Newsletter XXVII April 2002
Contents
Offshore Asset Protection Planning
President’s Message - Malpractice Crisis Update
Survey of NBME Disciplinary Actions
Guest Column: The St. Paul Crisis and Dr. Rotten Apple
Clark County Health District Disease Statistics * - February 2002
Offshore Asset Protection Planning
Jeffrey L. Burr and
Russell K. Bowler, Jeffrey L. Burr & Associates
The purpose of asset protection planning, generally speaking, is to protect assets from the reach of future creditors. Asset Protection planning should not be seen as a way to defraud creditors. Rather, it should be seen as a way to arrange one's assets to take advantage of legitimate legal means to shield assets from creditors. Asset protection planning is becoming more popular as the number of lawsuits continues to grow at a frightening rate.
One of the basic themes of asset protection planning is that form matters. Thus, for example, investment assets held in a limited partnership or a limited liability company are generally more difficult to reach and therefore less desirable to creditors than investments owned in one's own name. This is true even though the same individual may control his or her investment assets through an entity such as a limited liability company.
A good asset protection plan will generally employ various strategies to protect one's assets. A good plan should have various levels of protection. If a creditor breaks through one level of the asset protection structure they should not then have a clear path to all of one's assets. Rather, they should then face the prospect of having to break down even more barriers.
The various levels of asset protection one employs in their asset protection plan may include the homestead exemption, liability insurance (professional, automobile, an umbrella policy, etc.), owning exempt assets such as certain qualified plans, gift-giving strategies, spendthrift trusts, limited partnerships, limited liability companies and others. Many appear to consider the offshore trust as the biggest weapon in this asset protection planning arsenal.
In this
article we provide an overview of offshore trusts. First we will discuss some background
information with regard to offshore trusts. We will then discuss some of the
initial considerations such as selecting an offshore jurisdiction. Then we will discuss some of the tax and reporting
issues involved with actually taking assets offshore. We will next discuss some of the current
[Ex. Dir. note - a Nevada On-Shore Trust is a descriptive
term for
Understanding
some of the terminology in this area is important. A "Settlor" is the person who
establishes a trust. The terms
"grantor" or "trustor" also refer
to a settlor. A "Spendthrift
trust" is a trust where the assets cannot generally be reached by the
beneficiaries' creditors. A self-settled
spendthrift trust is a creditor protected trust where the settlor is a
beneficiary. The laws of most of the
states (and most other common law jurisdictions) do not recognize self-settled
spendthrift trusts as a way for a settlor to protect his or her assets from
creditors. However, at least four states
have enacted legislation to change that law to some degree.
The foundational basis for offshore asset protection planning is twofold. First, the laws of the foreign jurisdiction are generally more favorable than domestic laws and second, the physical location of the assets makes them more difficult to reach. Thus, there are legal and practical barriers to reaching assets that are offshore.
Another basic tenet of asset protection planning is that the optimal situation is where the plan is established and the transfers are made when the owner of the assets is not in trouble with creditors. The best time for putting a plan into effect is when the waters are clear, so to speak. Fraudulent transfer laws are less likely to apply to transfers made before the trouble hits. Also, a court is going to be less impressed with planning that is quick and in the wake of financial troubles. They are more likely to try to find a way to disregard the offshore or other asset protection arrangement if it appears that it was established as a result of current creditor problems. Planning should occur before the storm hits. In short, the time to plan is now!
Giving Up Some Control. In order to obtain offshore protection a settlor must generally give up some control over the assets that will be transferred to the offshore trust. However, the trust document and any other agreement are put in place to establish a contractual framework of how the assets are to be controlled and administered by a third party, the trustee. A trust company will generally have to be employed. This company should be selected carefully as it will have control over assets.
The importance of giving up control has been highlighted in some US Bankruptcy Court cases where the court allowed the assets in offshore trusts to be included in the bankrupt's estate because the courts found that the debtor kept control over the assets.
Selecting a Country. The jurisdiction should be carefully selected, as it should be one where the political and economic climates are friendly to the settlor. Also, the laws of the jurisdiction should be very settlor friendly vis a vis a judgment creditor. Judgment creditors should cringe when they find out that their debtor has assets in trust governed by that particular jurisdiction. There are many jurisdictions to choose from. One should look for the jurisdictions that they are comfortable with and that provides the greatest legal protection.
In an
effort to attract capital, many of these "offshore" countries have
enacted pro-debtor legislation. For
example, some of them will not recognize a foreign judgment. Thus, the case against a debtor will have to
be re-litigated in that country. Some
disallow contingency fees making it less desirable for a creditor to bring a
lawsuit there, as the creditor would likely have to pay their attorney on an
hourly fee basis. To make it even more
difficult, the laws of some of these jurisdictions set a higher standard of
proof. In the
Tax Considerations. Generally, our federal government imposes a
tax on assets that are transferred to a foreign trust. The amount subject to tax is the difference
between the adjusted basis and the fair market value of the assets transferred. However, most people who set up these
offshore trusts retain some certain controls over the assets and/or benefits
from the assets owned by the trust. As a
result, the trust is a grantor trust under our federal income tax laws. A grantor trust is one where the federal
income tax laws treat the grantor (or settlor) as the owner of the trust's
assets. Thus, the settlor is taxed on
the income of those assets and it is reported on the settlor's
In selecting an offshore trust jurisdiction one should consider whether its laws are tax friendly. Some jurisdictions, for example, make such trusts exempt from their tax laws (income and transfers taxes) if none of the settlor(s) and beneficiary(ies) are residents of those countries.
Other Asset Transfer and
Reporting Considerations.
Assets do not have to be physically located in the offshore trust
jurisdiction. A
A gift tax return is required upon certain transfers to offshore (and domestic) trusts even though no gift tax is due. The return is required for disclosure purposes where a transferor is claiming to retain certain powers. The IRS wants to make sure that a completed transfer has not occurred. Also, depending on whether the trust is a foreign or domestic trust under the income tax regulations, certain annual reporting forms may be required. These forms general cover the transfer of assets to and from a foreign trust. A discussion of the reporting requirements of foreign and domestic trusts is beyond the scope of this article. It is important to discuss these matters with the professionals who assist you in setting up an offshore trust. Finally, certain annual reports must be filed with regard to certain foreign bank accounts.
Recent Developments: Litigation Involving
Offshore Trusts. There have been a
couple of cases that have made some think that offshore planning is not as
viable as it used to be. In at least one
of these cases the judge held the settlors of a trust
in contempt of court (with the threat of jail time) for not returning the
assets they had transferred to an offshore trust. The facts of this case were egregious as the settlors transferred assets (that were allegedly obtained
in an illegal Ponzi scheme) to an offshore trust to
evade creditors. The trust appeared to
give the settlors too much power over the trust
assets and had
provisions that appears the settlers could have failed to
invoke. Once invoked, these provisions
did not allow the trustee to return the assets to the
As a
result, much has been written about the issue of a settlor being held in civil
contempt. The conventional wisdom
appears to be that a properly drafted trust and a properly structured plan
should avoid the civil contempt issue.
The key issue appears to be what powers the settlor(s) retain and what
ability they have under the trust agreement to bring the assets back to the
Comparison to NOST. For those who are uneasy with going offshore
or want a less costly alternative there is another option. A few states, including
Conclusion. This article is intended to give some basic information on the use of an offshore trust in asset protection planning. A good asset protection plan includes many barriers. The offshore trust is a powerful asset protection planning tool and can be an enormous barrier; however, the tradeoffs for such protection are complexity, high cost, and having to actually transfer control of assets to a foreign trustee. There are other alternatives to going offshore including the NOST.
Jeffrey L. Burr and Associates is a law firm specializing in Estate Planning
and Asset Protection.
Referral Tallies
The following referrals were provided to CCMS members in the first quarter of 2002 (through March 15)
Specialty Referrals
Addiction Medicine 2
Allergy 3
Anesthesiology 3
Cardiology 4
Cardiovascular Surgery 0
Dermatology 7
Diagnostic Radiology 0
Endocrinology 7
Family Practice 20
Gastroenterology 9
General Surgery 2
Geriatrics 5
Gynecologic Oncology 0
Hematology 1
Infectious Medicine 3
Internal Medicine 23
Nephrology 1
Neurology 12
Neurosurgery 0
Ob-Gyn 16
Oncology 2
Ophthalmology 9
Oral/Maxillofacial Surg. 0
Orthopaedic Surgery 13
Otolaryngology 4
Pain Management 2
Pathology 0
Pediatrics 3
Ped. Endocrinology 0
Ped. Neurology 0
Ped. Surgery 0
Physical Med/Rehab 0
Plastic Surgery 11
Preventative Medicine 0
Psychiatry 18
Pulmonology 1
Radiology 1
Rheumatology 4
Urology 1
Vascular Surgery 0
Totals 188
Member Applicants
If you have any pertinent information about the following membership candidates, please contact:
Donald Roberts, MD - Ob-Gyn
New Members
Congratulations and Welcome to the
Walter Kidwell, MD, Anesthesiology,
Louis La Mancusa, MD, Neurology,
Joanne Leovy, MD, Family Practice,
Dennis Moore,
Craig Nakamura, MD, Pediatric Pulmonology,
William Steinkohl, MD, Urology, 7200 Cathedral Rock Dr., Ste. 180, Las Vegas, NV 89128
Jason Zommick, MD, Urology,
President’s Message - Malpractice Crisis Update
Raj Chanderraj, M.D.,
2001-2002 CCMS President
The malpractice crisis is gaining momentum. It has caught the attention of the public, the politicians and the local industry. I hope something good comes out of it.
Let me outline what has happened so far, what needs to happen and what we need to do.
Since our last issue, the Medical
Liability Task Force has been formed, coming together with the Clark County
Medical Society, Nevada State Medical Association, Concerned Physicians of
Nevada, the Obstetrical and Gynecology Specialists Association, the Emergency
Physician Group, the
The task force hired a lobbyist and a public relations firm to further our cause. The immediate focus is on obtaining affordable liability coverage. To this end, several of the task force members testified at the Insurance Commissioner's meeting, wherein we made it abundantly clear to the Commissioner and the Governor that there was no affordable coverage to most physicians. The Governor was given information on the statistics and informed of the need for legislative reforms that need to be accomplished. HE IS WELL INFORMED NOW THROUGH OUR EFFORTS AND HE IS DOING EVERYTHING IN HIS CAPACITY TO HELP US. HE IS ON OUR SIDE. Very expeditiously he announced - at the risk of negative publicity - his invoking the Emergency Insurance Act at the expense of taxpayers to make sure we have something to fall back on.
Unfortunately, the tail coverage needed to make the liability coverage affordable still is a daunting problem and may still lead to an exodus of high risk specialists such as OB-GYN's, surgeons, and ER physicians. While the dialogue is still being carried on, the solution to this critical need remains elusive.
Upon learning the governor's initiative, the Medical Society, at an emergency meeting, elected to suspend its efforts of bringing about a mutual insurance company. We feel this only duplicates what the state is doing and may not be available to write policies for at least another 90 days, whereas the state plan will be effective by April 15th. The Medical Society may resume its efforts after an effective TORT reform package is passed by the legislature.
March 21st is the first meeting of the State's Legislative Committee charged with the responsibility of submitting a bill draft to the legislature. Several of the task force members have been called on to testify at the hearings.
There may be a catastrophic crisis
situation very soon that may provoke and force some physicians to take
unprecedented moves in
Lastly, I thank you all for turning out in large numbers at the Insurance Commissioner's hearing. I hope and trust we can stay UNITED.
CEO Editorial
Weldon (Don) Havins,
M.D., J.D., CCMS Executive Director/CEO and Special Counsel
Governor's Immediate
Medmal Insurance Availability Solution
This article was written just as Governor Guinn announced the plan to establish the Nevada Essential Insurance Association (NEIA). The NEIA start-up costs will be funded, up to $250,000, from the State Emergency Account controlled by Governor Guinn as chairman of the Board of Examiners. Insurance Commissioner Alice Molasky-Arman made the formal declaration that essential insurance in the medical professional liability area is not readily available to physicians. The Governor stated that the program would be in place and granting policies by April 15th, some 32 days from the announcement.
Thus,
before April 15th, the Board of Directors of the NEIA must be selected, the
Directors must contract for actuarial services, obtain those, select
underwriters and administrators, set policy premiums for the specialties of
medicine and surgery, process applications and send accepted physician
policyholders their policies. This will
be a very busy time for all concerned.
The Governor stated that the policy premiums would be set at a level
calculated to cover anticipated losses with a prudent surplus. There will be no reinsurance. The taxpayer of
Other specialty estimates for initial and second year premiums are as follows:
Cardiovascular Surgery: $25,500 and $46,000
Emergency Room Physicians: $13,000 and $25,000
General Surgery: $22,000 and $40,000
Orthopaedic Surgery: $25,000 and $50,000
Internal Medicine: $6,000 and $11,000
Pediatrics: $6,000 and $11,500
These are only unofficial estimates. Reliable, definitive premium prices will be available soon. Remember, tail coverage will need to be purchased by physicians from their current carrier. Tail coverage normally costs between 1.7 to 2.5 times the last annual premium.
The Governor announced that he had reached an understanding with St. Paul Insurance Company that payments on tail coverage (rather than the usual requirement of full payment on the tail within 30 days of termination of insurance) would be permitted for physicians paying premiums on a monthly or quarterly basis. For these physicians, payments on the tail coverage could be spread out over the year following coverage on a corresponding monthly or quarterly basis. Those having paid premiums on an annual basis would apparently be required to pay the complete tail amount within 30 days of the termination of the policy contract.
The Governor expressly stated that this Association constituted a temporary measure until the legislature has an opportunity to address the problems which have lead to the current crisis. Thus, it appears the Association will be with us through the 2003 legislative session.
State Medmal
Information Web site
A comprehensive collection of state by state medical malpractice associated statutes can be found at: http://www.mcandl.com/states.html The topics addressed in each state are:
Statute of Limitations
Contributory or Comparative Negligence
Joint and Several Liability
Contribution
Vicarious Liability
Expert Testimony
Damage Caps
Statutory Cap on Attorneys' Fees
Periodic Payments
Collateral Source Rule
Pre Judgment Interest
Patient Compensation Funds
Immunities
Arbitration
The web site is current through 1998. While it is possible that some of the
statutes have been amended or found unconstitutional, it is likely the vast
majority are currently valid law. It
appears that 21 states have caps or limits on non-economic (pain, suffering,
and inconvenience) damages, including
NTLA has
formed a committee to address the medical malpractice insurance availability
crisis. The voting members of the
Nevada Medical Liability Crisis Physician Task Force, and the organizations
represented, are lists below the attorneys.
Other members of the Physician Task Force are Arnold Wax, M.D.,
representing the
Timothy
Williams, Esq., president of the Nevada Trials Lawyers Association concluded a
series of articles entitled, Examining the Myths
Behind Tort Reform (Part 3 - Medical Malpractice). He contends that "contrary to what is
being reported in the media,
Mr.
Williams' criticisms of
Perhaps Mr.
Williams and the NTLA are correct.
Perhaps the premium increases demanded by medmal carriers in
For the
time being, it appears Governor Guinn's courageous action in initiating the
formation of the Nevada Essential Insurance Association will stem the insurance
premium increases that are driving excellent physicians from
While discussing this and other problems recently, Mark Howard, CEO of Mountain View Hospital, opined that we should all keep the following in mind: more than 50% of humans live in a one room accommodation with a dirt floor; only 20% of humans live in a house with more than one room and that has glass windows; less than 20% of humans read, wear shoes, have a change of underwear, and eat more than one type of food; and, finally, less than 1% of humans own a refrigerator, automobile, computer, microwave and a VCR.
Survey of NBME Disciplinary Actions
Several doctors have expressed interest or concern over the Nevada State Board of Medical Examiners disciplinary actions, specifically what penalties result from what sorts of transgressions. Deborah Barton, CCMS Public Relations Coordinator researched the published records of disciplinary actions taken by the BME. The sources used for this article were NBME actions published in the NBME newsletter at www.state.nv.us/medical, the Las Vegas Review-Journal database of physician disciplinary actions at http://db.lvrj.com/doctor-review/ and the Federation of State Medical Board's web site information at www.fsmb.org.
An analysis of the physician disciplinary actions listed on those websites resulted in information on 162 actions against 144 licensed physicians from 1988 through 2001. The complaints were separated into eight broad categories:
1. False Information on Application/Action Taken in Another State/Failure to Report Action
2. Not Listed
3. Malpractice
4. Business/Office Management
5. Criminal Actions
6. Excessive/Improper Prescribing
7. Substance Abuse
8. Competency
For convenience, physicians with complaints that fell into multiple categories were placed in the category for the most severe allegation. For instance, a physician who was convicted of a felony in another state and failed to report it to the Board would be categorized for criminal actions rather than failure to report.
Of the
physicians disciplined by NBME during this period, 54 of those disciplined were
for false information on the application, for actions taken by other states,
and/or failure by the physician to report these actions. Against the 54 physicians disciplined for
these offenses, the Board revoked, refused to renew or accepted the surrender
of 27 licenses. Only 14 of the 54 disciplined for these actions still have a
Of the seven remaining reasons for physician discipline, 20 complaints were "not listed," 19 were for malpractice, 16 were for business/office management issues, 15 were for criminal actions, 10 involved excessive or improper prescribing, seven were strictly for substance abuse and three were related to competency.
As far as could be determined from the published documentation, of the 20 physicians whose complaint was "not listed," three licenses were revoked, five licenses were voluntarily surrendered while under investigation and six of the physicians are still licensed.
Of the 19
physicians disciplined for malpractice, five licenses were revoked, one
physician voluntarily surrendered his license while under investigation, and
the others received various penalties, such as probation, restrictions on
practice, reprimands, and CME requirements. Six of the 19 physicians still have
a
Most of these disciplinary actions were taken for gross malpractice or multiple counts of malpractice; however it is important to note that, due to a 1997 change in NRS 630, it is now possible to be disciplined by the Board for a single act of malpractice. A Fallon physician received a fine, charged administrative costs and placed on probation until completing 10 CME hours in post-surgical complications for a
single complaint of malpractice.
The Medical Dental Screening Panel (MDSP), from 1986 through 2001, only lists findings on three of the 19 physicians disciplined for malpractice. One physician had two cases determined to be probable malpractice, one physician had one finding for probable malpractice, and one physician had two cases where the panel was unable to decide.
There were 16 physicians disciplined for offenses relating to the management of their practice. These involve billing issues, aiding unlicensed persons in practicing medicine, signing blank prescription forms, false advertising, and records management. Nine of these physicians are still licensed, two had their license revoked and one surrendered his license. The penalties for most licensees in this category involved fines, probation and/or reprimands.
Fifteen physicians' licenses were disciplined for criminal actions or conviction, of which five licenses were revoked and the remaining 10 faced various penalties. Six of the physicians are still licensed.
Of the 10
physicians penalized for improper or excessive prescribing, three had their
license revoked, two surrendered their license, and the remaining received
lesser penalties. Four of the physicians have a
According to the information, seven physicians were disciplined specifically for substance abuse. Of these, three had their license revoked and one voluntarily surrendered his license. Of the three physicians whose license was revoked, two were placed on probation prior to losing their license. The remaining three were placed on probation and required to seek treatment, and received other penalties as well. The MDSP has findings on two of these physicians: one physician has one finding of probable malpractice and one physician has one finding of probable malpractice and one finding of no probable malpractice.
During this period, three physicians were disciplined for failing competency exams. One physician retired, one surrendered his license and one was ordered to take refresher courses and retake a competency exam. That physician is still licensed. According to the materials analyzed, there has not been a physician disciplined for competency since 1992.
Information on all NBME disciplinary actions is a matter of public record. The Board charges 60 cents per page for the information. Another source for disciplinary information is the Federation of State Medical Boards, which will provide information on a physician for a $9 fee. The requestor must submit the physician's full name, city and state.
The above table displays NBME disciplinary actions taken against medical doctors as reported to the Federation of State Medical Boards from 1985 through 2000. NMBE defines miscellaneous actions as license restriction, public reprimand, licensure denied, CME ordered, drug or alcohol treatment program ordered, or competency exams (medical, physical, mental) ordered. (Data from NBME Newsletter, Volume 26, April 2001.)
CME Calendar
Cardiovascular
Consultants 691-9154
4/18 - “End of Life Dilemmas: The Ethics of Assisted
Suicide, Palliatire Sedation, Pain and Symptom
Management,”
4/13 - “Medical Ethics Symposium: Ethical Decision Making
and the Critical Care Patient,”
Southwest Medical
Associates 242-7347
Some courses also approved for nursing CEUs.
4/11 - “Genetics Update for the Primary Care Provider,”
5/9 - “Latest Clinical Standards and Interventions:
Providing Optimal Diabetes Care,”
UMC 383-2604
4/9 - “What’s New in Radiation Oncology,”
4/23 - “Reduction of Adverse Cardiac Events - The HOPE
Trial,”
5/14 - “Hodgkins Disease: An Overview,”
5/28 - “Venous Thromboembolic
Disorders,”
6/11 - “The Use of Intravenous PPI’s,”
6/25 - “Update on Asthma,”
7/9 - “Vaginal Births After Cesarean Sections(V-Bacs),”
7/23 - “Making the Valley Hospital Web site Work For You and Your Patients,”
*Special Note: CCMS members can receive free CME courses on the internet with World Medical Leaders.
To have your CME courses listed on our calendar, please contact Deborah Barton at 739-9989.
Guest Column: The St. Paul
Richard W. Myers,
Crockett & Myers
Once again a medical malpractice crisis is in the headlines. A look at the past might provide the solution to this present day problem.
Nevada’s J.U.A. Was
Profitable
Readers are
reminded of
They say one rotten apple can spoil the whole barrel. During the 1990’s Dr. Rotten Apple saw a chance to make a fortune. He went on a binge of unnecessary, poorly done surgeries each of which was excessive in scope and very expensive. He knew that medical malpractice claims would ultimately catch up to him and that his window of opportunity was therefore limited.
But
One Man Mass Disaster
Beginning in 1995 and through the end of 2001 more than 40
malpractice claims were filed against Dr. Rotten Apple. And it isn’t over yet. His
Dr. Rotten Apple was a one man mass disaster similar to a hotel fire or an airplane crash.
Never
under a
This never,
ever would have happened under N.M.L.I.C.
Local watchful eyes incented to identify
wrongdoing would have ousted Dr. Rotten Apple before he could spoil the whole
barrel as he has done under
There are
many
Rich Myers, Esq. earned selection as the 2001
Clark County Health District Disease Statistics * - February 2002
DISEASE CASES REPORTED YEAR TO DATE
Feb 2001 Feb 2002 2001 2002
VACCINE PREVENTABLE DISEASES
DIPTHERIA 0 0 0 0
HAEMOPHILUS INFLUENZA 0 1 0 1
(invasive)
HEPATITIS A 11 3 20 6
HEPATITIS B 2 0 4 3
INFLUENZA 8 23 24 24
MEASLES 0 0 0 0
MUMPS 0 0 0 0
PERTUSSIS 0 0 0 0
POLIO 0 0 0 0
RUBELLA 0 0 0 0
TETANUS 0 0 0 0
SEXUALLY TRANSMITTED DISEASES
AIDS 13 16 27 34
CHLAMYDIA 295 336 579 732
GONORRHEA 116 110 250 257
HIV 10 14 27 22
SYPHILIS 1 0 3 0
(Primary & Secondary)
SYPHILIS (Early Latent) 1 1 1 1
ENTERICS
AMEBIASIS 0 2 0 3
BOTULISM-INTESTINAL 0 0 0 0
CAMPYLOBACTERIOSIS 9 9 20 16
CHOLERA 0 0 0 0
CRYPTOSPORIDIOSIS 0 0 0 1
E. COLI O157:H7 0 1 0 1
GIARDIASIS 10 5 17 17
ROTAVIRUS 76 65 215 127
SALMONELLOSIS 3 17 24 31
SHIGELLOSIS 3 0 5 0
TYPHOID FEVER 0 0 0 0
YERSINIOSIS 0 0 0 0
ANTHRAX 0 0 0 0
BOTULISM INTOXIFICATION 0 0 0 0
BRUCELLOSIS 0 0 0 0
COCCIDIOIDOMYCOSIS 2 0 5 3
ENCEPHALITIS 0 0 0 0
HANTAVIRUS 0 0 0 0
HEMOLYTIC UREMIC
SYNDROME (HUS) 0 0 0 0
HEPATITIS C 0 0 0 0
LEGIONELLOSIS 0 0 0 0
LEPROSY (HANSEN'S DISEASE) 0 0 0 0
LEPTOSPIROSIS 0 0 0 0
LISTERIOSIS 1 0 1 0
LYME DISEASE 0 0 0 0
MALARIA 0 0 0 1
MENINGITIS,
ASEPTIC/VIRAL 3 5 6 9
MENINGITIS, BACTERIAL 3 3 6 5
MENINGOCOCCAL DISEASE 2 2 3 5
PLAGUE 0 0 0 0
RABIES (HUMAN) 0 0 0 0
RELAPSING FEVER 0 0 0 0
RSV (RESPIRATORY 348 590 691 891
SYNCYTIAL VIRUS)
ROCKY MOUNTAIN
SPOTTED FEVER 0 0 0 0
TOXIC SHOCK SYNDROME 0 0 0 0
TUBERCULOSIS 6 5 13 8
TULAREMIA 0 0 0 0
*Numbers include confirmed and probable cases
Classifieds
- FOR LEASE, MEDICAL OFFICE: Del Webb Medical Plaza in Green Valley, approx. 2335 sq. ft., turn key with four exam rooms, one procedure room and nice decor. Call Connie at 702-951-0770.
- OFFICE SPACE AVAILABLE.
- X-RAY EQUIPMENT. Like new! 500 MA Continental 125 KV with high frequency generator. Wall Bucky stand. Four-way float table. Floor rail mounted tube stand. Konica table model automatic processor. Cassettes - other accessories. New $20,000.00. Yours for only $9,800.00. Please call Family Medical Group, Evelyn (702) 459-5500.
- ADDICTION MEDICINE/MD SEEKS physician to help cover addiction medicine hospital practice - weekends and vacations. Psychiatrist or medical physician with experience in addiction medicine preferred, but training is available for interested MD’s. Please contact: Mel Pohl, MD 256-9255.
- FOR SALE - MEDICAL OFFICE EQUIPMENT and furniture. Excellent condition. Includes electric exam/treatment tables, Chattanooga Intelect combo therapy units, supplies, fully equipped X-ray room (Bennett), exercise rehabilitator, chairs, desks, office equipment, etc. For more information, call Alison (702) 252-7246.
- CLASSIFIED ADS ARE FREE (up to 40 words) for members of the Clark County Medical Society (an $85 value). For information about classified or display advertising, call Deborah Barton at CCMS, 739-9989. Members can fax their classified ad to 739-6345.