Clark County Medical Society

County Line

Newsletter 77     June 06

 

Contents

 

Urgent Changes Needed to Address Our Nursing Shortage

President’s Message

Malpractice Filings Against Health Care Providers, Jan 2001 – Apr 2006

Member News

Southern Nevada Health Officer Report

Alliance Message

NSMA’s 102nd Annual Meeting & Scientific Session held in Las Vegas has excellent turn out

The public has virtually nothing to do with who runs for office at any level

BOT Minutes

Classified Ads

CME Calendar

County Line Advertisers

 

 

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URGENT CHANGES NEEDED TO ADDRESS OUR NURSING SHORTAGE

By Michael P. Colletti, MDi & Weldon (Don) Havins, MD, JD

 

            Nevada's population is about 2.6 million with over 70% of the population residing in southern Nevada.  By 2016, Nevada's population will be 3.4 million, and most of that growth will occur in southern Nevada.  The Department of HHS predicts that Nevada's nursing shortage will accelerate from an 11% nursing shortage in 2000 (which placed Nevada 50th out of the 50 states in nurses per 100,000 population) to a nursing shortage of 27.5% in 2020ii.   Nevada's nursing workforce, in concert with what is occurring nationally, is aging every year.  The average age of a nurse is 48 years old.  The R.N. population under age 30 dropped from 25% in 1980 to 9% in 2000iii.   From every perspective, Nevada's nursing shortage crisis increasingly threatens the health, safety, and welfare of its residents. 

            For several years, we (the authors of this article) have been active members of the Southern Nevada Medical Industry Coalition Nursing Education Committee.  About three years ago, there was a shortage of qualified nursing student applicants.  The Committee addressed that issue with brochures and other methods to improve the quality of the applicant pool.  Johnson and Johnson Company developed television videos and advertised the benefits of the nursing profession.  As a consequence, we now have an abundance of qualified applicants for the available nursing school positions.  The committee has worked with hospitals, nurse recruiters and others to entice out-of-state R.N.s to move to southern Nevada.  Hospitals and other entities have made extensive efforts to recruit nurses from other English-speaking countries.  Unfortunately, every other state in the U.S. has been attempting the same thing to augment their lagging nurse workforce.  The fact is -- there is a nationwide nursing shortage - it just happens to be worse in southern Nevada than anywhere else. 

            Clark County is one of the fastest growing counties in the nation with 6000 people moving here monthly.  Less than 25% of the licenses issued by the Nevada Board of Nursing in 2004-2005 were to new nurses graduating from Nevada nursing schools.  In sum, we have an aging nursing population heading for retirement much faster than we are training even their replacements; we are in an exploding population which needs progressively more and more nurses; and we are training only a fraction of the nurses we need in Nevada.  The obvious solution to Nevada's nursing shortage crisis is for our state to produce our own nurses in sufficient numbers to meet our needs. 

            In 2003, in an attempt to address this problem, the Legislature passed a Bill requiring state nursing programs to double their enrollment.  Unfortunately, the Legislature did not adequately fund this mandate.  In spite of this, a few programs, such as the A.D.N. (Associate Degree in Nursing) program at the Community College of Southern Nevada did double their nursing enrollment.  Other state schools were unable to meet the mandate.  Even doubling enrollments, with every enrolled student graduating, would not begin to satisfy Nevada's acute nursing shortage. 

            Two years ago the Nevada State College implemented an accelerated nursing program in addition to their standard four year nursing program.  The accelerated program provides that applicants with a Bachelor's degree, who have completed the necessary prerequisite courses, can earn a B.S.N. (Bachelor of Science in Nursing) in one year.  This program, with little publicity, has experienced a high number of qualified individuals applying for admission.  The first class of 34 admitted students included two physicians (a dermatologist and a general surgeon, both from the Philippines), a graduate engineer, a former member of the State Department's diplomat corps, two students with Masters degrees in business, a former high school principal, and an accountant, among others with similar distinguished careers.  This first class graduated 32 students.  This academic year there were over 80 qualified applicants for the Nevada State College accelerated nursing program competing for the 40 available positions.  UNLV is implementing a similar one year programiv.   When Touro University contemplated a similar accelerated nursing program, Touro was informed that it was illegal.  The attorney general's office quoted nursing statute NRS 632.450 which provides that "any institution desiring to conduct a school of professional nursing in this State shall submit evidence to the Board that it is prepared to give a course of instruction of not less than 2 years."  Are private nursing schools being prejudiced by the selective enforcement of this law while public nursing programs apparently are above this law?  Clearly, this antiquated law, passed in 1973, should be eliminated from our Nursing Practice Act.

            As tax paying citizens, we must demand accountability of our state nursing programs and support those with proven records of productivity.  Enrollment in state nursing programs is important, and the education of those who would become nurse educators is very important.v   However, the efficiency in graduating nurses ready to take their licensing exam must be the fundamental measure of the value of a nursing program to tax paying Nevadans.  The programs that can produce nurses most cost effectively must be given priority in tax dollar support.  As taxpayers, we must urge our Legislators to provide annual audits of state supported nursing programs so that citizens can confirm that our tax dollars are being spent in the most productive manner in educating nurses.

            However, the limited tax funds available for nursing education programs will not train a sufficient number of nurses to satisfy the nursing needs of our growing population.  Private nursing programs must supplement the production of nursing graduates.  Four private institutions, all located in Henderson, will be producing nurses for Nevada.  Touro University and the University of Southern Nevada (formerly the Nevada College of Pharmacy) have matriculated their first nursing students.  National University has hired a nursing program director and intends to develop a B.S.N. nurse education program.  Apollo College intends to begin an Associate Degree in Nursing program.  We must support the successful implementation of these programs - none of which costs Nevada taxpayers anything.

            One aspect of the nursing shortage, which has not been appreciated until recently, is the unavailability of Masters- prepared nursing instructors, that is, R.N.s with a Masters degree in nursing to teach both didactically and clinically.  Currently, in southern Nevada, there are over 15 nursing faculty positions that are vacant in the public or private colleges and universities, and these don't include the programs under development.  The State Board of Nursing regulations require Masters-prepared nurses to teach all aspects of the nursing curriculum.  This "bottleneck" in the system is adversely affecting the number of nurses that can be matriculated to nursing programs.  The critical shortage of Masters-prepared nurses available for teaching will increasingly impede Nevada's production of nursing program graduates.  The small percentage of Masters-prepared nurses in Nevada generally prefer to work for the hospital systems where pay is substantially greater than that provided in schools of nursing.  At a minimum, our Legislators should provide for "market-rate" salaries for Masters-prepared nurses entering nursing education in our state supported programs.  If this is not done, Masters-prepared nurses produced by UNLV, Touro University, and UNR will be "lost" to the higher paying health care institutions.

            The Southern Nevada Medical Industry Coalition (SNMIC) and its Education Task Force have researched other state nursing boards' regulations (Arizona, California, and Oregon) to understand how they have coped with this national issue of a lack of Masters-prepared nurses to teach in their nursing programs.  All three of these states utilize B.S.N.s as Clinical Instructors to educate R.N. students.  The addition of these qualified and experienced B.S.N. nurses to the cadre of available nursing instructors would greatly enhance the number of students Nevada nursing programs could ultimately graduate.  The Nevada State Board of Nursing has, thus far, not been proactive in facilitating this change in our Nursing Board regulations.  When some members of the Nursing Board's Education Advisory Committee are asked about instituting this change, the pretext for resisting use of B.S.N. nurses as Clinical Instructors is that the "quality of nursing education" would be adversely affected and "we don't want to lower our standards."  Our citizens would counter that the fundamental "standard" critically important to Nevadans is an adequate number of nurses to provide quality care to our residents.  

            The pretext in those arguments is transparent.  Nevada hospitals would welcome nurses from any of those three states (Arizona, California, and Oregon) who would be interested in coming to Nevada to work.  There is no question of the good quality of their nursing education graduates, and no evidence of lower patient outcomes in the hospitals located in those states. 

            The Clark County Medical Society is prepared to support a Legislative Bill which would require the Nevada State Nursing Board to amend their regulations to permit B.S.N. nurses to serve as Clinical Instructors in Nevada nursing programs.  If Nevada is to educate its own nurses, and support the development of nursing programs, this reasonable modification in the qualifications of Clinical Instructors is both compelling and urgent.                                      Additionally, the State Board of Nursing's requirement of Masters-prepared nurses unreasonably impacts nursing education in some other areas of nursing curricula.  B.S.N.-trained nurses with a law degree from an American Bar Association accredited law school may not teach nursing law or ethics because the individual does not have a Masters degree in nursing.  It is patently absurd that a nurse with a law degree is less qualified to teach nursing law than a Masters degree prepared nurse without any formal legal education.  An individual with a Doctor of Pharmacology cannot teach pharmacology to Nevada nursing students because that individual does not have a Masters degree in nursing.  What hubris reasons that medical students can be taught pharmacology by a Doctor of Pharmacology, but nursing students cannot be taught pharmacology from anyone other than a Masters-prepared nurse?  The CCMS Board of Trustees will support a Legislative Bill that amends the Nurse Practice Act to ameliorate these illogical restrictions in Nevada nursing education.

            Together, as we work to build a healthy Nevada, we must ameliorate this growing nursing shortage crisis.

 

 i           Michael P. Colletti, MD is immediate past-president of the Clark County Medical Society.  Weldon (Don) Havins, MD, JD, is President-elect, Executive Director and Special Counsel of the Clark County Medical Society.  

 ii          Source:  U.S. Department of HHS National Center for Health Workforce analysis, 2005.   

 iii          AACN National Center for Health Workforce analysis; The Registered Nurse Population: Findings from the National Sample Survey of Registered Nurses, 2004.                                                           

iv           Personal communication with Professor Rosemary Witt, UNLV School of Nursing. 

v           A study by the Southern Regional Board of Education in February 2002 documented a serious shortage of nursing faculty.  The survey found that the combination of faculty vacancies (432) and newly budgeted positions (350) pointed to a 12% shortfall in the number of nurse educators needed.  Unfilled faculty positions, resignations, projected retirement, and the shortage of students being prepared for the faculty role pose a threat to the nursing education workforce over the next five years.

 

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President’s Message

By Ron Kline, MD, 2005-2006 CCMS President

 

 

WHAT I'VE LEARNED

            This column marks my last as CCMS president.  I wanted to start by thanking our membership for the support you have given me throughout the year.  It has been an honor to represent you.  Your kind words to me in the hallways about my columns have inspired me more than you know.  (It's good to know my wife is not the only one reading my columns).  I wish Florence Jameson the best of luck in her coming year as president.

            My special thanks go to Don Havins, our current executive director and CCMS president- elect.  Don is both a skilled ophthalmologist and lawyer.  I (and we as a society) have been blessed to have him as an advisor during this year.  He has saved me from stepping on land mines and helped me think through the implications of complex decisions.  His support has given me the confidence to do what needed to be done.  He will make a fine president in 2007-08.

            Much of the year has been occupied with trying to move the Health Sciences Center (HSC) forward and trying to "earn a seat at the table."  Many of us, including Don Havins, Ed Kingsley, Mark Doubrava and others have worked hard to continually express our interests and our thoughts to the powers that be to make them understand how important this project is to the medical world we inhabit, and how important it was for us to be involved in the process.  We have accomplished that this year.  The Advisory Board to the Regent's Committee on the HSC includes CCMS board members Don Havins, Mark Doubrava, Mitchell Forman (Dean of Touro), John McDonald (Dean of UNSOM) and I, as well as CCMS members Steven Glyman, Gerald Higgins and State Senator Joe Heck.  NSMA President Wayne Hardwick and NSMA Treasurer Richard Seher round out the members of organized medicine in this group.  We have fought hard to be included in the process; now that we're there, we have to make it succeed!  My thanks also go to Regents Bret Whipple (chair of the Board of Regents) and James Dean Leavitt (chair of the Regent's HSC committee), as well as Chancellor Jim Rogers, who all listened when we told them how important this endeavor was to us, and that we could make it better by being included.

            A large part of my year has also been spent trying to raise the political awareness of physicians.  Most of us still don't get it.  We continually complain about malpractice rates, managed care hassles, and an impoverished Medicaid system while choosing not to participate in the political and legislative processes that ultimately control these issues.  I think I understand the mindset, although I do not agree with it.  We feel that we have worked hard to get where we are, that we work hard to provide our patients with competent and sympathetic care, and that the rest of the world should realize that and leave us alone to do our good work.  Although we may feel that way, the trial lawyers and insurance companies view us as their fat and dumb prey.  To the trial lawyers, we are wealthy practitioners in a profession where bad outcomes sometimes occur no matter how good and conscientious we are.  The success of our profession has led to an expectation of near perfection for diseases that were routinely fatal a few decades ago.  Remember that when trial lawyers talk about victim's rights, they know that they receive 62% of all malpractice settlements in expenses and fees.

            To the insurance companies, we are but interchangeable cogs in "provider networks" that generate billions of dollars of profit for them, and hundreds of millions of dollars in bonuses for their executives.  We must work together in legal ways to preserve the viability of our practices. Curiously neither the previous Democratic administration nor the current Republican one view the continued consolidation of insurance companies as an anti-competitive threat, although the mere thought of doctors joining together seems to send the FTC into convulsive action. 

            Many of us were roused to political action in 2004 to support Question 3, and defeat Questions 4 and 5.  But like the great citizen armies of centuries past, we have now gone back to our stethoscopes.  Yet the battle is far from over.  Two of the three Nevada Supreme Court Justices who worked very hard to throw Question 3 off the ballot are up for election this year with credible opponents.  We must put the same effort into electing supportive justices to the Supreme Court as we did in passing Question 3, for the stakes are the same!  We can lose Question 3 in the Nevada Supreme Court and it will be just as dead as if we lost at the ballot box, or had it thrown off the ballot by those three justices in question.  Furthermore, Question 3 is a series of laws, not a constitutional amendment.  That means it can be changed by the legislature in the future (even during this coming session) as long as the effective date is after November 24, 2007.  I will again use the quote from Thomas Jefferson that I have used before in this column, "the price of liberty is eternal vigilance."

            Once the campaign season gets underway, members of CCMS and the CCMS alliance (led by Annette Mohs) will come to your office and ask you to display banners and literature informing people about the candidates that are supportive of medicine.  Please receive these people warmly and display the banners and literature in your offices.  We don't give money to campaigns like the trial lawyers do ($41 per doctor in the last election cycle vs. $750 per lawyer); we don't walk the precincts in support of our candidates like the unions do; but we do have offices filled with patients who trust us with their lives and the lives of their families, and care what we think about the people running for elective office.  

            Only 105 physicians have paid the $300 it takes to become a member of MedPac, CCMS' political action committee.  If the physicians of Clark County gave to MedPac only half of what their anticipated increases in malpractice insurance would be were it not for the passage of Question 3, and the defeat of Questions 4 and 5, MedPac would be, by far, the largest and best financed PAC in the State.  If physicians gave to AMPAC (the AMA PAC) only a small percentage of what they gained by having the AMA turn a 4.5% Medicare decrease into a freeze (and similar efforts in years past), AMPAC would be the wealthiest and most powerful PAC in the nation!

            Because only one third of Clark County physicians are part of CCMS, another important effort during my term of office has been increasing the benefits of membership.  Membership in both CCMS and NSMA is $780.  Add membership in the AMA and we are in the range of $1200.  Add your specialty societies and the number only goes up from there (as a member of five specialty societies, in addition to CCMS, NSMA, and AMA, I understand this very well).  Undoubtedly the biggest financial benefit to our members is the 5% discount on their malpractice insurance rates if they contract with PIC of Wisconsin or Nevada Mutual.  Also added to the list this year has been the two year waiver of maintenance fees for those who choose to use Allscripts electronic prescribing software, the waiver of medical staff dues at the St Rose Hospitals, and a new credit card from Community Bank of Nevada that gives members a 60 day no-interest grace period and overdraft and credit card loans at the prime rate (currently 8%).

            The most heartening thing I have seen during my year as president, is the respect and admiration that physicians still command in an increasingly cynical world.  Because of the good work that most of us do each day, we are still viewed as working largely for the benefit of our patients.  Our goal must be however, to be politically aware, and to turn that respect into the political power that allows us to preserve our profession against attacks from industries (e.g. insurance and trial lawyers) that view the good work we do each day as fodder for their personal enrichment.  Otherwise, we will be like the great Inca Empire; admired, respected and EXTINCT!

 

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Clark County District Court Medical Malpractice Filings

Against Health Care Providers, Jan 2001 – March 2006

 

                        2001     2002    2003    2004    2005    2006

Jan                   39        33        108      61        41        50

Feb                  20        14        98        72        63        61

Mar                  35        30        169      123      64        38

Apr                  37        34        111      81        70        58

May                 37        35        126      65        14

Jun                   27        24        103      90        65

Jul                    19        100      114      45        66

Aug                  54        51        76        67        33

Sep                  20        65        105      79        36

Oct                  37        83        110      59        26

Nov                 38        184      59        78        68

Dec                  9          170      67        47        30

Sum                372      823      1246     867      581

 

 

 

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Member News

Congratulations and Welcome to the Clark County Medical Society New Members –

May 2006

 

·        Eric J Anderson, MD – Emergency Medicine, 1200 S. MLK Blvd., 2nd Fl., Las Vegas, NV 89102

·        Frank J Andriola, MD – Internal Medicine, 595 W. Lake Mead Pkwy., Henderson, NV 89015

·        Jeffrey L. Brown, DO – Family Practice, 595 W. Lake Mead Pkwy., Henderson, NV 89015

·        Omar B Cabahug, MD – Neurology, 2500 Wigwam Pkwy., #112, Henderson, NV 89074

·        Nicholas G. Calica, MD – Internal Medicine, 1200 S. MLK Blvd., 2nd Fl., Las Vegas, NV 89102

·        Russel P Clark, MD – Emergency Medicine, 10441 W. Twain Ave., Las Vegas, NV 89135

·        Nam H Dang, MD – Internal Medicine, 10441 W. Twain Ave., Las Vegas, NV 89135

·        Prashant S Dani, MD – Pediatrics, 5575 S. Durango Rd., #103, Las Vegas, NV 89113

·        Gautam Daulat, DO – Internal Medicine, 4880 S. Wynn Rd., Las Vegas, NV 89108

·        Sandeep K Dhillon, MD – Pediatrics, 100 N. Green Valley Pkwy., #231, Henderson, NV 89074

·        Lisa A Durette, MD – Psychiatry, 7000 W. Spring Mtn. Rd., Las Vegas, NV 89117

·        Allen A Erisman, DO – Emergency Medicine, 1200 S. MLK Blvd., 2nd Fl., Las Vegas, NV 89102

·        Daniel C Fabito, MD – General Surgery, Las Vegas, NV

·        Louis M Fink, MD – Pathology, 1 Breakthrough Wy., Las Vegas, NV 89135

·        Kimberly A Fletcher, MD – Emergency Medicine, 1200 S. MLK Blvd., 2nd Fl., Las Vegas, NV 89102

·        Edward M Harding, MD – Family Practice, 9499 W. Charleston Blvd., #150, Las Vegas, NV 89117

·        John R Henner, DO – Emergency Medicine, 1200 S. MLK Blvd., 2nd Fl., Las Vegas, NV 89102

·        Patrick S Hong, MD – Internal Medicine, 595 W. Lake Mead Pkwy., Henderson, NV 89015

·        Teresa O Hong, MD – Family Practice, 595 W. Lake Mead Pkwy., Henderson, NV 89015

·        Yekaterina A Khronusova, MD – Internal Medicine, 1200 S. MLK Blvd., 2nd Fl., Las Vegas, NV 89102

·        Dennis C Lemon, DO – Emergency Medicine, 1200 S. MLK Blvd., 2nd Fl., Las Vegas, NV 89102

·        Vijaykumar Lingegowda, MD – Internal Medicine, 1200 S. MLK Blvd., 2nd Fl., Las Vegas, NV 89102

·        Yupo Ma, MD – Pathology, 1 Breakthrough Wy., Las Vegas, NV 89135

·        Lauri B Magee, MD – Emergency Medicine, 1200 S. MLK Blvd., 2nd Fl., Las Vegas, NV 89102

·        Paul D Navar, MD – Emergency Medicine, 1200 S. MLK Blvd., 2nd Fl., Las Vegas, NV 89102

·        Mitulkumar P Patel, MD – Internal Medicine, 520 E. Fremont St., Las Vegas, NV 89101

·        Roy L Perlot, MD – Internal Medicine, 9499 W. Charleston Blvd., #150, Las Vegas, NV 89117

·        Anita A Pomerantz, MD – Radiation Oncology, 10441 W. Twain Ave., Las Vegas, NV 89135

·        David A Pomerantz, MD – Radiation Oncology, 10441 W. Twain Ave., Las Vegas, NV 89135

·        Jennifer S Rozum, MD – Emergency Medicine, 1200 S. MLK Blvd., 2nd Fl., Las Vegas, NV 89102

·        Sana Safaei, MD – Family Practice, 4800 S. Wynn Rd., Las Vegas, NV 89103

·        Wade N Sears, MD – Emergency Medicine, 1200 S. MLK Blvd., 2nd Fl., Las Vegas, NV 89102

·        Sandesh K Singh, MD – Emergency Medicine, 1200 S. MLK Blvd., 2nd Fl., Las Vegas, NV 89102

·        Sunil Sharma, MD – Internal Medicine, 1200 S. MLK Blvd., 2nd Fl., Las Vegas, NV 89102

·        Geoffery L Stanczyk, MD – OB-Gyn, 98 E. Lake Mead Dr., #201, Henderson, NV 89015

·        Rajendra K Suvarna, MD – Internal Medicine, 1200 S. MLK Blvd., 2nd Fl., Las Vegas, NV 89102

·        Irfan Tahir, MD – Internal Medicine, 4880 S. Wynn Rd., Las Vegas, NV 89103

·        Dana L Trippi, DO – Emergency Medicine, 1200 S. MLK Blvd., 2nd Fl., Las Vegas, NV 89102

·        Nicholas J Vogelzang, MD – Internal Medicine, 10441 W. Twain Ave., Las Vegas, NV 89135

·        Bryan Y Wong, MD – Internal Medicine, 10441 W. Twain Ave., Las Vegas, NV 89135

·        James R Zinser, MD – Family Practice, 4880 S. Wynn Rd., Las Vegas, NV 89103

·        Jonathan R Zucker, MD – Anesthesiology, Las Vegas, NV

 

Reinstated Members:

  • Arthur J Taylor, MD – Orthopaedics

 

Student Members:

  • Kathryn G Mueller – Touro University

 

Physician’s Assistant Members:

  • Frederick B Bowles, PA – Supervising Member: Byron Kilpatrick, MD
  • Megan M Chipp, PA – Supervising Member: John Henner, DO
  • Eberhard J Maendel, PA – Supervising Member: Wade Sears, MD
  • Raymond Matheison, PA – Supervising Member: John Henner, DO
  • Richard J Nudd, PA – Supervising Members: Wade Sears, MD

 

Applicants to Go Before Credentialing Committee

If you have any pertinent information about the following membership candidates, please contact: 

Clark County Medical Society, 2590 E. Russell Rd., Las Vegas, NV 89120

 

  • Edward S Ashman, MD – Orthopaedics
  • Thomas C Kim, MD – Orthopaedics
  • Susan A Miko, DO – Internal Medicine
  • Alison M Nguyen, MD – Diagnostic Radiology
  • Mark S Scheller, MD – Anesthesiology
  • Gary R Skankey, MD – Infectious Disease
  • Robert Toledo, DO – OB-Gyn
  • Joseph F Urban, MD – Diagnostic Radiology

 

 

 

For information on becoming a member of the Clark County Medical Society, call Marlaina Burns at 739-9989.

 

***New Member Special*** $390 New members can join for half price their first year.

 

 

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Southern Nevada Health District Report

 

By Donald Kwalick, MD, MPH, Chief Health Officer

 

The health district monitors mumps cases

 

            By  Donald S. Kwalick, MD, MPH, Chief Health Officer

 

            The Southern Nevada Health District is actively monitoring the mumps outbreak in Iowa and neighboring states. No local cases of mumps have been reported in connection with the outbreak. However, contagious people may occasionally travel through our community potentially exposing others. Advisories on mumps symptoms, transmission, prevention and environmental clean up have been distributed to health care providers, hotels and resorts.

            Although the risk of exposure to mumps for most travelers is low, the health district is encouraging the public to make sure they are fully vaccinated, especially those who may be traveling to a state experiencing a mumps outbreak. As of May 5, the Centers for Disease Control and Prevention is reporting 13 states with one or more persons with mumps related to the current outbreak. Most cases are among persons aged 18-24 years and the states reporting cases are: Arkansas, Colorado, Iowa, Illinois, Kansas, Mississippi, Missouri, Minnesota, Nebraska, New York, Pennsylvania, South Dakota and Wisconsin.

            To be fully protected by vaccination:

            l           All children 12 months to 4 years of age should have had one dose of MMR vaccine.

            l           All school-aged children (K-12) and students attending post-high school educational institutions should have had two doses of vaccine since 12 months of age and no less than 28 days between doses.

            l           Adults who live in, or travel to, an outbreak affected area should have at least one dose, unless they were diagnosed by a physician with mumps earlier in life or have laboratory evidence of immunity to mumps.

            Most people born in the United States before 1957 had mumps and cannot get it again.  Persons who are unsure of their vaccination status, or whether they had mumps in the past, may safely get the vaccine. 

            Southern Nevada receives about 40 million visitors each year and can expect persons incubating or ill with mumps will travel through our community potentially exposing others. This is in addition to Southern Nevada residents who may travel to affected areas and later return home after being exposed to the mumps virus.

            Because people can unknowingly transmit the disease before the onset of their symptoms, it is likely that infectious persons will travel to Nevada and expose other visitors and residents. Unfortunately, there is no way to identify these individuals, and no way to prevent transmission in these situations. As a result, the control strategies of the health district focus on the rapid identification of illness, isolation and prevention of disease through vaccination, frequent hand-washing, and proper respiratory etiquette.

            These strategies have been shared with the resort and hotel industries in Southern Nevada. Hotel and resort personnel may have the first contact with a case if one occurs. The health district guidelines include referring the guest to a physician for diagnosis, contacting the Office of Epidemiology, isolation of the guest from the public areas of the establishment, and following environmental clean-up guidelines.

            To date, the Iowa Department of Public Health is reporting more than 1,600 confirmed, probable and suspect cases of mumps. From 2001 through 2005 there were 11 cases of mumps reported in Clark County.

            With the low incidence of mumps in Clark County, health care providers have become less likely to suspect mumps in patients with parotitis. Because a number of diseases can cause parotitis, laboratory identification of the illness is crucial for the proper diagnosis of mumps. Laboratory testing for mumps is through direct cultures of the virus, or through testing of serum for mumps IgM antibody.

            All known or suspected cases of mumps should be reported to the Southern Nevada Health District Office of Epidemiology at (702) 759-1300, option #2. This number is available 24-hours, seven days a week. Additional information, including technical bulletins may be accessed on the health district website at www.cchd.org.

 

 

 

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Alliance Message

By Pauline Lee & Andrea Yu, 2006-07 CCMS Alliance Co-Presidents 

 

            Whether it occurs at a Fortune 500 Company, a parent-teacher association or volunteer organization, a "changing of the guard" generates unbridled enthusiasm, hopeful anticipation, and optimistic caution.  As the new co-presidents of the Clark County Medical Society Alliance, we share some or all of these emotions with our members as we head into a year (2006-2007) replete with legislative and health/safety advocacy challenges for the family of medicine.

            As spouses of physicians, our top priority is to assist our spouses in their mission to provide the highest quality of healthcare in our community.  To do that, the Alliance should be and will be educating its members of opportunities to make a difference at the ballot box.  The Alliance's enthusiasm and "grass roots" acumen was critical to the success of last year's tort reform passage (Question 3).  This year, the Alliance's legislative committee will be involved in various judicial races which directly impact the preservation of last year's tort reform movement and the passage of the Nevada Clean Indoor Air Act which impacts the future health of children in our community.  We look forward to the Alliance working with the CCMS on these initiatives. 

            The threat of internet predators haunts parents of techno-savvy children of all ages.  This year, the Alliance will be participating in a state-wide alliance project named "Faux Paw" aimed at educating children on how to use the internet without disclosing personal information, without meeting any internet contacts and without gaining access to inappropriate chat rooms or websites.  The Alliance will be introducing the internet safety program to private schools, initially, with the intent to "spread the word" to the Clark County School District by year end.  These two projects scratch only the surface of the many activities engaged in by Alliance members this upcoming year.  Who makes up the Alliance? Who becomes an Alliance member? 

            Alliance members are spouses committed to improving our communities and the lives of physicians and families.  We come from different backgrounds