Friday, June 28, 2013
Realistic Plan
This week I
laid out a realistic plan for medical education in the state that works
now. It makes sense, saves money and capitalizes on the little that we
have done right. In the future these separate
tracks may well split into separate medical schools, but that is a
decision for another day. Today we can continue the petty bickering and
pointless discussion that has marked this subject for forty years or
actually get something done. You know me – I am
for action now. We can use our limited resources wisely, engage
donors, show southern Nevada that we mean business and make a
difference. Or we can continue talking for the next decade and be no
further down the road.
Thursday, June 27, 2013
A Plan We Can Do TODAY
Yesterday I
talked about building full medical school tracks north and south. While
serving their respective regions, this approach would avoid the
many bureaucratic barriers
to exchanging medical students, developing joint research programs, and
sharing clinical and academic expertise. Instead of each school going
its own way, as UNLV and UNR by and large do now, there could be
organized collaboration to avoid wasteful duplication
of programs and research. This is a plan we can do TODAY without the
necessity of separate costly and lengthy accreditation.
Wednesday, June 26, 2013
Medical Education
To expand medical education in Southern Nevada
will require a major academic facility, likely built on the UMC
campus, that has all the teaching and research facilities
you would expect to see in a full medical school, including an
auditorium, conference rooms, research and anatomy teaching
laboratories, and library facilities. There is nothing like this in Las
Vegas now but major efforts are underway to plan this expansion.
The two main advantages in this approach are the ability for both
campuses to easily collaborate in teaching and research, and the cost
efficiency of having a single statewide leadership structure, with local
campus administrative autonomy.
Tuesday, June 25, 2013
The Right Plan
The
fundamental issue facing public medical education in Nevada is how to
better serve the state, and in particular Las Vegas, in improving the
quality of its health care, and increasing the number and breadth of
physicians who train and practice in the state.
For my money – and my wife Beverly and I have pledged our support to
this critical project – the current Dean Tom Schwenk has the right
plan. He proposes that we develop full four-year campuses in both Reno
and Las Vegas rather than the split programs that
we have had for the last forty years. We will explore this idea in the
coming days.
Monday, June 24, 2013
Medical School In This State At UNLV
Last week I
talked about the ridiculous discussion to build a second medical school
in this state at UNLV.
Of course there is no budget, no identified donors, and an unbelievable estimate of the start-up costs that I have heard bandied about. But what does that mean for Southern Nevada – should we be forced to stumble forward with some of the worst health care in the nation? This week I will explore how we can work with our current structure to provide the kind of quality health care that this community deserves.
Of course there is no budget, no identified donors, and an unbelievable estimate of the start-up costs that I have heard bandied about. But what does that mean for Southern Nevada – should we be forced to stumble forward with some of the worst health care in the nation? This week I will explore how we can work with our current structure to provide the kind of quality health care that this community deserves.
The University of Texas at Austin is in the process of
creating the Dell Medical School which will be accepting its first class
of 50 students
in 2016. The following is a summary of the funding plan for this
newly-created school of medicine:
1-
$250 Million from Seton Health Care for a new teaching hospital.
2-
$50 Million gift from Michael and Susan Dell.
3-
$35 Million from Central Health.
4-
$25 Million from University of Texas System Board of Regents annually, plus an additional $5 million annually for 8 years for recruitment and support.
The
initial investment for the development of a new medical school to
educate 50 students each year is no small amount--$360 million.
The entire operating budget for UNLV is about $500 million a year.
Tell me where UNLV is going to get $360 million to build a Las Vegas medical school.
Friday, June 21, 2013
Still Looking
I’ve laid out a plan for the minimum
requirements to adequately fund Nevada’s medical school. It requires at
least one donor of one hundred million, at least two donors of fifty
million each; and at least ten donors of
twenty-five million a piece. That is just the beginning of the funds
required. To date, not one Nevadan, with the exception of my wife
Beverly and me has stepped forward to commit at least twenty-five
million. After ten years, I’m still looking for the
second donor.
Thursday, June 20, 2013
Not Capable Of Competing
I’ve had years of problems with the medical
school in Reno. It was the nightmare of my tenure as chancellor. But
the solution to its problems is not to build a second medical school at
UNLV. That doesn’t mean that UNLV
should never have a medical school. But until it can raise a half a
billion dollars from sources other than the state, it had better stay
out of a game in which it’s not capable of competing.
Wednesday, June 19, 2013
98% Short
The budget of the University of Nevada
Medical School is a drop in the bucket compared to the hundreds of
millions necessary to build even a mediocre medical school. I don’t
know where Doubrava gets his figures on the
pittance he believes will support a UNLV Medical School. I can tell
you one thing: he’s about 98% short of what it will actually take.
Tuesday, June 18, 2013
Doubrava
Dr. Tom Schwenk, the Dean of the University
of Nevada Medical School must be pulling his hair out as he sees the
ridiculous positions taken by those who believe that it is immediately
possible for UNLV to develop a medical
school. I don’t know what goes on in Regent Mark Doubrava’s mind
because I’ve always found him to be reasonable and logical. But at this
point, his inflexibility in pushing for UNLV to build its own medical
school, when no one on earth would even begin to
believe that UNLV has even the smallest down payment necessary to start
such a medical school, leads me to conclude that Doubrava simply has
not rationally and fully examined the situation.
Monday, June 17, 2013
Made As Complicated As Possible
Academic politics is a phenomenon different
from any other political game. Its participants are all very bright,
intellectually successful individuals who mistakenly believe that every
issue must be made as complicated
as possible, examined as thoroughly as possible, and debated until
every aspect of the issue is resolved. Academics, by there very nature,
can make the simplest issue complicated beyond solution. The medical
school of the Nevada higher education system is
forty years behind where it should be and yet, the academics involved
continue their petty infighting that ensures that Nevada medical
education will never succeed.
Friday, June 14, 2013
Give It Another Shot
The Nevada Board of Regents is arguing
about the incorrect issues that affect Nevada medical education.
Whatever the results of their arguments, those results are controlled
totally by a refusal of the state to fund medical education. As
chancellor, I worked for five years to improve Nevada’s medical
education. I failed, but I’m going to give it another shot. I hope
that this time all those petty, small thinking, selfish individuals
who have been involved in medical education will make it a new day with
new aspirations and new success in training medical professionals.
I’ll keep you informed.
Thursday, June 13, 2013
Doctors
Doctors, in spite of their high
intelligence and their ability to work with unmatched intensity, fight
like little children over the division of medical revenue in Southern
Nevada. That pettiness coupled with the inaction of the medical
school has made us a medical education community that is equal to none
other. We are in a category of inadequacy and ineptitude that is all
our own.
Wednesday, June 12, 2013
Forty Year Jump
For thirty years Bill Raggio put a
protective wall around the University of Nevada Reno Medical School and
in effect told its faculty that it need never worry about being
kidnapped and taken to Southern Nevada. During that thirty-year
period, the University of Arizona, the University of New Mexico and the
University of Utah medical schools got a forty year jump on Nevada’s
School of Medicine. I have doubts that Nevada’s medical school, even
with strong legislative support, could ever even
become a spot on the rear view mirrors of our surrounding state medical
schools.
Tuesday, June 11, 2013
Bullet Proof
Speaking to the University of Nevada Reno Medical
School faculty is like hollering into space. Your thoughts and your
voice are lost forever. For more than thirty years, Bill
Raggio, who I believe did more to harm Nevada’s education system than
any other single person or group, told the University of Nevada Reno
Medical School that its faculty was bullet proof because he would
protect them from outside forces. He did a hell of
a good job.
Monday, June 10, 2013
Reputation
If reputation is as effective as fact (and I’ve come to the conclusion it is), than the University of Nevada Medical School has two problems. First, it must change its reputation, and second, it must change what it actually is. A bad reputation takes longer to cure than a bad performance record. The UNR Medical School, for forty years, has had little or no respect from every other university medical school across this country. And the sad part is, it doesn’t seem to care.
Friday, June 7, 2013
Starting Over
It would be nice if we could tell all of our
governmental agencies that one year from now they will all be dissolved;
that all the administrators will be replaced by new administrators; and
that the product of that agency,
whatever it may be, must prove to have value to the entire economy.
That appears to me to require a solution that we dismantle our present
government structures and that we come as close as possible to starting
over.
Thursday, June 6, 2013
Standards Of Production
Businesses are successful in part because they have
standards of measurement to determine the productivity of each of their
employees. The measurements are easily analyzed and the problems are
quickly solved by the elimination
of positions in the organization or elimination of employees who do not
carry their fair share. Government has no standards of production.
Its answer to every problem is not to test the productivity of its
employees, but rather, to simply add more employees
to pick up the shortfall in production.
Wednesday, June 5, 2013
Bullet Proof
At random I could call a hundred individuals
employed by any endeavor that creates a product. By the time I’m at the
second sentence, I know from the attitude of the person with whom I’m
talking whether they understand
that they must produce to survive in their jobs, or whether they
believe they’re bullet proof because they work for a governmental
entity.
Tuesday, June 4, 2013
Government Employees
When one owns a business and begins to notice that
the cost of doing that business exceeds what that business receives, it
hardly takes a Rhodes Scholar to understand that if you can’t control
income, you’d better control
expenses. Businesses, often in a period of 30 to 60 days, develop
plans—though radical as they may seem—to cut their costs by eliminating
their workforce and by requiring that those employees still involved in
the operation do more. Government employees
are never faced with this type of decision-making. Before government
can adapt to the present situation, it first sucks the last drop of
blood out of the businesses and individuals who sustain it.
Monday, June 3, 2013
Burden
If necessity is the mother of invention, and the
recovery of the economy proves that to be true, that principle has no
relationship to solving the problems created by an ever-increasing
government. I’m a liberal and I
believe in helping those who have not been as fortunate as my wife and
I. However, our belief in helping one another has nothing to do with
allowing a government to increase in size while accomplishing less and
while continuing to become a burden we can’t
afford.
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