Internet Explorer 11 is not supported

For optimal browsing, we recommend Chrome, Firefox or Safari browsers.

Las Vegas Shooting Strains Nevada's Doctor Shortage, Prompts Medical Emergency

The state has one of the lowest resident-to-physician ratios in the country, which puts it in a uniquely vulnerable position to respond to large-scale emergencies.

The immediate aftermath of the mass shooting on the Las Vegas Strip on Sunday.
Almost immediately after the deadliest mass shooting in modern U.S. history, which killed at least 59 and injured more than 500 country music festivalgoers, the Sunrise Hospital and Medical Center in Las Vegas realized that it needed help.

It requested physicians from other states to come and treat the victims suffering gunshot wounds and injuries from being trampled while trying to escape the venue where bullets were firing at rapid speed from a room in a high-rise hotel. On Monday evening, Gov. Brian Sandoval issued a public health and medical state of emergency, which will make it easier for out-of-state doctors to get to work.

The emergency declaration reflects not just the large scale of this horrific event but also the state's doctor shortage, which puts Nevada in a uniquely vulnerable position when responding to a mass shooting.

The state routinely has one of the lowest resident-to-physician ratios in the country. A 2015 white paper from Merritt Hawkins, a physician research and consulting firm, ranked Nevada 49 out of 50 states, with only 180 doctors per 100,000 people.

“We need all the medical personnel that are available,” said Amy Shogren, director of communications for the Nevada Hospital Association, which worked with the governor to issue the state of emergency.  

A hospital can request emergency services from out-of-state doctors without a statewide emergency declaration, but having the support of the governor’s office helps. Shogren said she doesn't know how many out-of-state doctors to expect.

Whenever doctors come in from other states in an emergency, they must prove they are a licensed physician in good standing to both the state’s health department and a high-ranking hospital member. It’s a logistical hoop, but one that can be done quickly in times of crisis, says Janis Orlowski, chief health care officer for the Association of American Medical Colleges (AAMC). It’s necessary because hospitals can’t just have anyone walking in claiming to be a surgeon, she says. 

Requests for out-of-state doctors during an emergency usually correlate with whether or not a state already has a shortage of physicians. After Hurricane Harvey, medical officials in Texas -- which ranks 42 out of 50 in the Merritt Hawkins white paper -- requested out-of-state help. But after the 2013 mass shooting in Washington, D.C, at the Navy Yard, there was no need to bring in doctors from Virginia or Maryland because there were adequate trauma centers nearby, according to Orlowski.

As the country continues to deal with mass shootings and environmental disasters, it’s important that states continue to think about the number of physicians as a key part of their infrastructure, she says.

For its part, the state of Nevada has been trying to address its shortage. It opened a medical school this year at the University of Nevada, Las Vegas, and two Nevadans introduced a bill in Congress that would require more federal funding for medical residencies.

Sixty-eight percent of medical students stay where they trained and did their residency. In 2014, there were 340 residency students in Nevada. The number of residencies varies by state, but across the country, growth is largely flat, according to the AAMC. 

*Correction: This story was updated to clarify that 68 percent of medical students stay where they trained and did their residency -- not just where they did their residency.

Mattie covers all things health for Governing.

Special Projects
Sponsored Stories
In recent years, local governments have been forced to adapt to a wildly changing world, especially as it pertains to sending bills and collecting payments.
Workplace safety is in the spotlight as government leaders adapt to a prolonged pandemic.
While government employees, students and the general public had to wait in line for hours in the beginning of the pandemic, at-home test kits make it easy to diagnose for the novel coronavirus in less than 30 minutes.
Governments around the nation are working to design the best vaccine policies that keep both their employees and their residents safe. Although the latest data shows a variety of polarizing perspectives, there are clear emerging best practices that leading governments are following to put trust first: creating policies that are flexible and provide a range of options, and being in tune with the needs and sentiments of their employees so that they are able to be dynamic and accommodate the rapidly changing situation.
Service delivery and the individual experience within health and human services (HHS) is often very siloed and fragmented.
In this episode, Marianne Steger explains why health care for Pre-Medicare retirees and active employees just got easier.
Government organizations around the world are experiencing the consequences of plagiarism firsthand. A simple mistake can lead to loss of reputation, loss of trust and even lawsuits. It’s important to avoid plagiarism at all costs, and government organizations are held to a particularly high standard. Fortunately, technological solutions such as iThenticate allow government organizations to avoid instances of text plagiarism in an efficient manner.
Creating meaningful citizen experiences in a post-COVID world requires embracing digital initiatives like secure and ethical data sharing, artificial intelligence and more.
GHD identified four themes critical for municipalities to address to reach net-zero by 2050. Will you be ready?