Please join us in welcoming NSMA’s new Executive Director, Jaron Hildebrand.

Prior to joining NSMA, Jaron has served as the director of government affairs for the Nevada Trucking Association since October 2012. Jaron has an extensive background in government affairs and has lobbied five sessions of the Nevada Legislature. He also has political and campaign experience working as field director for Congressman Mark Amodei where he coordinated and promoted events, established grassroots relationships and oversaw logistical operations for campaign materials sent throughout the state.
Jaron is a native of Reno, Nevada. He graduated from the University of Nevada in 2010, with Bachelor of Political Science and Communications, while minoring in European History. Jaron is an adventurous traveler, a sports enthusiast and enjoys spending time with his wife Kaitlin and eight-month-old son, Calvin.
You can contact Jaron at the NSMA office at (775) 825-6788 or email him directly at [email protected]

Changing of the Seasons

It is that time of year again — July 1 is here and along with it, the changing of the medical season. It is time for all of us to transition from the roles we grew comfortable with into a new position with new responsibilities and expectations.

Some residents are graduating and embarking on fellowship or new jobs—with at least 11 years of education under their belts.

Interns are steadier on their feet in the hospital. For some, just 2 years until graduation. For others, they are finally moving into the specialty training.

Former fourth year medical students have graduated and taken the Hippocratic oath. They are falling from the top of the medical school food chain to getting lost in the corridors of a new hospital.

Our new fourth year medical students are preparing to apply to residencies and are happy to waive goodbye to the grueling MS3.

Newly minted MS3’s — like myself—are anxiously awaiting board score results and the first days of rotations. We have climbed the mountain that was step 1 only to realize it was just a foothill and the steepest slopes are still to come.

Our incoming MS2’s spent the last several months watching the upperclassmen stress about Step 1 and are enjoying “the last summer of their lives” before they too start the step 1 climb.
And our incoming MS1’s are excited, hopeful, and in preparation for the start of their medical education.

Good luck to everyone in their transitions and congratulations on another year of progress towards your goals—whatever they may be. And if you have already made your full metamorphosis into a provider, look for the students finding their footing and give them a hand during this change of seasons.

Geriatric Specialty Care Home-Based Medical Care Practice Receives National Recognition

Paving the Way for Young Medical Professionals

Teaching Anatomy Through Tech and Touch

Through the anatomical donation program at UNR Med, which began in 1987, donors teach medical students about far more than gross anatomy. Cadavers posthumously teach medical students how to care, detach, work as a team and develop a sense of curiosity and discovery.

Many medical schools solely provide anatomy training through technology. While we believe there is no substitute for true human touch, it is important for us to acknowledge that technology can enhance the ever-evolving study of human anatomy.

As of last fall, the anatomy lab now includes an AnatomageTM life-sized digital dissection table, made possible through a generous gift from the William N. Pennington Foundation. Not meant as a substitute for, but rather a supplement to human cadavers, life-sized cadavers are revolutionizing anatomy in three-dimensional high definition with the click of a button or touch of a screen that resembles and oversized computer tablet mounted on a wheeled stretcher.

The AnatomageTM Table allows medical students to examine a virtual human body layer-by-layer, perform digital dissections and identify anatomical features with ultra-high quality visualization that provides instant access to photorealistic human anatomy.

In the traditional cadaver course of dissection, whether removing a vein, artery or organ, only so much cutting can be done and internal or underside views can be hidden or blocked. By pausing the digital dissection, students are able to interact with the dissection, turn it around and look at in three-dimensions.

Second-year medical student Miguel Gonzales, Class of 2022, said the use of both cadavers and technology provides a beneficial blend of instruction in anatomy education.

“I strongly believe there is no substitute for having actual cadavers, but the Anatomage Table offers supplemental instruction that cannot be achieved with a traditional cadaver,” Gonzalez said. “The ability to view a perfect, digital cadaver allows me to see and learn everything I need to know to build a solid anatomy foundation for working on a more challenging, traditional cadaver.”

But the Anatomage Table is a supplement to, not a replacement for, traditional dissection. It cannot at all replace the emotional power of understanding the life and death of a cadaver donor, or the educational value of memorializing the donor’s gift with poetry, song and eulogies, or the professional value of learning how to thank the family for their loved one’s ultimate gift.

What’s New/Makes Me Proud

Also scheduled for this summer are back-to-back CME’s sponsored in collaboration with and presented by the NorCal Group. On July 31, NorCal will be presenting: Boosting Your Immunity to Burnout and Pain Management & Opioid Prescribing. Dinner and the programs were presented from 6:00-8:00 at The Grove.

Our happy hours at the Shore Bar in the Renaissance are continuing with attendance growing each month. These small networking events are proving to be a great way for new members to get acquainted with our leadership. If haven’t stopped by, please join us any third Thursday from 5:00-7:00.
The Family BBQ at Bartley Ranch is set for Aug. 22. Again, this year we are asking participants to bring kid stuff to support the Women’s and Children’s Center of the Sierra. The center is always in need disposable diapers, formula and children’s gently used clothing. Women’s toiletries also are much appreciated. Because it’s Friday, the party begins at 4:00. This is a very family friendly event so make it an evening out with kids.

After our July break, the board will be back together to work on governing issues such as some bylaws revisions to make certain we stay current, membership recruitment, reviewing and updating our strategic plan and planning for our 2020 board transition.

As always, to keep all programs, education and networking rolling, we need your support on committees and task forces. Contact Mary Ann at [email protected] and she’ll find the right spot for your talents and interests.

SAVE THE DATE
Monday, August 22
4:00 p.m. – 8:00 p.m.
Bartley Ranch Regional Park

Mark August 22 on your calendars for the third annual WCMS Family BBQ at Bartley Ranch Regional Park. We’ll gather from 4pm to 8pm for an evening of food, entertainment and activities for adults and children. Again, this year, we’re asking our guests to join us in supporting the Women’s & Children’s Center of the Sierra (waccs.org) by bringing clothing, diapers, formula and unopened toiletries to the BBQ.

The Women and Children’s Center of the Sierra (WACCS) provides services to support women as they work to move out of poverty and improve their lives. Their comprehensive approach includes ESL and GED (HiSet) education, job search and preparation, a free diaper bank, crisis intervention, and information and referrals for other community services a woman may need to move forward in her life. WACCS serves women as they work toward their individual goals on their journey out of poverty and away from public safety net programs. They counsel, educate, support, encourage, guide and otherwise empower women as they strive to transform their lives.

If you have questions or wish to be a sponsor, call 775.825.0278, or email Wendy at [email protected], or Mary Ann at [email protected].

We’re Your Seat at the Table

NSMA and WCMS represent you before, during and after the Legislature meets. We ensure that Nevada’s physicians have a seat at the table when regulatory boards, committees and the legislators meet to discuss the practice of medicine and delivery of health care. Being a member gives you an extra boost in that you can share your opinions as priorities are being set. Our voice could be louder and clout greater if each one would one recruit one member this year.

Our 2019 priorities were established through the NSMA House of Delegates and Catherine O’Mara’s many long hours at meetings representing NMSA and our county societies.

2019 Priorities: We are working to:

Opioid Law Refinement: Revise the law to keep certain patient protections in place, enhance clinical judgment, allow multiple practitioners to more easily provide patient care and reduce workflow burdens.

Medicaid: Ensure access to care under for all patients including Medicaid patients. This includes Medicaid reimbursement and reducing administrative burdens for physicians participating in Medicaid.

Surprise Lapse in Coverage for Emergency Services: Fight for fair payment for physicians who provide services to patients in emergency settings.

Tort Reform: Address challenges to Keep our Doctors in Nevada (KODIN), including the caps for non-economic damages.

Maternal Mortality Review Panel: Establish a Maternal Mortality Review Panel to study causes of maternal mortality that result in identifying best practices.

Insurance Issues: Reduce regulatory burdens such as prior authorization, step therapy and other insurance policies that may negatively impact patients.

Mandatory E-Prescribing: Oppose mandates without appropriate exemptions and flexibility to ensure that physician practices can modernize without penalty.

Highlights of 2017 Successes

2016-2017 Regulatory Successes

• Defeated a dental board regulation authorizing dentists and dental hygienists to administer botulinum toxin (“Botox”) and dermal filers.
• Defeated a Board of Health regulation requiring all providers of care to report actual or suspected cancer to the Cancer Registry or face a $25,000 fine.
• Lobbied to pass a new regulation allowing physician prescribers to delegate the transmission of an electronic prescription to a designated agent such as an RN, MA or scribe.
• Negotiated a Board of Medical Examiner’s regulation providing common sense guidelines for physician oversight of a medical assistant.

2017 Legislative Successes

• Secured Governor’s veto of an insurance bill banning balance billing and capping fees for out of network health care services to the insurer’s economic advantage.
• Negotiated with the Governor’s office to ensure new opioid legislation preserves clinical judgment and avoids draconian prescribing caps found in other states.
  Improved a collaborative pharmacy bill ensuring that physician’s oversight and clinical judgment directs the patient care and clarifying in Nevada law that pharmacists do not diagnose.
• Secured provision to reduce to three days the time a pharmacist must notify an ordering physician of the substitution of any interchangeable biosimilar.
• Negotiated a common-sense revision to a proposed partnership bill allowing physicians and psychologists to form partnerships and still protects the tenets of Nevada’s implied prohibition of the corporate practice of medicine.
• Defeated a measure criminalizing and prohibiting a physician from performing a procedure deemed to reassign the anatomical sex of a patient, including relocating the urethral meatus, unless the child assented to the procedure.
• Removed physicians from a bill assessing a “provider tax” on all physicians to leverage monies for Medicaid funding.
• Supported legislation requiring regular review and adequacy of Medicaid payment rates.
• Secured Governor’s veto of a bill allowing any Nevadan to purchase Medicaid without limitation.
• Protected patients from unskilled application of botulinum toxin (“Botox”) by limiting licensed professionals who may administer and requiring administration in medical facilities only.
• Protected Ambulatory Surgical Centers from attempts to force certain procedures into hospitals.
• Negotiated the reduction of proposed mandatory CME for suicide prevention from 3 CME units every two years to 2 CME units every four years.
• Worked with Board of Medical Examiners to authorize them to take possession of records due to physician death or another incapacitation.
• Supported a bill to place burden of supplying medical records on custodian of records instead of every physician who had seen the patient and reduced related penalty.

To support our advocacy, renew your membership, recruit a member and make sure you legislative updates by emailing [email protected].

Reflections from the Dean

In December, we celebrated the close of one of the most extraordinary years in the history of the University of Nevada, Reno School of Medicine. UNR Med emerged as a “new” school, but one with a 50-year history and a tradition of educating health care professionals and scientists who go on to serve the community, the state and the world.
In 2018, we continued to be deeply engaged with our community. We formed many new partnerships that led to several new and impactful programs. We put building blocks in place to expand our clinical services, our teaching network and research opportunities.
As we begin our new year, I reflect on a few highlights from 2018 that were transformative to our school and communities we serve:

1. UNR Med, in partnership with Renown Health, launched the first Physician Assistant Studies Program in the Nevada System of Higher Education, a program that will help address the critical need for more health care clinicians in Nevada. The first class of 24 students began instruction in July 2018 and will graduate work-force ready in August 2020.
2. UNR Med’s new department of OB/GYN opened a Women’s Health Center, an outpatient clinic on the University campus providing obstetrical, gynecological and midwifery care to women in Reno and northern Nevada.
3. In collaboration with community health care partners, UNR Med launched a Reno-based Department of Surgery to keep pace with the increasing level of student interest in surgical careers. The department’s programs provide medical students with enhanced hospital and clinic-based education at Renown Health, the VA Sierra Nevada Health Care System and offices of outstanding northern Nevada-based surgical groups.
4. In partnership with Nevada Health Centers, UNR Med started a new Elko Family Residency Program, expanding the school’s rural campus and commitment to providing high-quality health care to rural Nevadans. The program has four residents and will expand to six residents in July, serving primary care needs of patients in Elko and the surrounding area.
5. We kicked off a yearlong 50th anniversary celebration, which will culminate with a Golden Gala celebration on Saturday, March 16. In addition to a yearlong celebration of events, we unveiled a 50th anniversary website reflecting the developments and achievements of the School of Medicine since its establishment. I encourage you to tour the website to learn more about UNR Med’s anniversary, including a historic timeline, oral histories and upcoming events.

I extend my deepest thanks to our faculty and staff members, learners, campus colleagues, community faculty members, community health care partners and the community for helping make our many successes possible.