2256. All three of Nevada's Democratic members of the House signed on as co-sponsors; Congressman Amodei did not. The bill was referred to the House Subcommittee on Health and never got a hearing.
4/26/2023: Sen. Robert Menendez (D-NJ) again introduced the Resident Physician Shortage Reduction Act of 2023 (S-1302). Senator Jacky Rosen was a co-sponsor. It, too, was referred to the Senate Committee on Finance where it has sat ever since. The House's counterpart bill is H.R.2389. The bill aims to address workforce inadequacies by adding 14,000 Medicare-supported medical residency positions over a seven-year period. Once again, all three of Nevada's Democratic members of the House signed on as co-sponsors; Congressman Amodei did not. The bill was referred to the House Subcommittee on Health on 4/7/2023 where it has sat ever since.
Time and time again, research has shown that there is a higher probability of a healthy community when there are more primary care physicians available for the general population. Nevada needs to increase residency positions and specialties. Physicians who train in the state are more likely to stay and serve the local communities, especially if they completed medical school here. Increasing the number of physicians in the state would not only yield better patient outcomes, but it would also diversify Nevada’s economy by creating more jobs in its healthcare field.
Call to Action:
1. Write the Senate Committee on Finance and let them know you want S-1302 heard.
Chairman: U.S. Senator Ron Wyden (D-OR)
Ranking Member: U.S. Senator Mike Crappo (R-ID)
2. Write the House Energy and Commerce Committee and let them know you want their Subcommittee on Health to hear H.R. 2389:
Chair: Rep. Cathy McMorris Rodgers (R-WA)
Ranking Member: Rep Frank Pallone, Jr. (D-NJ)
3. Write the Subcommittee on Health and let them know you want H.R.2389 heard:
Chairman: Rep. Brett Guthrie (R-KY)
Vice-Chair: Rep. Larry Bucshon, M.D. (R-IN)
Ranking Member: Rep. Anna Eshoo (D-CA)