Medical school gets recognition for focus on family practitioners

Even without the impacts of health-care reform, Nevada needs many more family practice physicians.

The University of Nevada School of Medicine, however, gets high marks for its efforts to recruit and retain students interested in family practice medicine.

The problem: Nevada ranks 46th in the nation in availability of family physicians. A study by the School of Medicine this spring found 71.2 active primary care physicians per 100,000 population in Nevada, compared with a U.S. average of 89.6. (Primary care physicians include specialists in family practice, pediatrics and internal medicine.)

Some modest relief, however, may come from the School of Medicine's successes in recruiting students who are interested in family medicine.

The American Academy of Family Physicians this year recognized the School of Medicine as one the top 10 in the nation for its efforts to fill the pipeline with new family practitioners.

About 15.8 percent of the graduates of the medical school in the past three years chose to enter family medicine.

Dan Spogen, M.D., the chair of the department of family medicine in Reno, says efforts to increase the number of family physicians in the state begin with recruitment of students to the School of Medicine.

Students who grew up in rural communities, for instance, are more likely to be interested in careers in family practice. (The University of Nevada School of Medicine recruits in states such as Wyoming and Montana that don't have medical schools, as well as its home state.)

Personality, too, plays a role.

"Family medicine is relationship medicine," Spogen says. Students who are focused in diseases rather than patients are less likely to succeed in family practice.

The school looks to encourage students' enthusiasm through creation of student interest groups in family medicine and a student outreach clinic that's run through the family medicine department.

And all third-year medical students must do a clinical rotation in family medicine.

The University of Nevada, Reno School of Medicine has 30 residency positions in family practice in Las Vegas and Reno that are filled by its graduates as well as graduates of other medical schools.

That's important because new physicians are influenced to settle nearby after they complete their residencies. In Nevada, 58.5 percent of physicians who completed their graduate medical education in the state end up practicing in Nevada. That's the fifth-highest mark in the nation.

Still, Spogen notes that economic realities dissuade some student from careers in family practice.

"Family medicine is not the quickest way to pay off your $300,000 in student loans," he says, especially because insurance reimbursements often favor specialists rather than family practice physicians.

Despite the School of Medicine's success in recruiting and training family practice physicians, Spogen says the state has a long way to go. He figures the state could use about 600 additional primary care physicians. The School of Medicine has been graduating about 20 a year.