UNSOM Health Policy Report Physician Workforce in Nevada 2016 Edition John Packham, PhD, Tabor Griswold, PhD, Troy Jorgensen, BS, Laima Etchegoyhen, MPH, and Christopher Marchand, MPH March 2016 Office of Statewide Initiatives University of Nevada School of Medicine 411 West Second Street Reno, Nevada 89503 www.medicine.nevada.edu/statewide Acknowledgements Physician Workforce in Nevada – 2016 Edition contains current, historical, and comparative data on the Allopathic (MD) and Osteopathic (DO) physician workforce in Nevada. The focus of this report is to improve health workforce planning and policy development in Nevada through the preparation and dissemination of the most current information on the physician workforce. The data presented in this report are drawn from two principal sources: America Association of Medical Colleges (AAMC). State Physician Workforce Data Book. Washington DC: AAMC Center for Workforce Studies (2015). American Medical Association (AMA). Physician Characteristics and Distribution in the US. Washington DC: AMA (2015, 2005, 1995, 1982). Unpublished data obtained from the Nevada State Board of Medical Examiners (2016), and the Nevada State Board of Osteopathic Medicine (2016). The major professional activity categories, self-designated specialty areas and geographic regions are those used by the American Medical Association. In this report, states in the Mountain Region include Arizona, Colorado, Idaho, Montana, Nevada, New Mexico, Utah, and Wyoming. Suggested Citation Packham, J., Griswold, T., Jorgensen, T., Etchegoyhen, L., and Marchand, C. (2016). Physician Workforce in Nevada – 2016 Edition. Reno, NV: Office of Statewide Initiatives, University of Nevada School of Medicine. Physician Workforce in Nevada – 2016 Edition Table of Contents Section One: Demographic Characteristics of the Allopathic Physician Workforce in Nevada................................................................................................................. 1 Table 1: Licensed Physicians (MDs and DOs) in Nevada – 2016 ................................................................ 3 Table 2: Licensed Physicians (MDs and DOs) per 100,000 Population in Nevada – 2016 ......................... 4 Table 3: Allopathic Physicians (MDs) by Age in Nevada – 1993 to 2013 ................................................... 5 Table 4: Allopathic Physicians (MDs) by Gender in Nevada – 1993 to 2013.............................................. 5 Table 5: Male Allopathic Physicians (MDs) by Age in Nevada – 1993 to 2013 .......................................... 6 Table 6: Female Allopathic Physicians (MDs) by Age in Nevada – 1993 to 2013 ....................................... 6 Table 7: U.S. Medical Graduates (USMG) Allopathic Physicians (MDs) by Age and Gender in Nevada – 2013............................................................................................................................... 7 Table 8: International Medical Graduates (IMGs) Allopathic Physicians (MDs) by Age and Gender in Nevada – 2013 .............................................................................................................. 7 Section Two: Distribution of the Allopathic Physician Workforce (MDs) in Nevada by Major Professional Activity and Self-Designated Specialty.................................... 9 Table 9: Allopathic Physicians (MDs) by Major Professional Activity in Nevada – 1993 to 2013 ............................................................................................................................................. 11 Table 10: Female Allopathic Physicians (MDs) by Major Professional Activity in Nevada – 1993 to 2013 ............................................................................................................................... 12 Table 11: Male Allopathic Physicians (MDs) by Major Professional Activity in Nevada – 1993 to 2013 ............................................................................................................................... 12 Table 12: International Medical Graduates (IMGs) Physicians by Major Professional Activity in Nevada – 2003 to 2013 .............................................................................................. 13 Table 13: Allopathic Physicians (MDs) by Country of Undergraduate Medical Education and Self-Designated Primary Care Specialty in Nevada – 2013 .................................................. 14 Table 14: Allopathic Physicians (MDs) by Gender and Self-Designated Primary Care Specialty in Nevada – 2013 ......................................................................................................... 15 Table 15: Allopathic Physicians (MDs) by Self-Designated Primary Care Specialty in Nevada – 2003 to 2013 ............................................................................................................................ 16 Table 16: Allopathic Physicians (MDs) by Self-Designated Primary Care Specialty in Nevada and the U.S. – 2013 ........................................................................................................ 17 Office of Statewide Initiatives i Physician Workforce in Nevada – 2016 Edition Table 17: Allopathic Physicians (MDs) by Gender and Self-Designated Specialty in Nevada – 2013 .......................................................................................................................................... 18 Table 18: Allopathic Physicians (MDs) by Self-Designated Specialty in Nevada – 1993 to 2013 ............................................................................................................................................. 20 Table 19: Allopathic Physicians (MDs) in Patient Care by Gender and Self-Designated Specialty in Nevada – 2013 ......................................................................................................... 22 Table 20: Allopathic Physicians (MDs) in Patient Care by Self-Designated Specialty in Nevada – 1993 to 2013 ............................................................................................................... 24 Section Three: Comparative Data on the Physician Workforce in Nevada and the US .......................................................................................................................... 27 Table 21: Allopathic Physicians (MDs), Population, and Physician/Population Ratios in Nevada and the U.S. – 1993 to 2013 ........................................................................................... 33 Table 22: Active Physicians (MDs) by Selected Age Groups in Nevada and Neighboring States – 2014 ............................................................................................................................... 34 Table 23: Active Female Physicians (MDs) in Nevada and Neighboring States – 2014 ........................... 35 Table 24: Active Male Physicians (MDs) in Nevada and Neighboring States – 2014 ............................... 36 Table 25: Number of Allopathic Physicians (MDs) per 100,000 Population in Nevada and Neighboring States – 1993 to 2013 ............................................................................................. 37 Table 26: Number of Residents per One Allopathic Physician (MD) in Nevada and Neighboring States – 1993 to 2013 ............................................................................................. 37 Table 27: Number of Allopathic Physicians (MDs) in Patient Care per 100,000 Population in Nevada and Neighboring States – 1993 to 2013 ..................................................................... 38 Table 28: Number of Residents per One Allopathic Physician (MD) in Patient Care in Nevada and Neighboring States – 1993 to 2013 ......................................................................... 39 Table 29: Allopathic Physicians (MDs) per 100,000 Population by Self-Designated Specialty in Nevada – 1993 to 2013 ........................................................................................................... 40 Table 30: Allopathic Physicians (MDs) per 100,000 Population by Self-Designated Specialty in Nevada, Mountain Region, and the U.S. – 2013 ..................................................................... 42 Table 31: Allopathic Physicians (MDs) in Patient Care per 100,000 Population by SelfDesignated Specialty in Nevada – 1993 to 2013 ......................................................................... 44 Table 32: Allopathic Physicians (MDs) in Patient Care per 100,000 Population by SelfDesignated Specialty in Nevada, Mountain Region, and U.S. – 2013 ......................................... 46 Table 33: Number of Allopathic Physicians (MDs) Needed in Nevada to Meet Mountain Region Average per Capita Rates – 2013 .................................................................................... 48 Table 34: Number of Allopathic Physicians (MDs) Needed in Nevada to Meet U.S. Average per Capita Rates – 2013 .............................................................................................................. 50 ii Office of Statewide Initiatives Physician Workforce in Nevada – 2016 Edition Table 35: Number of Allopathic Physicians (MDs) in Nevada by County Compared to Mountain Region Average per Capita – 2013 ............................................................................. 52 Table 36: Number of Allopathic Physicians (MDs) in Nevada by County Compared to U.S. Average per Capita Rates – 2013 ................................................................................................ 53 Table 37: Total Allopathic Physicians (MDs) by County in Nevada – 1993 to 2013 ................................ 54 Table 38: Total Allopathic Physicians (MDs) per 100,000 Population by County in Nevada – 1993 to 2013 ............................................................................................................................... 55 Table 39: Allopathic Physicians (MDs) in Patient Care by County in Nevada – 1993 to 2013 ................ 56 Table 40: Allopathic Physicians (MDs) in Patient Care per 100,000 Population by County in Nevada – 1993 to 2013 ............................................................................................................... 57 Table 41: Allopathic Physicians (MDs) by Self-Designated Primary Care Specialty in Metropolitan/Micropolitan Areas in Nevada – 2013 .................................................................. 58 Table 42: Allopathic Physicians (MDs) by Major Professional Activity in Metropolitan/Micropolitan Areas in Nevada – 2013 .................................................................. 59 Table 43: Graduates of the University of Nevada School of Medicine (UNSOM) Practicing in the U.S. by Year of Graduation and Gender – 2013 ................................................................ 60 Table 44: Graduates of the University of Nevada School of Medicine (UNSOM) Practicing in the United States by Self-Designated Primary Care Specialty – 2003 to 2013 ....................... 61 Table 45: University of Nevada School of Medicine (UNSOM) Retention of Graduate Medical Education (GME) Graduates – 2015 .............................................................................. 62 Table 46: University of Nevada School of Medicine (UNSOM) Graduation and Retention – 2006 to 2015 ............................................................................................................................... 62 Table 47: Physicians Retained from Undergraduate Medical Education (UME) in Nevada and Neighboring States – 2014 ................................................................................................... 63 Table 48: Physicians Retained from Public Undergraduate Medical Education (UME) in Nevada and Neighboring States – 2014 ...................................................................................... 63 Table 49: Physicians (MDs and DOs) Retained from Graduate Medical Education (GME) in Nevada and Neighboring States – 2014 ...................................................................................... 64 Table 50: Physicians (MDs and DOs) Retained from Undergraduate Medical Education (UME) and Graduate Medical Education (GME) Combined in Nevada and Neighboring States – 2014 .......................................................................................................... 64 Table 51: Students Enrolled in All Medical or Osteopathic Schools in Nevada and Neighboring States – 2014 to 2015 Academic Year .................................................................... 65 Table 52: Students Enrolled in Public Medical or Osteopathic Schools in Nevada and Neighboring States – 2014 to 2015 Academic Year .................................................................... 66 Office of Statewide Initiatives iii Physician Workforce in Nevada – 2016 Edition Table 53: Change in the Number of Students Enrolled in Medical or Osteopathic Schools in Nevada and Neighboring States – 2004 to 2014 ......................................................................... 67 Table 54: In-State Matriculation to Medical School – 2014 to 2015 Academic Year ............................... 68 Table 55: Ratio of Residents and Fellows (GME) to Medical and Osteopathic Students (UME) in Nevada and Neighboring States – Academic Year 2013 to 2014 ................................. 69 Table 56: Change in the Number of Residents and Fellows in ACGME-Accredited Programs in Nevada and Neighboring States – 2004 to 2014 ..................................................................... 69 Table 57: Residents and Fellows on Duty as of December 31, 2014 in ACGME-Accredited Programs in Nevada and Neighboring States.............................................................................. 70 Table 58: Residents and Fellows on Duty as of December 31, 2014 in ACGME-Accredited Primary Care Programs per 100,000 Population by Degree Type in Nevada and Neighboring States ...................................................................................................................... 71 Table 59: Residents and Fellows on Duty as of December 31, 2014 in ACGME-Accredited Programs per 100,000 Population by Degree Type in Nevada and Neighboring States ........................................................................................................................................... 72 Section Four: Active Physicians by Degree Type (MDs & DOs) ............................................ 73 Table 60: Active Physicians by Medical School Type in Nevada and Neighboring States – 2014 ............................................................................................................................................. 75 Table 61: Active Physicians per 100,000 Population by Degree Type in Nevada and Neighboring States – 2014 .......................................................................................................... 76 Table 62: Active Patient Care Physicians per 100,000 Population by Degree Type in Nevada and Neighboring States – 2014 ................................................................................................... 77 Table 63: Active Primary Care Physicians per 100,000 Population by Degree Type in Nevada and Neighboring States – 2014 ...................................................................................... 78 Table 64: Active Patient Care Primary Care Physicians per 100,000 Population by Degree Type in Nevada and Neighboring States – 2014 ......................................................................... 79 Table 66: Total MD and DO Physicians by Gender and Major Professional Activity in Nevada – 2013............................................................................................................................. 80 Table 65: Total MD and DO Physicians by Gender and Age in Nevada – 2013 ........................................ 80 Table 67: Total MD and DO Physicians by Self-Designated Primary Care Specialty in Nevada and the U.S. – 2013 ........................................................................................................ 81 Table 68: Total MD and DO Physicians by Self-Designated Specialty and Major Professional Activity in Nevada – 2013 ............................................................................................................ 82 Section Five: Osteopathic Physicians (DOs) ........................................................................ 85 Table 69: Osteopathic Physicians (DOs) by Gender and Age in Nevada – 2013 ..................................... 87 iv Office of Statewide Initiatives Physician Workforce in Nevada – 2016 Edition Table 70: Osteopathic Physicians (DOs) by Gender and Major Professional Activity in Nevada – 2013............................................................................................................................. 87 Table 71: Osteopathic Physicians (DOs) by Self-Designated Primary Care Specialty in Nevada and the U.S. – 2013 ........................................................................................................ 88 Table 72: Osteopathic Physicians (DOs) by Major Professional Activity in Metropolitan/Micropolitan Areas in Nevada – 2013 .................................................................. 89 Table 73: Osteopathic Physicians (DOs) by Self-Designated Specialty and Major Professional Activity in Nevada – 2013 ....................................................................................... 90 Section Six: Physician Workforce Rankings ........................................................................ 93 Table 74: Nevada’s Rank Among the U.S. States in Physicians per 100,000 Population – 2013 ............................................................................................................................................. 95 Table 75: Nevada’s Rank Among the U.S. States in Physicians in Patient Care per 100,000 Population – 2013 ....................................................................................................................... 96 Table 76: Nevada’s Rank Among the U.S. States in the Number of Allopathic Physicians (MDs) per 100,000 Population – 1980 to 2013 ........................................................................... 97 Table 77: Nevada’s Rank Among the U.S. States in the Number of Allopathic Physicians (MDs) in Patient Care per 100,000 Population – 1980 to 2013 .................................................. 98 Appendix of Self-Designated Practice Specialties ............................................................. 103 Office of Statewide Initiatives v Physician Workforce in Nevada – 2016 Edition Section One: Demographic Characteristics of the Allopathic Physician Workforce in Nevada Executive Summary and Key Findings According to licensure data from the Nevada State Board of Medical Examiners and the Nevada State Board of Osteopathic Medicine, there are currently 5,726 physicians with an active license to practice or in residency in the State of Nevada (MDs and DOs) – 69.8% of these physicians are in Clark County and 22.4% are in Washoe County (Table 1). There are currently 200.6 physicians with an active license to practice in the State of Nevada (MDs and DOs) per 100,000 population – per capita rates range from 26.1 physicians per 100,000 population in Lyon County to 344.8 physicians per 100,000 population in Carson City (Table 2). According to the American Medical Association (AMA), the number of allopathic physicians (MDs) in Nevada has grown from 2,521 in 1993 to 6,299 in 2013 – an increase of 149.9% over the past twenty years (Table 3). While the number of MDs in Nevada has increased in every age category over the past two decades, the rate of growth has been faster in the older age categories. The percent of Nevada MDs over the age of 65 has increased from 16.1% in 1993 to 26.1% in 2013 (Table 3). In 1993, 12.8% of Nevada MDs were female, as compared to 25.8% in 2013 (Table 4). The relatively recent entry of women into the Nevada physician workforce is reflected in the different age distribution of the male versus female physician workforce. For example, 51.4% of male MDs in Nevada are over the age of 55, as compared to only 30.2% of female MDs who are over the age of 55 in 2013. Conversely, 43.1% of female MDs in Nevada are under the age of 45, as compared to 24.8% of male MDs who are under the age of 45 (Tables 5 and 6). In 2013, 2,063 MDs or 32.8% of all MDs in Nevada are international medical graduates (IMGs) – that is, they received their undergraduate medical education (UME) in another country excluding Canada (Tables 7 and 8). Office of Statewide Initiatives 1 Table 1: Licensed Physicians (MDs and DOs) in Nevada – 2016 Specialty Allergy Aerospace Medicine Anesthesiology Cardiovascular Diseases Child / Adolescent Psychiatry Colon / Rectal Surgery Dermatology Diagnostic Radiology Emergency Medicine Family Medicine Gastroenterology General Practice General Surgery Internal Medicine Medical Genetics Neurology Nuclear Medicine Neurological Surgery Obstetrics / Gynecology Occupational Medicine Ophthalmology Orthopedics Otolaryngology Psychiatry Pediatrics Pediatric Cardiology PH & Gen Prev Medicine Phys Med & Rehab Plastic Surgery Pathology, Anatomic Pathology, Forensic Pulmonary Diseases Radiology Radiation Oncology Thoracic Surgery Urology Other Specialties Totals Carson City 17 8 1 5 7 18 26 6 9 29 2 1 12 2 3 4 4 8 4 1 3 3 5 3 1 2 6 190 Churchill Clark Douglas Elko Esmeralda Eureka Humboldt Lander Lincoln Lyon Mineral Nye Pershing Storey Washoe 5 7 1 3 6 4 1 2 5 34 11 1 337 113 19 2 42 154 243 488 56 21 161 945 3 72 1 24 222 13 87 100 142 347 12 5 51 50 61 5 44 41 24 24 38 15 34 3,999 3 1 3 4 17 16 1 13 1 1 19 4 1 2 1 87 1 1 3 10 1 1 5 10 1 4 1 4 1 6 1 1 3 1 1 1 56 - - 1 1 8 1 1 12 1 2 1 4 2 2 1 8 1 2 1 1 14 1 3 2 6 1 1 2 10 6 1 22 3 3 - 7 107 44 14 1 21 33 99 179 25 4 61 225 19 16 67 6 36 43 60 72 2 3 23 11 22 3 17 14 10 5 16 2 16 1,283 Source: Nevada State Board of Medical Examiners (2016), and the Nevada State Board of Osteopathic Medicine (2016). White Pine 2 5 2 4 1 14 Nevada 18 1 464 166 35 3 72 201 393 767 88 28 244 1,244 3 94 2 40 312 23 127 171 206 439 14 10 81 62 90 8 64 60 38 30 61 19 57 5,726 Table 2: Licensed Physicians (MDs and DOs) per 100,000 Population in Nevada – 2016 Specialty Allergy Aerospace Medicine Anesthesiology Cardiovascular Diseases Child / Adolescent Psychiatry Colon / Rectal Surgery Dermatology Diagnostic Radiology Emergency Medicine Family Medicine Gastroenterology General Practice General Surgery Internal Medicine Medical Genetics Neurology Nuclear Medicine Neurological Surgery Obstetrics / Gynecology Occupational Medicine Ophthalmology Orthopedics Otolaryngology Psychiatry Pediatrics Pediatric Cardiology PH & Gen Prev Medicine Phys Med & Rehab Plastic Surgery Pathology, Anatomic Pathology, Forensic Pulmonary Diseases Radiology Radiation Oncology Thoracic Surgery Urology Other Specialties Totals Carson City 30.9 14.5 1.8 9.1 12.7 32.7 47.2 10.9 16.3 52.6 3.6 1.8 21.8 3.6 5.4 7.3 10.9 7.3 14.5 7.3 1.8 5.4 5.4 9.1 5.4 1.8 3.6 344.8 Churchill Clark Douglas Elko Esmeralda Eureka Humboldt Lander Lincoln Lyon Mineral Nye Pershing Storey Washoe 19.5 27.3 3.9 11.7 23.4 15.6 3.9 7.8 19.5 132.5 0.5 0.0 16.3 5.5 0.9 0.1 2.0 7.4 11.7 23.6 2.7 1.0 7.8 45.7 0.1 3.5 0.0 1.2 10.7 0.6 4.2 4.8 1.6 6.9 15.2 0.6 0.2 2.5 2.4 2.9 0.2 2.1 2.0 1.2 1.2 1.8 0.7 193.2 6.2 2.1 6.2 8.3 35.4 33.3 2.1 27.1 2.1 2.1 39.6 8.3 2.1 4.2 2.1 181.2 1.8 1.8 5.5 18.2 1.8 1.8 9.1 18.2 1.8 7.3 1.8 7.3 1.8 10.9 1.8 1.8 5.5 1.8 1.8 101.8 - - 5.5 5.5 43.8 5.5 5.5 65.8 14.9 29.8 14.9 59.6 39.1 39.1 1.9 14.9 1.9 3.7 1.9 1.9 26.1 23.0 68.9 45.9 137.7 2.2 2.2 4.4 22.2 2.2 13.3 2.2 48.8 42.7 42.7 - 1.6 24.1 9.9 3.2 0.2 4.7 7.4 22.3 40.3 5.6 0.9 13.7 50.7 4.3 3.6 15.1 1.4 8.1 9.7 3.6 13.5 15.1 0.5 0.7 5.2 2.5 5.0 0.7 3.8 3.2 2.3 1.1 3.6 0.5 289.1 Source: Nevada State Board of Medical Examiners (2016), and the Nevada State Board of Osteopathic Medicine (2016). Population data from Nevada State Demographer’s Office (2016). White Pine 19.3 48.3 19.3 38.7 9.7 135.3 Nevada 0.6 0.0 16.3 5.8 1.2 0.1 2.5 7.0 13.8 26.9 3.1 1.0 8.5 43.6 0.0 3.3 0.1 1.4 10.9 0.8 4.4 6.0 2.0 7.2 14.1 0.5 0.4 2.8 2.2 3.2 0.3 2.2 2.1 1.3 1.1 2.1 0.7 200.6 Physician Workforce in Nevada – 2016 Edition Table 3: Allopathic Physicians (MDs) by Age in Nevada – 1993 to 2013 1993 Age Category < 35 35–44 45–54 55–64 ≥ 65 Total MDs 2003 Change – 1993 to 2013 2013 Number Percent Number Percent Number Percent Number Percent 268 857 586 404 10.6 34.0 23.2 16.0 470 1,312 1,138 789 10.0 28.0 24.3 16.8 494 1,367 1,549 1,247 7.8 21.7 24.6 19.8 226 510 963 843 84.3 59.5 164.3 208.7 406 2,521 16.1 100.0 982 4,691 20.9 100.0 1,642 6,299 26.1 100.0 1,236 3,778 304.4 149.9 Source: AMA. Physician Characteristics and Distribution in the U.S., 2015; AMA. Physician Characteristics and Distribution in the U.S., 2005; AMA. Physician Characteristics and Distribution in the U.S., 1995. Notes: Figures for 1993, 2003, and 2013 include both federal and nonfederal physicians. Table 4: Allopathic Physicians (MDs) by Gender in Nevada – 1993 to 2013 Gender Male Physicians Female Physicians Total MDs 1993 2003 2013 Number Percent Number Percent Number 2,198 323 2,521 87.2 12.8 100.0 3,737 954 4,691 79.7 20.3 100.0 4,677 1622 6,299 Change – 1993 to 2013 Percent Number Percent 74.2 25.8 100.0 2,479 1299 3,778 112.8 402.2 149.9 Source: AMA. Physician Characteristics and Distribution in the U.S., 2015; AMA. Physician Characteristics and Distribution in the U.S., 2005; AMA. Physician Characteristics and Distribution in the U.S., 1995. Notes: Figures for 1993, 2003, and 2013 include both federal and nonfederal physicians Office of Statewide Initiatives 5 Physician Workforce in Nevada – 2016 Edition Table 5: Male Allopathic Physicians (MDs) by Age in Nevada – 1993 to 2013 1993 Age Category < 35 35–44 45–54 55–64 ≥ 65 Total MDs 2003 Change – 1993 to 2013 2013 Number Percent Number Percent Number Percent Number Percent 188 718 8.6 32.7 285 956 7.6 25.6 277 885 5.9 18.9 89 167 47.3 23.3 525 380 387 2,198 23.9 17.3 17.6 100.0 918 682 896 3737 24.6 18.2 24.0 100.0 1,115 985 1,415 4,677 23.8 21.1 30.3 100.0 590 605 1,028 2,479 112.4 159.2 265.6 112.8 Source: AMA. Physician Characteristics and Distribution in the U.S., 2015; AMA. Physician Characteristics and Distribution in the U.S., 2005; AMA. Physician Characteristics and Distribution in the U.S., 1995. Notes: Figures for 1993, 2003, and 2013 include both federal and nonfederal physicians. Table 6: Female Allopathic Physicians (MDs) by Age in Nevada – 1993 to 2013 1993 Age Category < 35 35–44 45–54 55–64 ≥ 65 Total Female MDs 2003 Number Percent 80 139 61 24 19 323 24.8 43.0 18.9 7.4 5.9 100.0 Number 185 356 220 107 86 954 Change – 1993 to 2013 2013 Percent Number Percent Number Percent 19.4 37.3 23.1 11.2 9.0 100.0 217 482 434 262 227 1,622 13.4 29.7 26.8 16.2 14.0 100.0 137 343 373 238 208 1,299 171.3 246.8 611.5 991.7 1,094.7 402.2 Source: AMA. Physician Characteristics and Distribution in the U.S., 2015; AMA. Physician Characteristics and Distribution in the U.S., 2005; AMA. Physician Characteristics and Distribution in the U.S., 1995. Notes: Figures for 1993, 2003, and 2013 include both federal and nonfederal physicians. 6 Office of Statewide Initiatives Physician Workforce in Nevada – 2016 Edition Table 7: U.S. Medical Graduates (USMG) Allopathic Physicians (MDs) by Age and Gender in Nevada – 2013 United States Medical Graduates (USMG) in Nevada Age Category < 35 35-44 45-54 55-64 ≥ 65 Total USMG MDs Male Female Total Number Percent Number Percent Number Percent 173 571 774 768 965 3,251 5.3 17.6 23.8 23.6 29.7 100.0 140 303 278 184 80 985 14.2 30.8 28.2 18.7 8.1 100.0 313 874 1,052 952 1,045 4,236 7.4 20.6 24.8 22.5 24.7 100.0 Source: AMA. Physician Characteristics and Distribution in the U.S., 2015. Notes: Figures include Canadian Medical School Graduates. Table 8: International Medical Graduates (IMGs) Allopathic Physicians (MDs) by Age and Gender in Nevada – 2013 International Medical Graduates (IMGs) Age Category Male Number < 35 35–44 45–54 55–64 ≥ 65 Total IMG MDs 104 314 341 217 450 1,426 Female Percent 7.3 22.0 23.9 15.2 31.6 100.0 Number 77 179 156 78 147 637 Total Percent Number Percent 12.1 28.1 24.5 12.2 23.1 100.0 181 493 497 295 597 2,063 8.8 23.9 24.1 14.3 28.9 100.0 Source: AMA. Physician Characteristics and Distribution in the U.S., 2015. Notes: Figures do not include Canadian Medical School Graduates. Office of Statewide Initiatives 7 Physician Workforce in Nevada – 2016 Edition Section Two: Distribution of the Allopathic Physician Workforce (MDs) in Nevada by Major Professional Activity and Self-Designated Specialty Executive Summary and Key Findings According to the American Medical Association (AMA), since 1993, the number of MDs in Nevada in each type of patient care activity – office-based and hospital-based patient care – has grown. However, the proportion of the total physician workforce in Nevada whose major professional activity is patient care has declined from 85.3% in 1993 to 76.5% in 2013 (Table 9). Currently, 80.0% of female MDs in Nevada report that their major professional activity is patient care, as compared to 75.3% of male MDs who report that their major professional activity is patient care (Tables 10 and 11). Over the past decade, the number of international medical graduates (IMGs) in Nevada in each type of patient care activity has grown. Reflecting general trends in the Nevada physician workforce, the proportion of the total IMG physician workforce in Nevada whose major professional activity is patient care declined from 83.8% in 2003 to 73.8% in 2013 (Table 12). In 2013, 51.5% of MDs who are IMGs (1,062 of 2,063 IMGs) in Nevada report a primary care specialty or sub-specialty, as compared to 32.6% of MDs in Nevada who are US Medical Graduates (USMGs) (1,355 of 4,166 USMGs) (Table 13). Currently, 38.7% of MDs in Nevada report that their self-designated practice specialty was in primary care – family medicine, general practice, internal medicine, obstetrics/gynecology, or pediatrics – or a primary-care sub-specialty (Table 14). In 2013, 33.2% of male MDs in Nevada are in a primary care specialty or subspecialty, as compared to 54.4% of female MDs reporting a primary care specialty or subspecialty (Table 14). Over the past two decades, the number of MDs in a primary care specialty has grown by 1,109 (128.5%) and the number of MDs in a primary care sub-specialty has grown by 339 (271.2%). However, the proportion of the total physician workforce in a primary care specialty or subspecialty declined from 39.2% in 1993 to 38.7% in 2013 (Table 15). The proportion of the allopathic physician workforce in Nevada (MDs) practicing in primary care (31.3%) is comparable to the national rate of 30.6% (Table 16). In 2013, when comparing the total female MD workforce with the total male MD workforce, greater percentages of women report a primary care specialty than do men. For example, 13.1% of female MDs are in pediatrics, as compared to 4.0% of male MDs in Nevada; likewise, Office of Statewide Initiatives 9 Physician Workforce in Nevada – 2016 Edition 12.8% of female MDs in Nevada are in family medicine, as compared to 8.0% of male MDs (Table 17). Since 1993, the number of MDs in Nevada has increased in almost every self-designated specialty area. Specialties with the greatest numerical growth over the past two decades are; internal medicine (774 or 218.0%), family medicine (369 or 171.6%), pediatrics (273 or 216.7%), anesthesiology (216 or 144.0%), emergency medicine (196 or 236.1%), obstetrics/gynecology (127 or 78.9%), and psychiatry (102 or 129.1%) (Table 18). Currently, when comparing the total female MD workforce in patient care with the total male MD workforce in patient care, greater percentages of women report a primary care specialty than do men. For example, 12.7% of female patient care MDs are in pediatrics, as compared to 3.8% of male patient-care MDs in Nevada; 20.2% of female patient care MDs in Nevada are in internal medicine, as compared to 16.2% of male patient care MDs; 12.4% of female patient care MDs in Nevada are in family medicine, as compared to 7.8% of male patient care MDs; and 7.1% of female patient care MDs in Nevada are in obstetrics/gynecology, as compared to 3.6% of male patient care MDs (Table 19). Over the past two decades, the number of patient care MDs in Nevada – that is, physicians whose principal professional activity is the provision of patient care in an office-based setting or hospital – has increased across most self-designated specialty areas. Major specialties with the greatest numerical growth of patient care MDs over the past two decades include internal medicine (744 or 218.8%), family medicine (360 or 173.9%), pediatrics (265 or 219.0%), anesthesiology (216 or 146.9%), emergency medicine (197 or 243.2%), obstetrics/gynecology (124 or 78.0%), and psychiatry (101 or 146.4%) (Table 20). 10 Office of Statewide Initiatives Physician Workforce in Nevada – 2016 Edition Table 9: Allopathic Physicians (MDs) by Major Professional Activity in Nevada – 1993 to 2013 Major Professional Activity Patient Care Office-based Hospital-based Residents & Fellows Hospital-based Physicians Staff Subtotal – Patient Care Other Professional Activity Administration Medical Teaching Medical Research Other MDs Subtotal – Other Prof Activity Not Classified MDs Inactive MDs Total MDs 1993 2003 Change – 1993 to 2013 2013 Number Percent Number Percent Number Percent Number Percent 1,821 125 204 2,150 72.2 5.0 8.1 85.3 3,350 197 305 3,852 71.4 4.2 6.5 82.1 4,055 321 443 4,819 64.4 5.1 7.0 76.5 2,234 196 239 2,669 122.7 156.8 117.2 124.1 44 19 11 16 90 43 238 2,521 1.7 0.8 0.4 0.6 3.6 1.7 9.4 100.0 71 30 18 18 137 163 539 4,691 1.5 0.6 0.4 0.4 2.9 3.5 11.5 100.0 63 51 19 24 157 214 1,109 6,299 1.0 0.8 0.3 0.4 2.5 3.4 17.6 100.0 19 32 8 8 67 171 871 3,778 43.2 168.4 72.7 50.0 74.4 397.7 366.0 149.9 Source: AMA. Physician Characteristics and Distribution in the U.S., 2015; AMA. Physician Characteristics and Distribution in the U.S., 2005; AMA. Physician Characteristics and Distribution in the U.S., 1995. Notes: Physicians in “Patient Care” refers to physicians whose principal professional activity is the provision of patient care in an office–based setting or hospital. Figures for 1993, 2003, and 2013 include both federal and nonfederal physicians, but not physicians whose address is unknown. Office of Statewide Initiatives 11 Physician Workforce in Nevada – 2016 Edition Table 10: Female Allopathic Physicians (MDs) by Major Professional Activity in Nevada – 1993 to 2013 Major Professional Activity Patient Care Office-based Hospital-based Residents & Fellows Hospital-based Physicians Staff Subtotal – Patient Care Other Professional Activity Administration Medical Teaching Medical Research Other MDs Subtotal – Other Prof Activity Not Classified MDs Inactive MDs Total Female MDs 1993 2003 Change – 1993 to 2013 2013 Number Percent Number Percent Number Percent Number Percent 202 0 88 290 62.5 0.0 27.2 89.8 668 76 81 825 70.0 8.0 8.5 86.5 1,049 138 110 1,297 64.7 8.5 6.8 80.0 847 138 22 1,007 419.3 25.0 347.2 0 0 0 4 4 10 18 323 0.0 0.0 0.0 1.2 1.2 3.1 5.6 100.0 6 5 2 0 13 58 58 954 0.6 0.5 0.2 0.0 1.4 6.1 6.1 100.0 15 17 5 3 40 88 197 1,622 0.9 1.0 0.3 0.2 2.5 5.4 12.1 100.0 15 17 5 -1 36 78 179 1,299 -25.0 900.0 780.0 994.4 402.2 Table 11: Male Allopathic Physicians (MDs) by Major Professional Activity in Nevada – 1993 to 2013 Major Professional Activity Patient Care Office-based Hospital-based Residents Hospital-based Physicians Staff Subtotal – Patient Care Other Professional Activity Administration Medical Teaching Medical Research Other MDs Subtotal – Other Prof Activity Not Classified MDs Inactive MDs Total Male MDs 1993 Number 2003 Percent Number Change – 1993 to 2013 2013 Percent Number Percent Number Percent 1,619 125 116 1,860 73.7 5.7 5.3 84.6 2,682 121 224 3,027 71.8 3.2 6.0 81.0 3,066 183 333 3,522 64.3 3.9 7.1 75.3 1,387 58 217 1,662 85.7 46.4 187.1 89.4 44 19 11 12 86 33 220 2,198 2.0 0.9 0.5 0.5 3.9 1.5 10.0 100.0 65 25 16 18 124 105 481 3,737 1.7 0.7 0.4 0.5 3.3 2.8 12.9 100.0 48 34 14 21 117 126 912 4,677 1.0 0.7 0.3 0.4 2.5 2.7 19.5 100.0 4 15 3 9 31 93 692 2,479 9.1 78.9 27.3 75.0 36.0 281.8 314.5 112.8 Source: AMA. Physician Characteristics and Distribution in the U.S., 2015; AMA. Physician Characteristics and Distribution in the U.S., 2005; AMA. Physician Characteristics and Distribution in the U.S., 1995. Notes: Physicians in “Patient Care” refers to physicians whose principal professional activity is the provision of patient care in an office–based setting or hospital. Figures for 1993, 2003, and 2013 include both federal and nonfederal physicians, but not physicians whose address is unknown. 12 Office of Statewide Initiatives Physician Workforce in Nevada – 2016 Edition Table 12: International Medical Graduates (IMGs) Physicians by Major Professional Activity in Nevada – 2003 to 2013 Major Professional Activity Patient Care Office-based Hospital-based Residents & Fellows Hospital-based Physicians Staff Subtotal – Patient Care Other Professional Activity Administration Medical Teaching Medical Research Other MDs Subtotal – Other Prof Not Classified MDs Inactive MDs Total IMG MDs 2003 Number 2008 Change – 2003 to 2013 2013 Percent Number Percent Number Percent Number Percent 806 78 107 991 68.1 6.6 9.0 83.8 1,119 121 132 1,372 64.2 6.9 7.6 78.7 1,249 136 138 1,523 60.5 6.6 6.7 73.8 443 58 31 532 55.0 74.4 29.0 53.7 7 4 4 1 16 67 109 1,183 0.6 0.3 0.3 0.1 1.4 5.7 9.2 100.0 11 6 4 6 27 96 248 1,743 0.6 0.3 0.2 0.3 1.5 5.5 14.2 100.0 5 15 5 6 29 104 401 2,063 0.2 0.7 0.2 0.3 1.4 5.0 19.4 100.0 -2 11 1 5 13 37 292 880 -28.6 275.0 25.0 500.0 81.3 55.2 267.9 74.4 Source: AMA. Physician Characteristics and Distribution in the U.S., 2015; AMA. Physician Characteristics and Distribution in the U.S., 2010; AMA. Physician Characteristics and Distribution in the U.S., 2005. Notes: Physicians in “Patient Care” refers to physicians whose principal professional activity is the provision of patient care in an office-based setting or hospital. Figures for 2003, 2008, and 2013 include both federal and nonfederal physicians, but not physicians whose address is unknown. “Inactive MDs” include physicians who are retired, semi-retired, working parttime, temporarily not in practice, or not active for other reasons and who indicated they worked 20 hours or less per week. “Not Classified MDs” includes physicians who did not provide information on their type of practice or their present employment. Office of Statewide Initiatives 13 Physician Workforce in Nevada – 2016 Edition Table 13: Allopathic Physicians (MDs) by Country of Undergraduate Medical Education and Self-Designated Primary Care Specialty in Nevada – 2013 Total MDs Specialty U.S. Medical Graduates (USMGs) International Medical Graduates (IMGs) Number Percent Number 371 18 361 209 160 1,119 8.9 0.4 8.7 5.0 3.8 26.9 236 Total Percent Number Percent 193 10 465 40 128 836 9.4 0.5 22.5 1.9 6.2 40.5 574 29 826 252 291 1,972 9.1 0.5 13.1 4.0 4.6 31.3 5.7 226 11.0 464 7.4 2,014 48.3 496 24.0 2,540 40.3 Not Classified MDs 108 2.6 104 5.0 214 3.4 Inactive or Address Unknown 689 16.5 401 19.4 1,109 17.6 4,166 100.0 2,063 100.0 6,299 100.0 Primary Care Specialties Family Medicine General Practice Internal Medicine Obstetrics/Gynecology Pediatrics Total Primary Care MDs Primary Care Sub-specialties All Other Specialties Total MDs Source: AMA. Physician Characteristics and Distribution in the U.S., 2015. Notes: See Appendix for sub-specialty classifications. Figures exclude Canadian Medical School Graduates. “Inactive MDs” include physicians who are retired, semi-retired, working part-time, temporarily not in practice, or not active for other reasons and who indicated they worked 20 hours or less per week. “Not Classified MDs” includes physicians who did not provide information on their type of practice or their present employment. 14 Office of Statewide Initiatives Physician Workforce in Nevada – 2016 Edition Table 14: Allopathic Physicians (MDs) by Gender and SelfDesignated Primary Care Specialty in Nevada – 2013 Total MDs Specialty Male Female Percent Number Percent 206 4 269 108 169 756 12.7 0.2 16.6 6.7 10.4 46.6 574 29 826 252 291 1,972 9.1 0.5 13.1 4.0 4.6 31.3 7.2 127 7.8 464 7.4 2,086 44.6 454 28.0 2,540 40.3 Not Classified MDs 126 2.7 88 5.4 214 3.4 Inactive or Address Unknown 912 19.5 197 12.1 1,109 17.6 4,677 100.0 1,622 100.0 6,299 100.0 Primary Care Specialties Family Medicine General Practice Internal Medicine Obstetrics/Gynecology Pediatrics Total Primary Care MDs Primary Care Sub-specialties All Other Specialties Total MDs Number Percent 368 25 557 144 122 1,216 7.9 0.5 11.9 3.1 2.6 26.0 337 Number Total Source: AMA. Physician Characteristics and Distribution in the U.S., 2015. Notes: See Appendix for sub-specialty classifications. Office of Statewide Initiatives 15 Physician Workforce in Nevada – 2016 Edition Table 15: Allopathic Physicians (MDs) by Self-Designated Primary Care Specialty in Nevada – 2003 to 2013 Total MDs Specialty 1993 Number 2003 Change – 1993 to 2013 2013 Percent Number Percent Number Percent Number Percent Primary Care Specialties Family Medicine General Practice Internal Medicine Obstetrics/Gynecology Pediatrics Total Primary Care MDs 228 87 298 144 106 863 9.0 3.5 11.8 5.7 4.2 34.2 450 72 626 239 240 1,627 9.6 1.5 13.3 5.1 5.1 34.7 574 29 826 252 291 1,972 9.1 0.5 13.1 4.0 4.6 31.3 346 -58 528 108 185 1,109 151.8 -66.7 177.2 75.0 174.5 128.5 Primary Care Sub-specialties 125 5.0 271 5.8 464 7.4 339 271.2 1,252 49.7 2,091 44.6 2,540 40.3 1,288 102.9 Not Classified MDs 43 1.7 163 3.5 214 3.4 171 397.7 Inactive or Address Unknown 238 9.4 539 11.5 1,109 17.6 871 366.0 2,521 100.0 4,691 100.0 6,299 100.0 3,778 149.9 All Other Specialties Total MDs Source: AMA. Physician Characteristics and Distribution in the U.S., 2015; AMA. Physician Characteristics and Distribution in the U.S., 2009; AMA. Physician Characteristics and Distribution in the U.S., 2005. Notes: See Appendix for sub-specialty classifications. 16 Office of Statewide Initiatives Physician Workforce in Nevada – 2016 Edition Table 16: Allopathic Physicians (MDs) by Self-Designated Primary Care Specialty in Nevada and the U.S. – 2013 Specialty MD Physicians in Nevada MD Physicians in United States Number Percent 574 29 826 252 291 1,972 9.1 0.5 13.1 4.0 4.6 31.3 91,615 6,683 121,127 40,045 60,411 319,881 8.8 0.6 11.6 3.8 5.8 30.6 464 7.4 90,147 8.6 2,540 40.3 444,670 42.5 214 3.4 43,536 4.2 Inactive or Address Unknown 1,109 17.6 147,676 14.1 Total MDs 6,299 100.0 1,045,910 100.0 Primary Care Specialties Family Medicine General Practice Internal Medicine Obstetrics/Gynecology Pediatrics Total Primary Care MDs Primary Care Sub-specialties All Other Specialties Not Classified MDs Number Percent Source: AMA. Physician Characteristics and Distribution in the U.S., 2015. Notes: See Appendix for sub-specialty classification by major specialty categories. Figures exclude MD physicians whose address is unknown. Office of Statewide Initiatives 17 Physician Workforce in Nevada – 2016 Edition Table 17: Allopathic Physicians (MDs) by Gender and Self-Designated Specialty in Nevada – 2013 Total MDs Major Specialty Male Number General and Family Practice Family Medicine General Practice Medical Specialties Allergy & Immunology Cardiovascular Disease Dermatology Gastroenterology Internal Medicine Pediatric Cardiology Pediatrics Pulmonary Disease Surgical Specialties Colon & Rectal Surgery General Surgery Neurological Surgery Obstetrics & Gynecology Ophthalmology Orthopedic Surgery Otolaryngology Plastic Surgery Thoracic Surgery Urology Surgery Other Specialties Aerospace Medicine Anatomic/Clinical Pathology Anesthesiology Child & Adolescent Psychology Diagnostic Radiology Emergency Medicine Forensic Medicine General Preventive Medicine Medical Genetics Neurology 18 Female Percent Number Total Percent Number Percent 401 376 25 8.6 8.0 0.5 212 208 4 13.1 12.8 0.2 613 584 29 9.7 1,285 13 118 36 73 789 14 187 55 27.5 0.3 2.5 0.8 1.6 16.9 0.3 4.0 1.2 603 6 15 18 5 340 2 212 5 37.2 0.4 0.9 1.1 0.3 21.0 0.1 13.1 0.3 1,888 19 133 54 78 1,129 16 399 60 30.0 0.3 2.1 0.9 1.2 17.9 0.3 6.3 1.0 798 7 181 27 171 86 146 40 55 25 60 17.1 0.1 3.9 0.6 3.7 1.8 3.1 0.9 1.2 0.5 1.3 218 2 50 3 117 18 5 8 8 2 5 13.4 0.1 3.1 0.2 7.2 1.1 0.3 0.5 0.5 0.1 0.3 1,016 9 231 30 288 104 151 48 63 27 65 16.1 0.1 3.7 0.5 4.6 1.7 2.4 0.8 1.0 0.4 1.0 1,155 1 57 321 17 133 225 1 9 2 63 24.7 304 0 21 45 18 30 54 5 6 1 21 18.7 0.0 1.3 2.8 1.1 1.8 3.3 0.3 0.4 0.1 1.3 1,459 1 78 366 35 163 279 6 15 3 84 23.2 0.0 1.2 5.8 0.6 2.6 4.4 0.1 0.2 0.0 1.3 0.0 1.2 6.9 0.4 2.8 4.8 0.0 0.2 0.0 1.3 9.3 0.5 Office of Statewide Initiatives Physician Workforce in Nevada – 2016 Edition Nuclear Medicine Occupational Medicine Other Specialty Physical Med & Rehabilitation Psychiatry Public Health & Gen Prev Med Radiation Oncology Radiology Transplant Surgery Unspecified 4 9 27 61 126 2 24 53 1 19 0.1 0.2 0.6 1.3 2.7 0.0 0.5 1.1 0.0 0.4 1 3 5 17 55 0 17 8 0 6 0.1 0.2 0.3 1.0 3.4 0.0 1.0 0.5 0.0 0.4 5 12 32 78 181 2 32 61 1 25 0.1 0.2 0.5 1.2 2.9 0.0 0.5 1.0 0.0 0.4 Not Classified MDs 126 2.7 88 5.4 214 3.4 Inactive MDs 912 19.5 197 12.1 1,109 17.6 4,677 100.0 1,622 100.0 6,299 100.0 Total MDs Source: AMA. Physician Characteristics and Distribution in the U.S., 2015. Notes: See Appendix for sub-specialty classification by major specialty categories. Figures exclude physicians whose address is unknown. Office of Statewide Initiatives 19 Physician Workforce in Nevada – 2016 Edition Table 18: Allopathic Physicians (MDs) by Self-Designated Specialty in Nevada – 1993 to 2013 Total MDs Major Specialty 1993 Number General and Family Practice Family Medicine Percent Number 2013 Percent Number Percent Number Percent General Practice 300 215 85 12.3 8.8 3.5 524 452 72 11.2 9.6 1.5 613 584 29 9.7 9.3 0.5 313 369 -56 104.3 171.6 -65.9 Medical Specialties Allergy & Immunology Cardiovascular Disease Dermatology Gastroenterology Internal Medicine Pediatric Cardiology Pediatrics Pulmonary Disease 658 13 81 24 30 355 4 126 25 27.1 0.5 3.3 1.0 1.2 14.6 0.2 5.2 1.0 1,402 18 133 49 53 792 8 300 49 29.9 0.4 2.8 1.0 1.1 16.9 0.2 6.4 1.0 1,888 19 133 54 78 1,129 16 399 60 30.0 0.3 2.1 0.9 1.2 17.9 0.3 6.3 1.0 1,230 6 52 30 48 774 12 273 35 186.9 46.2 64.2 125.0 160.0 218.0 300.0 216.7 140.0 Surgical Specialties Colon & Rectal Surgery General Surgery Neurological Surgery Obstetrics & Gynecology Ophthalmology Orthopedic Surgery Otolaryngology Plastic Surgery Thoracic Surgery Urology Surgery 567 4 139 25 161 53 81 30 30 9 35 23.3 0.2 5.7 1.0 6.6 2.2 3.3 1.2 1.2 0.4 1.4 891 5 199 28 267 93 121 48 44 31 55 19.0 0.1 4.2 0.6 5.7 2.0 2.6 1.0 0.9 0.7 1.2 1,016 9 231 30 288 104 151 48 63 27 65 16.1 0.1 3.7 0.5 4.6 1.7 2.4 0.8 1.0 0.4 1.0 449 5 92 5 127 51 70 18 33 18 30 79.2 125.0 66.2 20.0 78.9 96.2 86.4 60.0 110.0 200.0 85.7 Other Specialties Aerospace Medicine Anatomic/Clinical Pathology Anesthesiology Child & Adolescent Psychology Diagnostic Radiology Emergency Medicine Forensic Pathology General Preventive Medicine Medical Genetics 626 3 57 150 10 77 83 4 3 0 37 25.7 0.1 2.3 6.2 0.4 3.2 3.4 0.2 0.1 0.0 1.5 1,172 2 90 307 21 135 169 6 9 1 57 25.0 0.0 1.9 6.5 0.4 2.9 3.6 0.1 0.2 0.0 1.2 1,459 1 78 366 35 163 279 6 15 3 84 23.2 0.0 1.2 5.8 0.6 2.6 4.4 0.1 0.2 0.0 1.3 833 -2 21 216 25 86 196 2 12 3 47 133.1 -66.7 36.8 144.0 250.0 111.7 236.1 50.0 400.0 127.0 Neurology 20 2003 Change – 1993 to 2013 Office of Statewide Initiatives Physician Workforce in Nevada – 2016 Edition 1 16 18 79 7 15 34 0 25 7 0.0 0.7 0.7 3.2 0.3 0.6 1.4 0.0 1.0 0.3 5 17 51 162 7 24 56 0 41 12 0.1 0.4 1.1 3.5 0.1 0.5 1.2 0.0 0.9 0.3 5 12 78 181 2 32 61 1 32 25 0.1 0.2 1.2 2.9 0.0 0.5 1.0 0.0 0.5 0.4 4 -4 60 102 -5 17 27 1 7 18 400.0 -25.0 333.3 129.1 -71.4 113.3 79.4 28.0 257.1 Active MDs – Patient Care 2,061 84.7 3,852 82.1 4,819 76.5 2,758 133.8 Active MDs – Non-Patient Care 90 3.7 137 2.9 157 2.5 67 74.4 Not Classified MDs 43 1.8 163 3.5 214 3.4 171 397.7 238 9.8 539 11.5 1,109 17.6 871 366.0 2,432 100.0 4,691 100.0 6,299 100.0 3,867 159.0 Nuclear Medicine Occupational Medicine Physical Med & Rehab Psychiatry Public Health & Gen Prev Med Radiation Oncology Radiology Transplant Surgery Other Specialty Unspecified Inactive MDs Total MDs Source: AMA. Physician Characteristics and Distribution in the U.S., 2015. Notes: See Appendix for sub-specialty classification by major specialty categories. Figures exclude physicians whose address is unknown. Office of Statewide Initiatives 21 Physician Workforce in Nevada – 2016 Edition Table 19: Allopathic Physicians (MDs) in Patient Care by Gender and Self-Designated Specialty in Nevada – 2013 Total MDs in Patient Care Major Specialty Males Number General and Family Practice Family Medicine General Practice Medical Specialties Allergy & Immunology Cardiovascular Disease Dermatology Gastroenterology Internal Medicine Pediatric Cardiology Pediatrics Pulmonary Disease Surgical Specialties Colon & Rectal Surgery General Surgery Neurological Surgery Obstetrics & Gynecology Ophthalmology Orthopedic Surgery Otolaryngology Plastic Surgery Thoracic Surgery Urology Surgery Other Specialties Aerospace Medicine Anatomic/Clinical Pathology Anesthesiology Child and Adolescent Psychology Diagnostic Radiology Emergency Medicine Forensic Medicine General Preventive Medicine Medical Genetics Neurology 22 Females Percent Number Total Percent Number Percent 389 366 23 8.3 7.8 0.5 205 201 4 12.6 12.4 0.2 594 567 27 9.4 9.0 0.4 1,241 13 114 36 73 757 14 180 54 26.5 0.3 2.4 0.8 1.6 16.2 0.3 3.8 1.2 583 5 15 18 5 327 2 206 5 35.9 0.3 0.9 1.1 0.3 20.2 0.1 12.7 0.3 1,824 18 129 54 78 1,084 16 386 59 29.0 0.3 2.0 0.9 1.2 17.2 0.3 6.1 0.9 783 7 179 26 168 83 146 38 54 25 57 16.7 0.1 3.8 0.6 3.6 1.8 3.1 0.8 1.2 0.5 1.2 215 2 49 3 115 18 5 8 8 2 5 13.3 0.1 3.0 0.2 7.1 1.1 0.3 0.5 0.5 0.1 0.3 998 9 225 29 283 101 151 46 62 27 62 15.8 0.1 3.6 0.5 4.5 1.6 2.4 0.7 1.0 0.4 1.0 1,109 1 51 318 16 23.7 0.0 1.1 6.8 294 0 20 45 16 18.1 0.0 1.2 2.8 1.0 1,403 1 72 363 32 22.3 0.0 1.1 5.8 5.8 0.5 29 54 4 6 0 20 1.8 3.3 0.2 0.4 0.0 1.2 159 278 4 13 1 80 2.5 4.4 0.1 0.2 0.0 1.3 130 224 0 4 1 60 0.3 2.8 4.8 0.0 0.1 0.0 1.3 Office of Statewide Initiatives Physician Workforce in Nevada – 2016 Edition Nuclear Medicine Occupational Medicine Other Specialty Physical Med & Rehab Psychiatry Public Health & Gen Prev Med Radiation Oncology Radiology Transplant Surgery Unspecified 4 6 20 60 117 1 23 49 1 19 0.1 0.1 0.4 1.3 2.5 0.0 0.5 1.0 0.0 0.4 1 3 5 16 53 0 8 5 0 6 0.1 0.2 0.3 1.0 3.3 0.0 0.5 0.3 0.0 0.4 5 9 25 76 170 1 31 57 1 25 0.1 0.1 0.4 1.2 2.7 0.0 0.5 0.9 0.0 0.4 3,522 75.3 1,297 80.0 4,819 76.5 Active MDs – Non-Patient Care 117 2.5 40 2.5 157 2.5 Not Classified MDs 126 2.7 88 5.4 214 3.4 Inactive MDs 912 19.5 197 12.1 1,109 17.6 4,677 100.0 1,622 100.0 6,299 100.0 Active MDs – Patient Care Total MDs Source: AMA. Physician Characteristics and Distribution in the U.S., 2015; AMA. Physician Characteristics and Distribution in the U.S., 2005; AMA. Physician Characteristics and Distribution in the U.S., 1995. Notes: See Appendix for sub-specialty classification by major specialty categories. Physicians in “Patient Care” refers to physicians whose principal professional activity is the provision of patient care in an office-based setting or hospital. Figures for 1993, 2003, and 2013 are for both federal and nonfederal physicians. Figures exclude physicians whose address is unknown. Office of Statewide Initiatives 23 Physician Workforce in Nevada – 2016 Edition Table 20: Allopathic Physicians (MDs) in Patient Care by SelfDesignated Specialty in Nevada – 1993 to 2013 Total MDs in Patient Care Major Specialty 2003 2013 Number Percent Number Percent Number Percent General Practice 290 207 83 11.9 8.5 3.4 512 444 68 10.9 9.5 1.4 594 567 27 Medical Specialties Allergy & Immunology Cardiovascular Disease Dermatology Gastroenterology Internal Medicine Pediatric Cardiology Pediatrics Pulmonary Disease 633 13 77 23 30 340 4 121 25 26.0 0.5 3.2 0.9 1.2 14.0 0.2 5.0 1.0 1,358 17 128 48 53 765 8 291 48 28.9 0.4 2.7 1.0 1.1 16.3 0.2 6.2 1.0 Surgical Specialties Colon & Rectal Surgery General Surgery Neurological Surgery Obstetrics & Gynecology Ophthalmology Orthopedic Surgery Otolaryngology Plastic Surgery Thoracic Surgery Urology Surgery 559 4 139 24 159 51 79 30 30 8 35 23.0 0.2 5.7 1.0 6.5 2.1 3.2 1.2 1.2 0.3 1.4 875 5 196 28 263 90 119 46 44 30 54 Other Specialties Aerospace Medicine Anatomic/Clinical Pathology Anesthesiology 579 2 51 147 10 74 81 2 1 0 35 23.8 0.1 2.1 6.0 0.4 3.0 3.3 0.1 0.0 0.0 1.4 1,107 2 81 303 21 132 166 4 7 0 54 General and Family PracticeMedicine Family Child & Adolescent PsychologyRadiology Diagnostic Emergency Medicine Forensic Medicine General Prev Medicine Medical Genetics Neurology 24 1993 Change – 1993 to 2013 Number Percent 9.4 9.0 0.4 304 360 -56 104.8 173.9 -67.5 1,824 18 129 54 78 1,084 16 386 59 29.0 0.3 2.0 0.9 1.2 17.2 0.3 6.1 0.9 1,191 5 52 31 48 744 12 265 34 188.2 38.5 67.5 134.8 160.0 218.8 300.0 219.0 136.0 18.7 0.1 4.2 0.6 5.6 1.9 2.5 1.0 0.9 0.6 1.2 998 9 228 29 283 101 151 46 62 27 62 15.8 0.3 3.6 0.5 4.5 1.6 2.4 0.7 1.0 0.4 1.0 439 5 89 5 124 50 72 16 32 19 27 78.5 125.0 64.0 20.8 78.0 98.0 91.1 53.3 106.7 237.5 77.1 23.6 0.0 1.7 6.5 0.4 2.8 3.5 0.1 0.1 0.0 1.2 1,403 1 72 363 32 159 278 4 13 1 80 22.3 0.0 1.1 5.8 0.5 2.5 4.4 0.1 0.2 0.0 1.3 824 -1 21 216 22 85 197 2 12 1 45 142.3 -50.0 41.2 146.9 220.0 114.9 243.2 100.0 1,200.0 128.6 Office of Statewide Initiatives Physician Workforce in Nevada – 2016 Edition 1 14 15 18 69 4 14 34 0 7 0.0 0.6 0.6 0.7 2.8 0.2 0.6 1.4 0.0 0.3 4 14 29 49 153 2 23 53 0 10 0.1 0.3 0.6 1.0 3.3 0.0 0.5 1.1 0.0 0.2 5 9 25 76 170 1 31 57 1 25 0.1 0.1 0.4 1.2 2.7 0.0 0.5 0.9 0.0 0.4 4 -5 10 58 101 -3 17 23 1 18 400.0 -35.7 66.7 322.2 146.4 -75.0 121.4 67.6 257.1 2,061 84.7 3,852 82.1 4,819 76.5 2,758 133.8 Active MDs – Non Patient Care 90 3.7 137 2.9 157 2.5 67 74.4 Not Classified MDs 43 1.8 163 3.5 214 3.4 83 397.7 238 9.8 539 11.5 1,109 17.6 674 366.0 2,432 100.0 4,691 100.0 6,299 100.0 3,867 100.0 Nuclear Medicine Occupational Medicine Other Specialty Physical Med & Rehabilitation Psychiatry Public Health & Gen Prev Med Radiation Oncology Radiology Transplant Surgery Unspecified Active MDs – Patient Care Inactive MDs Total MDs Source: AMA. Physician Characteristics and Distribution in the U.S., 2015. Notes: See Appendix for sub-specialty classification by major specialty categories. Physicians in “Patient Care” refers to physicians whose principal professional activity is the provision of patient care in an office-based setting or hospital. Figures exclude physicians whose address is unknown. Office of Statewide Initiatives 25 Physician Workforce in Nevada – 2016 Edition Section Three: Comparative Data on the Physician Workforce in Nevada and the US Executive Summary and Key Findings Over the past three decades, the number of MDs in Nevada has grown from 2,432 in 1993 to 6,299 in 2013 (437.9%). Likewise, the number of MDs per 100,000 population in Nevada has grown from 167.9 to 225.7 (34.4%). However, Nevada’s physician-to-population rank among US states dropped from 46th to 47th during the same time period (Table 21). According to the American Medical Association (AMA), only 13.5% of allopathic physicians (MDs) in Nevada are under the age of 40. Among states bordering Nevada, Utah had the largest percentage of physicians under the age of 40 (17.1%). Currently, 17.0% of the national physician workforce is under the age of 40 (Table 22). Currently, 26.9% of the MD workforce in Nevada is aged 60 and over. Nationally, 29.4% of the MD workforce is aged 60 and over (Table 22). Women currently represent 26.5% of the MD workforce in Nevada. Nationally, 33.3% of the MD workforce is women (Tables 23). Men currently represent 73.5% of the MD workforce in Nevada. Nationally, 66.7% of the MD workforce is men (Table 24). While the number of MDs per 100,000 population in Nevada has improved from 168 to 226 over the last two decades, Nevada is bordered by three states – Arizona, Idaho and Utah – with physician-to-population ratios below the national rate of 326 MDs per 100,000 population (Table 25). The number of MDs in patient care per 100,000 population in Nevada has improved from 142 in 1993 to 173 in 2013. Nonetheless, the Nevada population-to-physician ratio is well below the national rate of 253 MDs in patient care per 100,000 population (Table 27). Since 1993, the number of MDs in Nevada has increased in almost every self-designated specialty area (Table 18). However, over the past two decades, change in the number of MDs per capita has been comparatively modest. For example, the number of family medicine MDs increased by 171.6% since 1993; however, the number of family medicine MDs per capita increased by only 41.0% during the same time period (Table 29). In 16 of 39 medical specialties, the number of MDs per capita has not kept pace with population growth in Nevada over the last two decades. For example, while the number of MDs in cardiovascular disease increased by 52 or 64.2% since 1993, the number of MDs in cardiovascular disease per capita declined by 14.8% during the same time period (Table 29). 27 Office of Statewide Initiatives Physician Workforce in Nevada – 2016 Edition 28 Currently, of the 39 self-designated specialties, only four specialty areas possess a higher number of MDs per capita in Nevada versus states in the Mountain Region: internal medicine, plastic surgery, nuclear medicine, and transplant surgery. Across all 39 specialty areas, the number of MDs per capita in Nevada is 82.6% of the average rate for the Mountain Region (Table 30). In 2013, only 1 of 39 medical specialties has a higher number of MDs per capita in Nevada versus the US: forensic medicine. Across all 39 specialty areas, the number of MDs per capita in Nevada is 68.2% of the average rate for the US (Table 30). Over the past two decades, the number of patient care MDs in Nevada has increased in almost every self-designated specialty area (Table 20). However, change in the number of MDs per capita has been comparatively modest. For example, the number of patient care MDs in pediatrics increased by 219.0% since 1993; however, the number of patient care MDs in pediatrics per capita increased by only 65.6% during the same time period (Table 31). In 15 of 39 medical specialties, the number of patient care MDs per capita has not kept pace with population growth in Nevada over the last two decades. For example, while the number of MDs specializing in obstetrics and gynecology increased by 124 or 78.0% (Table 20). Since 1993, the number of MDs in obstetrics and gynecology per capita declined by 7.6% during the same time period (Table 31). Currently, only 5 of 39 self-designated specialty areas possess a higher number of patient care MDs per capita in Nevada versus states in the Mountain Region: colon & rectal surgery, internal medicine, plastic surgery, nuclear medicine, and transplant surgery. Across all 39 specialty areas, the number of patient care MDs per capita in Nevada is 82.6% of the average rate for the Mountain Region (Table 32). In 2013, in none of the 39 medical specialties does Nevada have a higher number of patient care MDs per capita in Nevada versus the US. Across all 39 specialty areas, the number of MDs per capita in Nevada is 68.2% of the average rate for the US (Table 32). Currently, there are 6,299 MDs in Nevada or 225.8 MDs per 100,000 population. By comparison, the per capita number of MDs in the Mountain Region is 273.3 per 100,000 population. To meet or exceed the regional per capita rate, Nevada would need a minimum of 1,326 additional MDs. In other words, the supply of MDs in Nevada would need to increase by 21.1% to reach the regional rate (Table 33). Of 39 self-designated specialties, 34 specialty areas possess a lower number of MDs per capita in Nevada compared to the Mountain Region. For example, there are 399 pediatric MDs in Nevada or 14.3 pediatric MDs per 100,000 population. The per capita number of pediatric MDs in the Mountain Region is 20.0 per 100,000 population. To meet or exceed the regional Office of Statewide Initiatives Physician Workforce in Nevada – 2016 Edition number of family medicine MDs per capita, Nevada would need a minimum of 158 additional family medicine MDs (Table 33). Currently, there are 6,299 MDs in Nevada or 225.8 MDs per 100,000 population. By comparison, the per capita number of MDs in the United States is 330.8 per 100,000 population. To meet or exceed the national per capita rate, Nevada would need a minimum of 2,932 additional MDs. In other words, the supply of MDs in Nevada would need to increase by 46.5% to reach the national rate (Table 34). Of 39 self-designated specialties, all specialty areas possess a lower number of MDs per capita in Nevada compared to the United States. For example, there are 584 MDs in family medicine in Nevada or 20.9 family medicine MDs per 100,000 population. The per capita number of family medicine MDs in the United States is 29.6 per 100,000 population. To meet or exceed the national number of family medicine MDs per capita, Nevada would need a minimum of 243 additional family medicine MDs (Table 34). Tables 35 through 36 estimate the number of additional physicians that would be needed in each county in Nevada to meet or exceed regional and national MD per capita rates. For example, Clark County needs 1,144 additional physicians to reach the Mountain Region rate of 273.3 MDs per 100,000 population and would need an additional 2,312 MDs to reach the U.S. rate of 330.8 MDs per 100,000 population. Since 1993, the number of MDs in Nevada has increased by 3,867 or 159.0%. This growth has occurred across all regions of the state. In rural and frontier counties, the number of MDs has increased by 150 or 133.9%. In urban counties, the number has increased by 3,717 or 160.2% (Table 37). Currently, 70.0% of MDs in Nevada are located in Clark County, 23.4% are located in Washoe County, 2.5% are located in Carson City, and 4.2% are located in the state’s fourteen rural and frontier counties. By comparison, 72.5% of the state’s population resides in Clark County, 15.4% resides in Washoe County, 2.0% resides in Carson City, and 10.1% resides in rural and frontier Nevada. (Table 37) Over the past two decades, the number of MDs per 100,000 population in Nevada has increased by 32.9%. In rural and frontier counties, the number of MDs per capita has increased by 55.6%, as compared to 28.6% in urban counties (Table 38). Since 1993, the number of patient care MDs in Nevada has increased by 2,758 or 133.8%. In rural and frontier counties, the number of patient care MDs has increased by 98 or 107.7%. In urban counties, the number has increased by 2,660 or 135.0% (Table 39). Office of Statewide Initiatives 29 Physician Workforce in Nevada – 2016 Edition 30 Over the past two decades, the number of patient care MDs per 100,000 population in Nevada has increased by 20.0%. In rural and frontier counties, the number of MDs per capita has increased by 38.2%, as compared to 16.1% in urban counties (Table 40). Currently, 38.3% of MDs in metropolitan counties in Nevada list a primary care specialty or subspecialty as their self-designated specialty, as compared to 41.4% of MDs in micropolitan counties and 65.4% of MDs in non-metropolitan counties (Table 41). In 2013, 64.6% of MDs in metropolitan counties in Nevada are providing patient care in an office-based practice, as compared to 59.6% of MDs in micropolitan counties and 50.0% of MDs in non-metro/micropolitan counties. Currently, 12.1% of MDs in metropolitan counties in Nevada and 11.7% of MDs in micropolitan counties are providing patient care in a hospitalbased practice, as compared to 31.8% of MDs in non-metro/micropolitan counties (Table 42). According to the American Medical Association (AMA), 1,652 graduates of the University of Nevada School of Medicine (UNSOM) are practicing in the United States. Nearly, three in five UNSOM graduates are currently practicing in the US (55.8%) received their undergraduate medical education degree (MD) prior to 2000 (Table 43). Over the past decade, the number of UNSOM graduates practicing in the US has increased by 526 or 46.7%. During the same period, the number of UNSOM graduates with a self-designated primary care specialty or sub-specialty has increased from 534 in 2003 to 755 in 2013 (Table 44). In 2015, 50.5% of physicians completing UNSOM residencies and fellowships report that they will remain in Nevada to begin patient care practice or continue their graduate medical education (GME) (Table 45). Over the past decade, 51.5% of physicians completing UNSOM residencies and fellowships reported that they will remain in Nevada to begin patient care practice or continue their GME (Table 46). In 2013, there were 1,608 active physicians in the US who graduated from an MD or DO school in Nevada – of this total, 58.3 or 36.4% are currently practicing in Nevada (Table 47). Among US states, Nevada ranks 27th in the percentage of physicians who are practicing in the same state within which they received their undergraduate medical education (UME) degree (MD or DO) (Table 47). In 2013, there were 1,409 active physicians in the US who graduated from a public MD or DO school in Nevada – of this total, 547 or 38.8% are currently practicing in Nevada (Table 48). Among US states, Nevada ranks 31st in the percentage of physicians who are practicing in the same state within which they received their public undergraduate medical education (UME) degree (MD or DO) (Table 48). Office of Statewide Initiatives Physician Workforce in Nevada – 2016 Edition In 2013, there were a total of 1,168 active physicians (MD and DO) in the US who completed their GME in Nevada – of this total, 631 or 54.0% are currently practicing in Nevada (Table 49). Among US states, Nevada ranks 8th in the percentage of physicians who are practicing in the same state within which they completed their GME (Table 49). In 2013, there were a total of 229 active physicians (MD and DO) in the US who completed both their UME and GME in Nevada – of this total, 177 or 77.3% are currently practicing in Nevada (Table 50). Among US states, Nevada ranks 6th in the percentage of physicians who are practicing in the same state within which they completed both their UME and GME (Table 50). In Academic Year 2014-2015 (AY 14-15), there were 816 students enrolled in an allopathic or osteopathic medical school in Nevada. This figure translated to a rate of 28.7 medical students per 100,000 population and a rank of 27th among US states in per capita medical school enrollment (Table 51). In AY 14-15, there were 280 students enrolled in a public medical school in Nevada. This figure translated to a rate of 9.9 students enrolled in a public medical school per 100,000 population and a rank of 38th among US states in per capita public medical school enrollment (Table 52). Over the past decade, the number of students enrolled in an allopathic or osteopathic medical school in Nevada increased from 296 in 2004 to 816 in 2014 – an increase of 175.7% in Nevada and a ranking of 1st among US states in total enrollment growth in medical schools during that time period (Table 53). In AY 14-15, 54 of 86 first-year medical school matriculants (allopathic schools only) in Nevada were legal residents of Nevada – Nevada’s in-state matriculation rate of 68.6% was above the national average of 61.6% and resulted in a ranking of 23rd among US states (Table 54). In 2013, there were 814 medical students (MD and DO) enrolled in undergraduate medical education (UME) programs and 373 physicians (MD and DO) enrolled in graduate medical education (GME) programs in Nevada. The ratio of physicians enrolled in GME to students enrolled in UME in Nevada was 0.5 which resulted in a rank of 45 th among US states (Table 55). Over the past decade, the number of residents and fellows in ACGME-Accredited Programs (Accreditation Council for Graduate Medical Education) in Nevada increased from 201 in 2004 to 340 in 2014 – an increase of 69.2% in Nevada and a ranking of 3rd among US states in the growth of medical residents and fellows during that time period (Table 56). In 2014, there were 340 residents and fellows in ACGME-Accredited Programs in Nevada, including 146 MDs who graduated from US allopathic medical schools, 51 DOs, and 143 MDs who are international medical graduates (IMGs). In Nevada, 42.1% of residents and fellows in Office of Statewide Initiatives 31 Physician Workforce in Nevada – 2016 Edition ACGME-Accredited Programs were IMGs – among US states, Nevada has the 4th highest percentage of IMGs in ACGME-Accredited residency and fellowship programs (Table 57). 32 In 2014, there were 208 residents and fellows in ACGME-Accredited primary care residency and fellowship programs in Nevada, including 190 MDs and 18 DOs (Table 58). Among US states, Nevada has a rate of 7.3 residents and fellows per 100,000 population in primary care residency and fellowship programs resulting a rank of 42nd among US states (Table 58). Among US states, Nevada has a rate of 12.0 residents and fellows per 100,000 population in ACGME-Accredited residency and fellowship programs resulting a rank of 46 th among US states (Table 59). Office of Statewide Initiatives Physician Workforce in Nevada – 2016 Edition Table 21: Allopathic Physicians (MDs), Population, and Physician/Population Ratios in Nevada and the U.S. – 1993 to 2013 Year Category United States Total Population (Millions) Total MDs (Thousands) Total MDs per 100,000 Population Individuals per One Physician Nevada Total Population (Thousands) Total MDs Total MDs per 100,000 Population Individuals per One Physician Nevada Rank Among U.S. States Change – 1993 to 2013 1993 2003 2013 Number Percent 259 653 252 397 291 859 295 339 316 1,045 331 302 57 392 79 -95 22.0 60.0 31.3 -23.9 1,448 2,432 167.9 595 46 2,241 4,691 209.3 478 48 2,790 6,299 225.7 443 47 1,342 3,867 57.8 -152 - 92.7 159.0 34.4 -25.5 - Source: AMA. Physician Characteristics and Distribution in the U.S., 2015; AMA. Physician Characteristics and Distribution in the U.S., 2005; AMA. Physician Characteristics and Distribution in the U.S., 1995; AMA. Notes: Figures for 1993 through 2013 include both federal and nonfederal physicians. All figures exclude physicians whose address is unknown. Office of Statewide Initiatives 33 Physician Workforce in Nevada – 2016 Edition Table 22: Active Physicians (MDs) by Selected Age Groups in Nevada and Neighboring States – 2014 State/Region Total Active Physicians Under Age 40 Number Percent Age 60 or Older Number Percent Rank Arizona California Idaho 15,657 101,752 3,099 2,251 15,903 441 14.4 15.6 14.2 4,489 33,178 843 28.7 32.6 27.2 25 5 37 Nevada Oregon Utah Region Subtotal Region Subtotal ̶ CA United States 5,573 11,512 6,098 143,691 41,939 844,854 751 1,825 1,043 22,214 6,311 143,308 13.5 15.9 17.1 15.5 15.0 17.0 1,501 3,246 1,565 44,822 11,644 248,572 26.9 28.2 25.7 31.2 27.8 29.4 41 27 47 - Source: AAMC. State Physician Workforce Data Book. Center for Workforce Studies, 2015. Notes: “Active physicians” refer to those physicians who report working in administration, direct patient care, medical research, medical teaching, or other non-patient care activities. The “total active physicians” figure for the U.S. excludes 1,643 physicians whose age was missing. 34 Office of Statewide Initiatives Physician Workforce in Nevada – 2016 Edition Table 23: Active Female Physicians (MDs) in Nevada and Neighboring States – 2014 State/Region Total Active Physicians Active Female Physicians Number Percent Rank Arizona California Idaho 15,725 101,662 3,096 4,789 35,534 727 30.5 35.0 23.5 30 16 49 Nevada Oregon Utah Region Subtotal Region Subtotal ̶ CA United States 5,594 11,551 6,102 143,730 42,068 845,594 1,480 4,183 1,398 48,111 12,577 281,259 26.5 36.2 22.9 33.5 29.9 33.3 44 8 50 - Source: AAMC. State Physician Workforce Data Book. Center for Workforce Studies, 2015. Notes: “Active physicians” refer to those physicians who report working in administration, direct patient care, medical research, medical teaching, or other non-patient care activities. Physicians whose major professional activity is unclassified are also considered active. Physicians whose sex was missing (n=1,093) are excluded. Office of Statewide Initiatives 35 Physician Workforce in Nevada – 2016 Edition Table 24: Active Male Physicians (MDs) in Nevada and Neighboring States – 2014 State/Region Arizona Total Active Physicians Active Male Physicians Number Percent Rank 1,881 1,203 64.0 21 California Idaho Nevada Oregon Utah Region Subtotal 101,662 3,096 5,594 11,551 6,102 129,886 66,128 2,369 4,114 7,368 4,704 85,886 65.0 76.5 73.5 63.8 77.1 66.1 1 43 35 27 30 - Region Subtotal ̶ CA United States 28,224 845,594 19,758 564,335 70.0 66.7 - Source: AAMC. State Physician Workforce Data Book. Center for Workforce Studies, 2015. Notes: “Active physicians” refer to those physicians who report working in administration, direct patient care, medical research, medical teaching, or other non-patient care activities. Physicians whose major professional activity is unclassified are also considered active. Physicians whose sex was missing (n=1,093) are excluded. 36 Office of Statewide Initiatives Physician Workforce in Nevada – 2016 Edition Table 25: Number of Allopathic Physicians (MDs) per 100,000 Population in Nevada and Neighboring States – 1993 to 2013 Number of Physicians per 100,000 Population State Arizona California Idaho Nevada Oregon Utah United States Change – 1993 to 2013 1993 2003 2013 Number 230 270 154 168 242 205 252 244 294 193 209 302 234 295 276 329 208 226 357 249 326 46 59 54 58 115 44 74 Percent 20.0 21.9 35.1 34.5 47.5 21.5 29.4 Source: AMA. Physician Characteristics and Distribution in the U.S., 2015; AMA. Physician Characteristics and Distribution in the U.S., 2005; AMA. Physician Characteristics and Distribution in the U.S., 1995. Notes: All figures exclude physicians whose address is unknown. Table 26: Number of Residents per One Allopathic Physician (MD) in Nevada and Neighboring States – 1993 to 2013 State Arizona California Idaho Nevada Oregon Utah United States Number of Residents per One Physician in Patient Care Change – 1993 to 2013 1993 2003 2013 Number Percent 435 371 650 595 414 488 397 409 340 517 478 331 426 339 362 304 481 443 280 401 306 -73 -67 -169 -152 -134 -87 -91 -16.8 -18.1 -26.0 -25.5 -32.4 -17.8 -22.9 Source: AMA. Physician Characteristics and Distribution in the U.S., 2015; AMA. Physician Characteristics and Distribution in the U.S., 2005; AMA. Physician Characteristics and Distribution in the U.S., 1995. Notes: All figures exclude physicians whose address is unknown. Office of Statewide Initiatives 37 Physician Workforce in Nevada – 2016 Edition Table 27: Number of Allopathic Physicians (MDs) in Patient Care per 100,000 Population in Nevada and Neighboring States – 1993 to 2013 State Arizona California Idaho Nevada Oregon Utah United States Number of Physicians in Patient Care per 100,000 Population 1993 2003 2013 179 216 126 142 193 170 207 189 228 161 172 235 191 235 213 250 164 173 269 201 253 Change – 1993 to 2013 Number Percent 34 34 19.0 15.7 38 31 76 31 46 30.2 21.8 39.4 18.2 22.2 Source: AMA. Physician Characteristics and Distribution in the U.S., 2015; AMA. Physician Characteristics and Distribution in the U.S., 2005; AMA. Physician Characteristics and Distribution in the U.S., 1995. Notes: All figures exclude physicians whose address is unknown. 38 Office of Statewide Initiatives Physician Workforce in Nevada – 2016 Edition Table 28: Number of Residents per One Allopathic Physician (MD) in Patient Care in Nevada and Neighboring States – 1993 to 2013 State Arizona California Idaho Nevada Oregon Utah United States Number of Residents per One Physician in Patient Care Change – 1993 to 2013 1993 2003 2013 Number Percent 558 462 796 703 519 588 483 528 438 622 582 425 525 426 469 399 608 579 372 498 395 -89 -63 -188 -124 -147 -90 -88 -15.9 -13.6 -23.6 -17.6 -28.3 -15.3 -18.2 Source: AMA. Physician Characteristics and Distribution in the U.S., 2015; AMA. Physician Characteristics and Distribution in the U.S., 2005; AMA. Physician Characteristics and Distribution in the U.S., 1995. Notes: All figures exclude physicians whose address is unknown. Office of Statewide Initiatives 39 Physician Workforce in Nevada – 2016 Edition Table 29: Allopathic Physicians (MDs) per 100,000 Population by Self-Designated Specialty in Nevada – 1993 to 2013 Total MDs per 100,000 Population Change – 1993 to 2013 1993 2003 2013 Change Percent General and Family Practice Family Medicine General Practice 20.7 14.8 5.9 23.4 20.2 3.2 22.0 20.9 1.0 1.3 6.1 -4.8 6.0 41.0 -82.3 Medical Specialties Allergy & Immunology Cardiovascular Disease Dermatology Gastroenterology Internal Medicine Pediatric Cardiology Pediatrics Pulmonary Disease 45.4 0.9 5.6 1.7 2.1 24.5 0.3 8.7 1.7 62.6 0.8 5.9 2.2 2.4 35.3 0.4 13.4 2.2 67.7 0.7 4.8 1.9 2.8 40.5 0.6 14.3 2.2 22.2 -0.2 -0.8 0.3 0.7 15.9 0.3 5.6 0.4 48.9 -24.1 -14.8 16.8 34.9 65.1 107.6 64.3 24.6 Surgical Specialties Colon & Rectal Surgery General Surgery Neurological Surgery Obstetrics & Gynecology Ophthalmology Orthopedic Surgery Otolaryngology Plastic Surgery Thoracic Surgery Urology Surgery 39.2 0.3 9.6 1.7 11.1 3.7 5.6 2.1 2.1 0.6 2.4 39.8 0.2 8.9 1.2 11.9 4.1 5.4 2.1 2.0 1.4 2.5 36.4 0.3 8.3 1.1 10.3 3.7 5.4 1.7 2.3 1.0 2.3 -2.7 0.0 -1.3 -0.7 -0.8 0.1 -0.2 -0.4 0.2 0.3 -0.1 -7.0 16.8 -13.7 -37.7 -7.2 1.8 -3.2 -17.0 9.0 55.7 -3.6 Other Specialties Aerospace Medicine Anatomic/Clinical Pathology Anesthesiology Child & Adolescent Psychology Diagnostic Radiology Emergency Medicine Forensic Medicine General Prev Medicine Medical Genetics Neurology 43.2 0.2 3.9 10.4 0.7 5.3 5.7 0.3 0.2 0.0 2.6 52.3 0.1 4.0 13.7 0.9 6.0 7.5 0.3 0.4 0.0 2.5 52.3 0.0 2.8 13.1 1.3 5.8 10.0 0.2 0.5 0.0 3.0 9.1 -0.2 -1.1 2.8 0.6 0.5 4.3 -0.1 0.3 0.0 0.5 21.0 -82.7 -29.0 26.6 81.6 9.9 74.5 -22.2 159.5 0.0 17.8 Major Specialty 40 Office of Statewide Initiatives Physician Workforce in Nevada – 2016 Edition Nuclear Medicine Occupational Medicine Other Specialty Physical Med & Rehabilitation Psychiatry Public Health & Gen Prev Med Radiation Oncology Radiology Transplant Surgery Unspecified 0.1 1.1 1.7 1.2 5.5 0.5 1.0 2.3 0.0 0.5 0.2 0.8 1.8 2.3 7.2 0.3 1.1 2.5 0.0 0.5 0.2 0.4 1.1 2.8 6.5 0.1 1.1 2.2 0.0 0.9 0.1 -0.7 -0.6 1.6 1.0 -0.4 0.1 -0.2 0.0 0.4 159.5 -61.1 -33.6 124.9 18.9 -85.2 10.7 -6.9 0.0 85.4 Active MDs – Non Patient Care 6.2 6.1 5.6 -0.6 -9.5 Not Classified MDs 3.0 7.3 7.7 4.7 158.3 16.4 24.1 39.7 23.3 141.8 168.0 209.3 225.8 57.8 34.4 Inactive MDs Total MDs Source: AMA. Physician Characteristics and Distribution in the U.S., 2015; AMA. Physician Characteristics and Distribution in the U.S., 2005; AMA. Physician Characteristics and Distribution in the U.S., 1995. Notes: See Appendix for sub-specialty classification by major specialty categories. Physicians in “Patient Care” refer to physicians whose principal professional activity is the provision of patient care in an office-based setting or hospital. Figures exclude physicians whose address is unknown. “Inactive MDs” include physicians who are retired, semi-retired, working part-time, temporarily not in practice, or not active for other reasons and who indicated they worked 20 hours or less per week. “Not Classified MDs” includes physicians who did not provide information on their type of practice or their present employment. Office of Statewide Initiatives 41 Physician Workforce in Nevada – 2016 Edition Table 30: Allopathic Physicians (MDs) per 100,000 Population by Self-Designated Specialty in Nevada, Mountain Region, and the U.S. – 2013 Total MDs per 100,000 Population Major Specialty Nevada per Capita Number as a Percent of – Nevada Mountain Region United States Mountain Region United States General and Family Practice Family Medicine General Practice 22.0 20.9 1.0 33.0 31.4 1.2 31.7 29.6 2.1 66.6 66.8 83.7 69.2 70.6 Medical Specialties Allergy & Immunology Cardiovascular Disease Dermatology Gastroenterology Internal Medicine Pediatric Cardiology Pediatrics Pulmonary Disease 67.7 0.7 4.8 1.9 2.8 40.5 0.6 14.3 2.2 76.3 1.1 5.0 3.1 3.4 39.6 0.7 20.0 3.5 104.8 1.4 7.5 3.8 4.5 56.0 0.8 26.7 4.0 88.7 63.9 96.0 61.8 81.8 102.3 85.8 71.6 61.0 . 64.6 47.2 63.9 50.4 61.5 72.3 71.0 53.5 54.1 Surgical Specialties Colon & Rectal Surgery General Surgery Neurological Surgery Obstetrics & Gynecology Ophthalmology Orthopedic Surgery Otolaryngology Plastic Surgery Thoracic Surgery Urology Surgery 36.4 0.3 8.3 1.1 10.3 3.7 5.4 1.7 2.3 1.0 2.3 45.5 0.3 10.2 1.8 11.9 4.5 8.0 2.8 2.1 1.1 2.8 54.4 0.5 12.4 2.0 14.0 6.1 8.4 3.4 2.5 1.5 3.5 80.0 99.7 80.9 60.9 86.9 82.2 67.9 61.8 109.5 86.5 82.8 67.0 59.9 66.7 53.8 73.7 60.9 64.6 50.5 89.6 65.5 66.6 49.2 Other Specialties Aerospace Medicine 52.3 0.0 66.9 0.2 79.4 0.1 78.2 18.6 65.8 30.1 Anatomical & Clinical Pathology Anesthesiology Child & Adolescent Psychology Diagnostic Radiology Emergency Medicine Forensic Medicine 2.8 13.1 1.3 5.8 10.0 0.2 4.5 14.1 2.1 7.1 12.9 0.2 6.1 14.6 2.6 8.6 12.1 0.2 16.7 93.2 59.6 81.8 77.6 98.4 45.9 89.8 47.5 67.9 82.4 99.8 0.5 0.1 3.0 0.7 0.2 4.3 0.8 0.2 5.7 78.9 64.7 70.4 69.2 45.1 53.1 General Preventive Medicine Medical Genetics Neurology 42 Office of Statewide Initiatives Physician Workforce in Nevada – 2016 Edition Nuclear Medicine 0.2 0.2 0.4 102.5 40.1 Occupational Medicine Other Specialty Physical Med & Rehabilitation Psychiatry Public Health & Gen Prev Medicine Radiation Oncology 0.4 1.1 2.8 6.5 0.1 1.1 0.8 1.6 2.9 9.1 0.3 1.3 0.7 1.9 3.3 12.9 0.5 1.6 54.1 73.9 96.2 71.2 24.9 87.5 60.4 59.6 84.1 50.3 15.7 69.6 Radiology Transplant Surgery Unspecified 2.2 0.0 0.9 2.9 0.0 1.6 3.2 0.1 3.7 75.7 136.7 55.0 67.5 54.5 24.0 Not Classified MDs 7.7 6.6 13.8 116.5 55.7 39.7 45.4 46.7 87.5 85.1 225.8 273.3 330.8 82.6 68.2 Inactive MDs Total MDs Source: AMA. Physician Characteristics and Distribution in the U.S., 2015. Notes: See Appendix for sub-specialty classification by major specialty categories. Per capita difference may not sum due to rounding errors. Nevada and Mountain Region figures exclude physicians whose address is unknown. United States figures for not classified includes physicians whose address is unknown. Mountain Region includes Arizona, Colorado, Idaho, Montana, Nevada, New Mexico, Utah, and Wyoming. Office of Statewide Initiatives 43 Physician Workforce in Nevada – 2016 Edition Table 31: Allopathic Physicians (MDs) in Patient Care per 100,000 Population by Self-Designated Specialty in Nevada – 1993 to 2013 Number of MDs in Patient Care per 100,000 Population Change – 1993 to 2013 1993 2003 2013 Number General and Family Practice Family Medicine General Practice 20.0 14.3 5.7 22.8 19.8 3.0 21.3 20.3 1.0 1.3 6.0 -4.8 6.3 42.2 -83.1 Medical Specialties Allergy & Immunology Cardiovascular Disease Dermatology Gastroenterology Internal Medicine Pediatric Cardiology Pediatrics Pulmonary Disease 43.7 0.9 5.3 1.6 2.1 23.5 0.3 8.4 1.7 60.6 0.8 5.7 2.1 2.4 34.1 0.4 13.0 2.1 65.4 0.6 4.6 1.9 2.8 38.9 0.6 13.8 2.1 21.7 -0.3 -0.7 0.3 0.7 15.4 0.3 5.5 0.4 49.5 -28.1 -13.1 21.9 34.9 65.5 107.6 65.6 22.5 Surgical Specialties Colon & Rectal Surgery General Surgery Neurological Surgery Obstetrics & Gynecology Ophthalmology Orthopedic Surgery Otolaryngology Plastic Surgery Thoracic Surgery Urology Surgery 38.6 0.3 9.6 1.7 11.0 3.5 5.5 2.1 2.1 0.6 2.4 39.0 0.2 8.7 1.2 11.7 4.0 5.3 2.1 2.0 1.3 2.4 35.8 0.3 8.2 1.0 10.1 3.6 5.4 1.6 2.2 1.0 2.2 -2.8 0.0 -1.4 -0.6 -0.8 0.1 0.0 -0.4 0.2 0.4 -0.2 -7.3 16.8 -14.9 -37.3 -7.6 2.8 -0.8 -20.4 7.3 75.2 -8.1 Major Specialty Percent Other Specialties Aerospace Medicine 40.0 0.1 49.4 0.1 50.3 0.0 10.3 -0.1 25.8 -74.1 Anatomical & Clinical Pathology Anesthesiology Child & Adolescent Psychology Diagnostic Radiology Emergency Medicine Forensic Medicine 3.5 10.2 0.7 5.1 5.6 0.1 3.6 13.5 0.9 5.9 7.4 0.2 2.6 13.0 1.1 5.7 10.0 0.1 -0.9 2.9 0.5 0.6 4.4 0.0 -26.7 28.2 66.1 11.5 78.1 3.8 0.1 0.0 2.4 0.3 0.0 2.4 0.5 0.0 2.9 0.4 0.0 0.5 574.7 0.0 18.6 General Preventive Medicine Medical Genetics Neurology 44 Office of Statewide Initiatives Physician Workforce in Nevada – 2016 Edition Nuclear Medicine 0.1 0.2 0.2 0.1 159.5 Occupational Medicine Other Specialty Physical Med & Rehabilitation Psychiatry Public Health & Gen Prev Medicine Radiation Oncology 1.0 1.0 1.2 4.8 0.3 1.0 0.6 1.3 2.2 6.8 0.1 1.0 0.3 0.9 2.7 6.1 0.0 1.1 -0.6 -0.1 1.5 1.3 -0.2 0.1 -66.6 -13.5 119.1 27.9 -87.0 14.9 Radiology Transplant Surgery Unspecified 2.3 0.0 0.5 2.4 0.0 0.4 2.0 0.0 0.9 -0.3 0.0 0.4 -13.0 0.0 85.4 Not Classified MDs 3.0 7.3 7.7 4.7 158.3 16.4 24.1 39.7 23.3 141.8 168.0 209.3 225.8 57.8 34.4 Inactive MDs Total MDs Source: AMA. Physician Characteristics and Distribution in the U.S., 2015. Notes: See Appendix for sub-specialty classification by major specialty categories. Per capita difference may not sum due to rounding errors. Nevada and Mountain Region figures exclude physicians whose address is unknown. United States figures for not classified includes physicians whose address is unknown. Mountain Region includes Arizona, Colorado, Idaho, Montana, Nevada, New Mexico, Utah, and Wyoming. Office of Statewide Initiatives 45 Physician Workforce in Nevada – 2016 Edition Table 32: Allopathic Physicians (MDs) in Patient Care per 100,000 Population by Self-Designated Specialty in Nevada, Mountain Region, and U.S. – 2013 Major Specialty Total MDs in Patient Care per 100,000 Population Nevada per Capita Number as a Percent of – Nevada Mountain Region United States Mountain Region United States General and Family Practice Family Medicine General Practice 21.3 20.3 1.0 31.4 30.2 1.2 30.5 28.5 2.0 67.8 67.2 83.6 69.7 71.2 48.0 Medical Specialties Allergy & Immunology Cardiovascular Disease Dermatology Gastroenterology Internal Medicine Pediatric Cardiology Pediatrics Pulmonary Disease 65.4 0.6 4.6 1.9 2.8 38.9 0.6 13.8 2.1 72.6 1.0 4.7 3.0 3.3 37.5 0.6 19.0 3.3 98.6 1.3 7.1 3.7 4.3 52.5 0.8 25.3 3.7 90.1 65.3 97.5 63.5 84.2 103.5 92.4 72.8 64.2 66.3 49.2 65.4 51.6 64.3 74.1 76.1 54.8 57.1 Surgical Specialties Colon & Rectal Surgery General Surgery Neurological Surgery Obstetrics & Gynecology Ophthalmology Orthopedic Surgery Otolaryngology Plastic Surgery Thoracic Surgery Urology Surgery 35.8 0.3 8.2 1.0 10.1 3.6 5.4 1.6 2.2 1.0 2.2 44.5 0.3 10.0 1.7 11.6 4.5 7.9 2.7 2.0 1.1 2.8 53.0 0.5 12.0 2.0 13.6 6.0 8.2 3.3 2.5 1.4 3.4 80.3 101.1 81.7 60.4 87.7 81.0 68.9 60.7 108.6 88.6 80.7 67.5 61.1 67.8 53.3 74.7 60.4 65.7 49.3 89.6 68.1 64.8 Other Specialties Aerospace Medicine 50.3 0.0 63.0 0.1 74.0 0.1 79.8 41.0 68.0 52.7 Anatomic/Clinical Pathology Anesthesiology Child & Adolescent Psychology Diagnostic Radiology Emergency Medicine Forensic Medicine 2.6 13.0 1.1 5.7 10.0 0.1 3.8 13.8 2.0 6.9 12.6 0.2 5.2 14.2 2.5 8.3 11.7 0.2 67.2 94.4 58.3 82.2 79.4 82.0 49.9 91.5 46.1 68.4 85.1 95.4 0.5 0.0 2.9 0.6 0.1 4.0 0.6 0.2 5.2 80.2 26.5 71.3 74.9 19.0 54.7 General Preventive Medicine Medical Genetics Neurology 46 Office of Statewide Initiatives Physician Workforce in Nevada – 2016 Edition Nuclear Medicine Occupational Medicine Other Specialty Physical Med & Rehabilitation 0.2 0.3 0.9 2.7 0.2 0.7 1.0 2.8 0.4 0.5 1.3 3.2 110.8 49.5 85.4 96.9 45.0 62.3 68.9 84.8 Psychiatry Pub Health & Gen Prev Med Radiation Oncology Radiology Transplant Surgery Unspecified 6.1 0.0 1.1 2.0 0.0 0.9 8.5 0.1 1.3 2.8 0.0 1.6 12.0 0.1 1.6 3.1 0.1 3.6 71.6 54.7 86.2 74.0 136.7 56.5 50.9 56.9 69.3 66.6 59.3 24.9 172.7 211.5 256.2 81.7 67.4 Active MDs – Non Patient Care 5.6 9.8 14.2 57.4 39.7 Not Classified 7.7 6.6 13.8 116.5 55.7 39.7 45.4 46.7 87.5 85.1 225.8 273.3 330.8 82.6 68.2 Active MDs – Patient Care Inactive Total MDs in Patient Care Source: AMA. Physician Characteristics and Distribution in the U.S., 2015. Notes: See Appendix for sub-specialty classification by major specialty categories. Physicians in “Patient Care” refers to physicians whose principal professional activity is the provision of patient care in an office-based setting or hospital. Nevada and Mountain Region figures exclude physicians whose address is unknown. United States figures for not classified includes physicians whose address is unknown. Mountain Region includes Arizona, Colorado, Idaho, Montana, Nevada, New Mexico, Utah, and Wyoming. Office of Statewide Initiatives 47 Physician Workforce in Nevada – 2016 Edition Table 33: Number of Allopathic Physicians (MDs) Needed in Nevada to Meet Mountain Region Average per Capita Rates – 2013 Nevada MDs Major Specialty Mountain Region MDs 613 584 29 22.0 20.9 1.0 Additional Number Needed 307 291 6 Medical Specialties Allergy & Immunology Cardiovascular Disease Dermatology Gastroenterology Internal Medicine Pediatric Cardiology Pediatrics Pulmonary Disease 1,888 19 133 54 78 1,129 16 399 60 67.7 0.7 4.8 1.9 2.8 40.5 0.6 14.3 2.2 241 11 6 33 17 3 158 38 17,459 244 1,136 717 782 9,053 153 4,567 807 76.3 1.1 5.0 3.1 3.4 39.6 0.7 20.0 3.5 Surgical Specialties Colon & Rectal Surgery General Surgery Neurological Surgery Obstetrics & Gynecology Ophthalmology Orthopedic Surgery Otolaryngology Plastic Surgery Thoracic Surgery Urology Surgery 1,016 9 231 30 288 104 151 48 63 27 65 36.4 0.3 8.3 1.1 10.3 3.7 5.4 1.7 2.3 1.0 2.3 253 0 54 19 44 23 71 30 4 14 10,409 74 2,341 404 2,719 1,038 1,824 637 472 256 644 45.5 0.3 10.2 1.8 11.9 4.5 8.0 2.8 2.1 1.1 2.8 Other Specialties 1,459 1 52.3 407 15,306 66.9 0.0 2.8 13.1 1.3 5.8 10.0 4 46 27 24 36 80 44 1,021 3,220 482 1,634 2,948 0.2 4.5 14.1 2.1 7.1 12.9 0.2 0.5 0.1 3.0 0 4 2 35 50 156 38 979 0.2 0.7 0.2 4.3 General and Family Practice Family Medicine General Practice Aerospace Medicine Anatomic/Clinical Pathology Anesthesiology Child & Adolescent Psychology Diagnostic Radiology Emergency Medicine Forensic Medicine General Preventive Medicine Medical Genetics Neurology 48 Total Number 78 366 35 163 279 6 15 3 84 per 100,000 Population Number per 100,000 Population 7,549 7,175 284 33.0 31.4 1.2 Office of Statewide Initiatives Physician Workforce in Nevada – 2016 Edition Nuclear Medicine Occupational Medicine Other Specialty Physical Med & Rehabilitation Psychiatry Public Health & Gen Prev Med Radiation Oncology Radiology Transplant Surgery Unspecified 5 12 32 78 181 2 32 61 1 25 0.2 0.4 1.1 2.8 6.5 0.1 1.1 2.2 0.0 0.9 10 11 3 73 6 5 20 20 40 182 355 665 2,085 66 300 661 6 373 0.2 0.8 1.6 2.9 9.1 0.3 1.3 2.9 0.0 1.6 Not Classified MDs 214 7.7 - 1.506 6.6 Inactive MDs 1,109 39.7 158 10,394 45.4 Total MDs 6,299 225.8 1,326 62,533 273.3 Source: AMA. Physician Characteristics and Distribution in the U.S., 2015. Office of Statewide Initiatives 49 Physician Workforce in Nevada – 2016 Edition Table 34: Number of Allopathic Physicians (MDs) Needed in Nevada to Meet U.S. Average per Capita Rates – 2013 Nevada MDs Major Specialty Total Number per 100,000 Population 613 584 29 22.0 20.9 1.0 Medical Specialties Allergy & Immunology Cardiovascular Disease Dermatology Gastroenterology Internal Medicine Pediatric Cardiology Pediatrics Pulmonary Disease 1,888 19 133 54 78 1,129 16 399 60 67.7 0.7 4.8 1.9 2.8 40.5 0.6 14.3 2.2 Surgical Specialties Colon & Rectal Surgery General Surgery Neurological Surgery Obstetrics & Gynecology Ophthalmology Orthopedic Surgery Otolaryngology Plastic Surgery Thoracic Surgery Urology Surgery 1,016 9 231 30 288 104 151 48 63 27 65 Other Specialties Aerospace Medicine Anatomic/Clinical Pathology 1,459 1 78 366 General and Family Practice Family Medicine General Practice Anesthesiology Child & Adolescent Psychology Diagnostic Radiology Emergency Medicine Forensic Medicine General Preventive Medicine Medical Genetics Neurology 50 35 163 279 6 15 3 84 United States MDs Additional Number Needed 273 243 30 Number per 100,000 Population 100,358 93,675 6,683 31.7 29.6 2.1 1,036 21 75 53 79 434 7 347 51 331,364 4,561 23,575 12,131 14,366 177,056 2,552 84,559 12,564 104.8 1.4 7.5 3.8 4.5 56.0 0.8 26.7 4.0 36.4 0.3 8.3 1.1 10.3 3.7 5.4 1.7 2.3 1.0 2.3 501 6 115 26 103 67 83 47 7 14 33 171,854 1,702 39,247 6,314 44,299 19,355 26,477 10,766 7,970 4,668 11,056 54.4 0.5 12.4 2.0 14.0 6.1 8.4 3.4 2.5 1.5 3.5 52.3 0.0 2.8 757 2 92 251,122 376 19,237 79.4 0.1 6.1 13.1 1.3 5.8 10.0 0.2 0.5 42 39 77 60 0 7 46,173 8,342 27,204 38,373 681 2,455 14.6 2.6 8.6 12.1 0.2 0.8 0.1 3.0 4 74 754 17,916 0.2 5.7 Office of Statewide Initiatives Physician Workforce in Nevada – 2016 Edition Nuclear Medicine Occupational Medicine Other Specialty Physical Med & Rehabilitation Psychiatry Public Health & Gen Prev Med Radiation Oncology Radiology Transplant Surgery Unspecified 5 12 32 78 181 2 32 61 1 25 0.2 0.4 1.1 2.8 6.5 0.1 1.1 2.2 0.0 0.9 7 8 22 15 179 11 14 29 1 79 1,414 2,252 6,079 10,513 40,737 1,444 5,210 10,239 208 11,786 0.4 0.7 1.9 3.3 12.9 0.5 1.6 3.2 0.1 3.7 Not Classified 214 7.7 170 43,536 13.8 Inactive 1,109 39.7 194 147,676 46.7 Total MDs 6,299 225.8 2,932 1,045,910 330.8 Source: AMA. Physician Characteristics and Distribution in the U.S., 2015. Office of Statewide Initiatives 51 Physician Workforce in Nevada – 2016 Edition Table 35: Number of Allopathic Physicians (MDs) in Nevada by County Compared to Mountain Region Average per Capita – 2013 Nevada MDs Region/County Rural Counties Churchill County Douglas County Elko County Esmeralda County Eureka County Humboldt County Lander County Lincoln County Lyon County Mineral County Nye County Pershing County Storey County White Pine County Rural Subtotal Urban Counties Carson City Clark County Washoe County Urban Subtotal Nevada Total MDs Total Number per 100,000 Population Additional Number Needed to meet Regional Average 30 103 51 0 0 9 2 2 15 5 32 2 0 11 262 118.5 212.5 95.5 51.6 31.5 39.8 28.3 107.3 71.5 29.1 109.0 92.8 39 29 95 39 15 12 130 8 90 17 17 509 157 4,409 1,471 6,037 6,299 287.2 217.0 340.3 239.7 225.8 1,144 847 1,326 Source: AMA. Physician Characteristics and Distribution in the U.S., 2015. Population data from Nevada State Demographer’s Office, 2013. Notes: Regional average refers to the number of MDs per 100,000 population in the Mountain Region in 2013 (273.3). 52 Office of Statewide Initiatives Physician Workforce in Nevada – 2016 Edition Table 36: Number of Allopathic Physicians (MDs) in Nevada by County Compared to U.S. Average per Capita Rates – 2013 Nevada MDs Region/County Rural Counties Churchill County Douglas County Elko County Esmeralda County Eureka County Humboldt County Lander County Lincoln County Lyon County Mineral County Nye County Pershing County Storey County White Pine County Rural Subtotal Urban Counties Carson City Clark County Washoe County Urban Subtotal Nevada Total MDs Total Number per 100,000 Population Additional Number Needed to meet National Average 30 103 51 0 0 9 2 2 15 5 32 2 0 11 262 118.5 212.5 95.5 51.6 31.5 39.8 28.3 107.3 71.5 29.1 109.0 92.8 54 57 126 49 19 15 160 10 116 21 22 672 157 4,409 1,471 6,037 6,299 287.2 217.0 340.3 239.7 225.8 24 2,312 2,295 2,930 Source: AMA. Physician Characteristics and Distribution in the U.S., 2015. Population data from Nevada State Demographer’s Office, 2013. Notes: National average refers to the number of MDs per 100,000 population in the U.S. in 2013 (330.8). Office of Statewide Initiatives 53 Physician Workforce in Nevada – 2016 Edition Table 37: Total Allopathic Physicians (MDs) by County in Nevada – 1993 to 2013 Total MDs Region/County 1993 Rural Counties Churchill County Douglas County Elko County Esmeralda County Eureka County Humboldt County Lander County Lincoln County Lyon County Mineral County Nye County Pershing County Storey County White Pine County Rural Subtotal Urban Counties Carson City Clark County Washoe County Urban Subtotal Nevada Total MDs 2003 Change – 1993 to 2013 2013 Number Percent 14 35 22 0 0 9 1 1 8 5 8 1 0 8 112 35 98 50 0 1 9 3 1 20 4 24 2 0 15 262 30 103 51 0 0 9 2 2 15 5 32 2 0 11 262 16 68 29 0 1 1 7 0 24 1 3 150 114.3 194.3 131.8 0.0 100.0 100.0 87.5 0.0 300.0 100.0 37.5 133.9 96 1,452 772 2,320 2,432 161 3,091 1,176 4,428 4,690 157 4,409 1,471 6,037 6,299 61 2,957 699 3,717 3,867 63.5 203.7 90.5 160.2 159.0 Source: AMA. Physician Characteristics and Distribution in the U.S., 2015; AMA. Physician Characteristics and Distribution in the U.S., 2005; AMA. Physician Characteristics and Distribution in the U.S., 1995. Notes: All figures exclude physicians whose address is unknown. 54 Office of Statewide Initiatives Physician Workforce in Nevada – 2016 Edition Table 38: Total Allopathic Physicians (MDs) per 100,000 Population by County in Nevada – 1993 to 2013 Region/County Rural Counties Churchill County Douglas County Elko County Esmeralda County Eureka County Humboldt County Lander County Lincoln County Lyon County Mineral County Nye County Pershing County Storey County White Pine County Rural Subtotal Urban Counties Carson City Clark County Washoe County Urban Subtotal Nevada Total MDs Total MDs per 100,000 Population Change – 1993 to 2013 1993 2003 2013 Number Percent 70.4 103.3 55.8 0.0 0.0 62.0 15.5 25.8 33.6 81.1 39.9 19.0 0.0 89.4 59.6 135.6 214.9 109.2 0.0 67.3 54.7 56.9 26.7 48.5 85.3 65.5 28.7 0.0 169.6 105.9 118.5 212.5 95.5 0.0 0.0 51.6 31.5 39.8 28.3 107.3 71.5 29.1 0.0 109.0 92.8 48.1 109.1 39.7 -10.4 16.0 14.0 -5.3 26.2 31.6 10.0 19.6 33.2 68.2 105.6 71.1 -16.8 103.2 54.4 -15.6 32.3 79.3 52.6 21.9 55.6 212.7 158.4 273.6 186.4 169.8 291.6 190.7 315.1 216.1 204.2 287.2 217.0 340.3 239.7 225.8 74.5 58.6 66.7 53.3 55.9 35.0 37.0 24.4 28.6 32.9 Source: AMA. Physician Characteristics and Distribution in the U.S., 2015; AMA. Physician Characteristics and Distribution in the U.S., 2005; AMA. Physician Characteristics and Distribution in the U.S., 1995. Population data from Nevada State Demographer’s Office, 1993, 2003, and 2013. Notes: All figures exclude physicians whose address is unknown. Office of Statewide Initiatives 55 Physician Workforce in Nevada – 2016 Edition Table 39: Allopathic Physicians (MDs) in Patient Care by County in Nevada – 1993 to 2013 Physicians in Patient Care Region/County 1993 Rural Counties Churchill County Douglas County Elko County Esmeralda County Eureka County Humboldt County Lander County Lincoln County Lyon County Mineral County Nye County Pershing County Storey County White Pine County Rural Subtotal Urban Counties Carson City Clark County Washoe County Urban Subtotal Nevada Total MDs 2003 Change – 1993 to 2013 2013 Number Percent 13 23 19 0 0 7 1 1 6 5 7 1 0 8 91 32 65 44 0 1 9 3 1 14 3 18 2 0 14 206 26 72 38 0 0 8 2 2 9 4 18 0 0 10 189 13 49 19 0 1 1 1 3 -1 11 -1 2 98 100.0 213.0 100.0 14.3 100.0 100.0 50.0 -20.0 157.1 -100.0 25.0 107.7 84 1,237 649 1,970 2,061 139 2,559 947 3,645 3,851 130 3,337 1,163 4,630 4,819 46 2,100 514 2,660 2,758 54.8 169.8 79.2 135.0 133.8 Source: AMA. Physician Characteristics and Distribution in the U.S., 2015; AMA. Physician Characteristics and Distribution in the U.S., 2005; AMA. Physician Characteristics and Distribution in the U.S., 1995. Population data from Nevada State Demographer’s Office, 1993, 2003, and 2013. Notes: Physicians in “Patient Care” refers to physicians whose principal professional activity is the provision of patient care in an office-based setting or hospital. All figures exclude physicians whose address is unknown. Population base from 2010 Census. 56 Office of Statewide Initiatives Physician Workforce in Nevada – 2016 Edition Table 40: Allopathic Physicians (MDs) in Patient Care per 100,000 Population by County in Nevada – 1993 to 2013 Physicians in Patient Care per 100,000 Population Region/County 1993 Rural Counties Churchill County Douglas County Elko County Esmeralda County Eureka County Humboldt County Lander County Lincoln County Lyon County Mineral County Nye County Pershing County Storey County White Pine County Rural Subtotal Urban Counties Carson City Clark County Washoe County Urban Subtotal Nevada Total MDs Change – 1993 to 2013 2003 2013 Number Percent 65.4 67.9 48.2 0.0 0.0 48.2 15.5 25.8 25.2 81.1 34.9 19.0 0.0 89.4 48.5 124.0 142.5 96.1 0.0 67.3 54.7 56.9 26.7 33.9 64.0 49.1 28.7 0.0 158.3 83.3 102.7 148.5 71.2 0.0 0.0 45.8 31.5 39.8 17.0 85.8 40.2 0.0 0.0 99.1 67.0 37.3 80.6 23.0 0.0 -2.4 16.0 14.0 -8.2 4.7 5.3 -19.0 9.7 18.5 57.0 118.7 47.6 -4.9 103.2 54.4 -32.5 5.8 15.3 -100.0 10.9 38.2 186.1 134.9 230.0 158.3 143.9 251.7 157.9 253.7 177.9 167.7 237.8 164.2 269.0 183.8 172.7 51.7 29.3 39.0 25.6 28.8 27.8 21.7 17.0 16.1 20.0 Source: AMA. Physician Characteristics and Distribution in the U.S., 2015; AMA. Physician Characteristics and Distribution in the U.S., 2005; AMA. Physician Characteristics and Distribution in the U.S., 1995. Population data from Nevada State Demographer’s Office, 1993, 2003, and 2013. Notes: Physicians in “Patient Care” refers to physicians whose principal professional activity is the provision of patient care in an office-based setting or hospital. All figures exclude physicians whose address is unknown. Office of Statewide Initiatives 57 Physician Workforce in Nevada – 2016 Edition Table 41: Allopathic Physicians (MDs) by Self-Designated Primary Care Specialty in Metropolitan/Micropolitan Areas in Nevada – 2013 Metropolitan Micropolitan Major Professional Activity Neither Metro nor Micro Total Number Percent Number Percent Number Percent Number Percent 513 23 793 244 281 1,854 8.5 0.4 13.1 4.0 4.7 30.7 41 4 26 5 8 84 19.5 1.9 12.4 2.4 3.8 40.0 20 2 7 3 2 34 38.5 3.8 13.5 5.8 3.8 65.4 574 29 826 252 291 1,972 9.1 0.5 13.1 4.0 4.6 31.3 461 7.6 3 1.4 0 0.0 464 7.4 All Other Specialties 2,465 40.8 65 31.0 10 19.2 2,540 40.3 Not Classified MDs 1,257 20.8 58 27.6 8 15.4 1,323 21.0 Total MDs 6,037 100.0 210 100.0 52 100.0 6,299 100.0 Primary Care Specialties Family Medicine General Practice Internal Medicine Obstetrics/Gynecology Pediatrics Total Primary Care MDs Physicians Primary Care Sub-specialties Source: AMA. Physician Characteristics and Distribution in the U.S., 2015. Notes: Physicians in “Patient Care” refers to physicians whose principal professional activity is the provision of patient care in an office-based setting or hospital. “Other” includes other, inactive, and not classified physicians. Metropolitan cities are in Carson City, Clark, and Washoe counties. Micropolitan cities are in Churchill, Douglas, Elko, Humboldt, Lyon, and Nye counties. Neither Metro nor Micro are the remaining rural counties: Esmeralda, Eureka, Lander, Lincoln, Mineral, Pershing, Storey, and White Pine. 58 Office of Statewide Initiatives Physician Workforce in Nevada – 2016 Edition Table 42: Allopathic Physicians (MDs) by Major Professional Activity in Metropolitan/Micropolitan Areas in Nevada – 2013 Metropolitan Micropolitan Major Professional Activity Number Percent Number 456 1,465 850 1,130 3,901 7.6 24.3 14.1 18.7 64.6 44 38 32 29 143 18.3 15.8 13.3 12.1 59.6 6 4 1 0 11 Practice Hospital-based Practice 729 12.1 28 11.7 Total Patient Care MDs 4,630 76.7 171 Physicians Other Professional Activity 150 2.5 Not Classified MDs 209 Inactive no Address MDMDsUnknown Total MDs Office-based Practice Family Medicine/General Medical Specialties Practice Surgical Specialties Other Specialties Subtotal Office-based Percent Neither Metro nor Micro Number Percent Total Number Percent 27.3 18.2 4.5 0.0 50.0 506 1,507 883 1,159 4,055 8.0 23.9 14.0 18.4 64.4 7 31.8 764 12.1 71.3 18 81.8 4,819 76.5 7 2.9 0 0.0 157 2.5 3.5 5 2.1 0 0.0 214 3.4 1,048 17.4 57 23.8 4 18.2 1,109 17.6 6,037 100.0 240 100.0 22 100.0 6,299 100.0 Source: AMA. Physician Characteristics and Distribution in the U.S., 2015. Notes: Physicians in “Patient Care” refers to physicians whose principal professional activity is the provision of patient care in an office-based setting or hospital. Other includes other, inactive, and not classified physicians Metropolitan cities are in Carson City, Clark, and Washoe counties. Micropolitan cities are in Churchill, Douglas, Elko, Humboldt, Lyon, and Nye counties. Neither Metro nor Micro are the remaining rural counties: Esmeralda, Eureka, Lander, Lincoln, Mineral, Pershing, Storey, and White Pine. Office of Statewide Initiatives 59 Physician Workforce in Nevada – 2016 Edition Table 43: Graduates of the University of Nevada School of Medicine (UNSOM) Practicing in the U.S. by Year of Graduation and Gender – 2013 UNSOM Graduates Practicing in the United States – 2013 Year of Graduation Male Number 1980 – 1989 1990 – 1999 2000 – To Present Total MDs 315 301 391 1,007 Female Total Percent Number Percent Number Percent 70.8 63.1 53.6 61.0 130 176 339 645 29.2 36.9 46.4 39.0 445 477 730 1,652 100.0 100.0 100.0 100.0 Source: AMA. Physician Characteristics and Distribution in the U.S., 2015. 60 Office of Statewide Initiatives Physician Workforce in Nevada – 2016 Edition Table 44: Graduates of the University of Nevada School of Medicine (UNSOM) Practicing in the United States by Self-Designated Primary Care Specialty – 2003 to 2013 UNSOM Graduates Practicing Primary Care in The U.S. Specialty 2003 Number Primary Care Specialties Family Medicine General Practice Internal Medicine Obstetrics/Gynecology Pediatrics Total Primary Care MDs 2008 Percent Number Change –2003 to 2013 2013 Percent Number Percent Number Percent 205 5 127 89 61 487 18.2 0.4 11.3 7.9 5.4 43.3 226 6 157 103 70 562 16.3 0.4 11.4 7.4 5.1 40.6 259 6 187 120 84 656 15.7 0.4 11.3 7.3 5.1 39.7 54 1 60 31 23 169 26.3 20.0 47.2 34.8 37.7 34.7 47 4.2 58 4.2 99 6.0 52 110.6 All Other Specialties 543 48.2 678 49.0 811 49.1 268 49.4 Not Classified MDs 36 3.2 69 5.0 51 3.1 15 41.7 Inactive no Address 13 1.2 16 1.2 35 2.1 22 169.2 1,126 100.0 1,383 100.0 1,652 100.0 526 46.7 Primary Care Sub-specialties Unknown Total MDs Source: AMA. Physician Characteristics and Distribution in the U.S., 2015; AMA. Physician Characteristics and Distribution in the U.S., 2009; AMA. Physician Characteristics and Distribution in the U.S., 2005. Notes: See Appendix for sub-specialty classifications. Office of Statewide Initiatives 61 Physician Workforce in Nevada – 2016 Edition Table 45: University of Nevada School of Medicine (UNSOM) Retention of Graduate Medical Education (GME) Graduates – 2015 Patient Care Practice Physicians Remaining in Nevada Physicians Leaving Nevada Total 44 (42.7%) 34 (33.0%) 78 (75.7%) Continuing GME or Other 8 (7.8%) 17 (16.5%) 25 (24.3%) Total 52 (50.5%) 51 (49.5%) 103 (100.0%) Source: Nevada Office of Statewide Initiatives, University of Nevada School of Medicine. Nevada Residency and Fellowship Training Outcomes – 2004 to 2013, 2014. Table 46: University of Nevada School of Medicine (UNSOM) Graduation and Retention – 2006 to 2015 Patient Care Practice Physicians Remaining in Nevada Physicians Leaving Nevada Total 341 (44.1%) 277 (35.8%) 618 (79.9%) Continuing GME or Other 57 (7.4%) 98 (12.7%) 155 (20.1%) Total 398 (51.5%) 375 (48.5%) 773 (100.0%) Source: Nevada Office of Statewide Initiatives, University of Nevada School of Medicine. Nevada Residency and Fellowship Training Outcomes – 2004 to 2013, 2014. 62 Office of Statewide Initiatives Physician Workforce in Nevada – 2016 Edition Table 47: Physicians Retained from Undergraduate Medical Education (UME) in Nevada and Neighboring States – 2014 State/Region Arizona California Idaho Nevada Oregon Utah Region Subtotal Region Subtotal – CA United States Active Physicians Who Graduated from MD or DO Schools In-State Active Physicians Who Graduated from MD or DO School In-State and are Active In-State Number Percent Rank 4,289 41,020 1,608 3,734 3,661 1,824 25,705 583 1,683 1,654 42.5 62.7 36.4 45.1 45.2 19 1 27 15 14 54,312 13,292 630,376 31,449 5,744 244,040 57.9 43.2 38.7 - - Source: AAMC. State Physician Workforce Data Book. Center for Workforce Studies, 2015. Notes: Idaho has no physicians retained from an in-state medical or osteopathic school. Table includes UNSOM and Touro University data. Table 48: Physicians Retained from Public Undergraduate Medical Education (UME) in Nevada and Neighboring States – 2014 State/Region Arizona California Idaho Nevada Oregon Utah Region Subtotal Region Subtotal – CA United States Active Physicians Who Graduated from Public MD or DO Schools In-State Active Physicians Who Graduated from Public MD or DO School InState and are Active In-State Number Percent Rank 3,152 22,243 1,409 3,734 1,553 15,188 547 1,683 49.7 68.3 38.8 45.1 14 1 31 20 3,661 34,199 11,956 347,057 1,654 20,625 5,437 164,408 45.2 60.3 45.5 38.7 19 - Source: AAMC. State Physician Workforce Data Book. Center for Workforce Studies, 2015. Notes: Idaho has no physicians retained from a public in-state medical or osteopathic school. Table includes only UNSOM data. Office of Statewide Initiatives 63 Physician Workforce in Nevada – 2016 Edition Table 49: Physicians (MDs and DOs) Retained from Graduate Medical Education (GME) in Nevada and Neighboring States – 2014 State/Region Arizona California Idaho Nevada Oregon Utah Region Subtotal Region Subtotal – CA United States Active Physicians Who Completed GME InState Active Physicians Who Completed GME In-State and are Active In-State Number Percent Rank 8,258 79,976 378 1,168 5,628 4,821 4,014 55,842 204 631 2,961 2,021 48.6 69.8 54.0 54.0 52.6 41.9 14 1 9 8 10 32 100,229 20,253 801,906 65,673 9,831 37,604 65.5 48.5 47.2 - Source: AAMC. State Physician Workforce Data Book. Center for Workforce Studies, 2015. Notes: Table includes all residencies from both UNSOM and non-UNSOM Table 50: Physicians (MDs and DOs) Retained from Undergraduate Medical Education (UME) and Graduate Medical Education (GME) Combined in Nevada and Neighboring States – 2014 State/Region Arizona California Idaho Nevada Oregon Utah Region Subtotal Region Subtotal – CA United States Active Physicians Who Graduated from UME and Completed GME InState and are Active In-State Active Physicians Who Graduated from UME and Completed GME In-State Number Percent Rank 1,379 25,523 - 1,023 20,529 - 74.3 80.4 - 12 4 - 229 1,070 947 29,148 3,625 214,572 177 737 656 23,122 2,593 161,418 77.3 68.9 69.3 79.3 71.5 66.8 6 22 21 - Source: AAMC. State Physician Workforce Data Book. Center for Workforce Studies, 2015. Notes: Idaho has no physicians retained from an in-state medical or osteopathic school. UME data includes UNSOM and Touro. GME data includes UNSOM and non-UNSOM. 64 Office of Statewide Initiatives Physician Workforce in Nevada – 2016 Edition Table 51: Students Enrolled in All Medical or Osteopathic Schools in Nevada and Neighboring States – 2014 to 2015 Academic Year State/Region Total Population Total Students Enrolled in Medical or Osteopathic Schools Number Students Enrolled in Medical Schools Students Enrolled in Osteopathic Schools Rate per 100,000 Rank Number Rate per 100,000 Number Rate per 100,000 Arizona California 6,731,484 38,802,500 2,240 7,150 33.3 18.4 20 43 781 5,266 11.6 13.6 1,459 1,884 21.7 5.0 Idaho Nevada Oregon Utah Region Subtotal Region Subtotal – CA 1,634,464 2,839,099 3,970,239 2,942,902 56,920,688 18,118,188 816 574 396 11,176 4,026 28.7 14.5 13.5 19.6 22.2 27 44 45 - 280 574 369 7,270 2,004 9.9 14.5 13.5 12.8 11.1 536 3,879 1,995 19.0 6.8 11.0 318,857,056 108,494 34.0 - 83,930 26.3 24,564 7.7 United States Source: AAMC. State Physician Workforce Data Book. Center for Workforce Studies, 2015. Notes: Idaho does not have either a medical or osteopathic school. Oregon and Utah do not have an osteopathic school. Rates are calculated using the U.S. Census estimates for July 1, 2015. Office of Statewide Initiatives 65 Physician Workforce in Nevada – 2016 Edition Table 52: Students Enrolled in Public Medical or Osteopathic Schools in Nevada and Neighboring States – 2014 to 2015 Academic Year State/Region Total Population Total Students Enrolled in Medical or Osteopathic Schools Students Enrolled in Medical Schools Number Rate per 100,000 Rank Number Rate per 100,000 Students Enrolled in Osteopathic Schools Number Rate per 100,000 Arizona California 6,731,484 38,802,500 781 3,279 11.6 8.5 35 40 781 3,279 11.6 8.5 - - Idaho Nevada Oregon Utah Region Subtotal Region Subtotal – CA 1,634,464 2,839,099 3,970,239 2,942,902 56,920,688 18,118,188 280 574 396 5,310 2,031 9.9 14.5 13.5 9.3 11.2 38 26 31 - 280 574 396 5,310 2,031 9.9 14.5 13.5 9.3 11.2 - - 318,857,056 55,685 17.5 - 51,025 16.0 4,660 1.5 United States Source: AAMC. State Physician Workforce Data Book. Center for Workforce Studies, 2015. Notes: Idaho does not have either a medical and/or osteopathic school. There are no public osteopathic schools in any of the selected states. Rates are calculated using the U.S. Census estimates for July 1, 2015. 66 Office of Statewide Initiatives Physician Workforce in Nevada – 2016 Edition Table 53: Change in the Number of Students Enrolled in Medical or Osteopathic Schools in Nevada and Neighboring States – 2004 to 2014 Total Students Enrolled in Undergraduate Medical Education (UME) State/Region Arizona California Idaho Nevada Oregon Utah Region Subtotal Region Subtotal – CA United States 2004 2014 1,004 5,920 296 480 429 8,129 2,209 81,239 Change – 2004 to 2014 Students Enrolled in Medical School Students Enrolled in Osteopathic School 2004 2014 2004 2014 4 24 - 447 4,702 - 781 5,266 - 557 1,218 - 1,459 1,884 - 1 31 45 - 218 480 429 6,276 1,574 38,804 280 574 396 7,297 2,031 83,930 78 1,853 635 12,525 536 3,879 1,995 24,564 Number Percent Rank 2,240 7,150 - 1,236 1,230 - 123.1 20.8 - 816 574 396 11,176 4,026 108,494 520 94 -33 3,047 1,817 27,255 175.7 19.6 -7.7 37.5 82.3 33.4 Source: AAMC. State Physician Workforce Data Book. Center for Workforce Studies, 2015. Notes: Idaho does not have either a medical and/or osteopathic school. Oregon and Utah do not have an osteopathic school. Office of Statewide Initiatives 67 Physician Workforce in Nevada – 2016 Edition Table 54: In-State Matriculation to Medical School – 2014 to 2015 Academic Year State/Region Arizona California Idaho Nevada Oregon Utah Region Subtotal Region Subtotal – CA United States Matriculants to MD Granting Institution by State of Legal Residence First-Year Medical Students Who Matriculated to a Medical School in Their Legal State of Residence Number Percent Rank 28 2,306 72 86 130 870 59 48.5 37.7 68.6 34 40 23 196 214 2,902 596 19,833 102 83 1,244 374 12,213 52.0 38.8 42.9 62.8 61.6 33 39 - Source: AAMC. State Physician Workforce Data Book. Center for Workforce Studies, 2015. Notes: Data are for students in allopathic (MD) medical schools only; students attending osteopathic (DO) schools are excluded. “–“ indicates that the data is not applicable, Idaho does not have a medical school. 68 Office of Statewide Initiatives Physician Workforce in Nevada – 2016 Edition Table 55: Ratio of Residents and Fellows (GME) to Medical and Osteopathic Students (UME) in Nevada and Neighboring States – Academic Year 2013 to 2014 Students Enrolled in UME Residents/Fellows in GME State/Region Arizona California Idaho Nevada Oregon Utah Region Subtotal Region Subtotal – CA United States Total MDs DOs Total 2,200 6,973 814 742 5,198 266 1,458 1,775 548 1,712 10,426 373 ACGME Programs 1,640 10,159 294 564 373 10,924 3,951 105,152 564 373 7,143 1,945 82,081 3,781 2,006 2,307 981 756 14,248 3,822 124,877 896 754 13,743 3,584 116,667 OGME Programs 72 267 79 85 2 505 238 8,210 GME to UME Ratio Rank 0.8 1.5 0.5 33 9 45 1.7 2.0 1.3 1.0 1.2 5 2 - Source: AAMC. State Physician Workforce Data Book. Center for Workforce Studies, 2015. Notes: Accreditation Council for Graduate Medical Education (ACGME). Osteopathic Graduate Medical Education (OGME). Idaho does not have either a medical or osteopathic undergraduate medical education program. Oregon and Utah do not have an osteopathic undergraduate osteopathic program. Idaho and Utah have no residents or fellows in an osteopathic graduate medical education program in the 2013 to 2014 academic year. Table 56: Change in the Number of Residents and Fellows in ACGMEAccredited Programs in Nevada and Neighboring States – 2004 to 2014 State/Region Arizona California Idaho Nevada Oregon Utah Region Subtotal Region Subtotal – CA United States Total Residents and Fellows in ACGME-Accredited Programs 2004 2014 1,173 9,047 42 1,640 10,142 105 201 726 613 11,802 2,755 102,699 340 900 731 13,858 3,716 117,535 Change – 2004 to 2014 Number Percent Rank 467 1,095 63 39.8 12.1 150.0 5 40 2 139 174 118 2,056 961 14,836 69.2 24.0 19.2 17.4 34.9 14.4 3 14 21 - Source: AAMC. State Physician Workforce Data Book. Center for Workforce Studies, 2015. Office of Statewide Initiatives 69 Physician Workforce in Nevada – 2016 Edition Table 57: Residents and Fellows on Duty as of December 31, 2014 in ACGME-Accredited Programs in Nevada and Neighboring States State/Region Arizona California Idaho Nevada Oregon Utah Region Subtotal Region Subtotal – CA United States Total Residents/ Fellows USMDs Number Percent DOs Number IMGs Percent Number Percent Rank 1,640 10,142 105 340 900 731 1,003 8,471 68 146 744 623 61.2 83.5 64.8 42.9 82.7 85.2 218 638 24 51 80 35 13.3 6.3 22.9 15.0 8.9 4.8 418 1,018 13 143 75 73 25.5 10.0 12.4 42.1 8.3 10.0 18 45 42 4 47 46 13,858 3,716 117,535 11,055 2,584 77,445 79.8 69.5 65.9 1,046 408 10,122 7.5 11.0 8.6 1,740 722 29,812 12.6 19.4 25.4 - Source: AAMC. State Physician Workforce Data Book. Center for Workforce Studies, 2015. Notes: Accreditation Council for Graduate Medical Education (ACGME). “Total Residents/Fellows” includes 188 physicians who are graduates of Canadian schools. Rates are calculated using the US Census estimates for July 1, 2015. 70 Office of Statewide Initiatives Physician Workforce in Nevada – 2016 Edition Table 58: Residents and Fellows on Duty as of December 31, 2014 in ACGME-Accredited Primary Care Programs per 100,000 Population by Degree Type in Nevada and Neighboring States State/Region Arizona California Idaho Nevada Oregon Utah Total Population 6,731,484 38,802,500 1,634,464 2,839,099 3,970,239 2,942,902 Region Subtotal 56,920,688 Region Subtotal – CA 18,118,188 United States 318,857,056 Total Residents/Fellows in Primary Care ACGME Programs Rate per Number Rank 100,000 623 9.3 36 3,697 9.5 33 104 6.4 48 208 7.3 42 348 8.8 39 259 8.8 38 MDs in Primary Care ACGME Programs Rate per Number 100,000 523 7.8 3,290 8.5 80 4.9 190 6.7 294 7.4 246 8.4 5,239 1,542 43,232 4,623 1,333 38,407 9.2 8.5 13.6 - 8.1 7.4 12.0 DOs in Primary Care ACGME Programs Rate per Number 100,000 100 1.5 407 1.0 24 1.5 18 0.6 53 1.3 13 0.4 615 208 4,825 1.1 1.1 1.5 Source: AAMC. State Physician Workforce Data Book. Center for Workforce Studies, 2015. Notes: Accreditation Council for Graduate Medical Education (ACGME). The number of MDs includes MDs from international medical schools. Rates are calculated using the US Census estimates for July 1, 2015. Office of Statewide Initiatives 71 Physician Workforce in Nevada – 2016 Edition Table 59: Residents and Fellows on Duty as of December 31, 2014 in ACGME-Accredited Programs per 100,000 Population by Degree Type in Nevada and Neighboring States State/Region Total Population Total Residents/Fellows in ACGME Programs Number Rate per 100,000 MDs in ACGME Programs Rank Number Rate per 100,000 DOs in ACGME Programs Number Rate per 100,000 Arizona California 6,731,484 38,802,500 1,640 10,142 24.4 26.1 36 31 1,422 9,504 21.1 24.5 218 638 3.2 1.6 Idaho Nevada Oregon Utah Region Subtotal Region Subtotal – CA 1,634,464 2,839,099 3,970,239 2,942,902 56,920,688 18,118,188 105 340 900 731 13,858 3,716 6.4 12.0 22.7 24.8 24.3 20.5 48 46 38 35 - 81 289 820 696 12,812 3,308 5.0 10.2 20.7 23.7 22.5 18.3 24 51 80 35 1,046 408 1.5 1.8 2.0 1.2 1.8 2.3 318,857,056 117,535 36.9 - 107,413 33.7 10,122 3.2 United States Source: AAMC. State Physician Workforce Data Book. Center for Workforce Studies, 2015. Notes: Accreditation Council for Graduate Medical Education (ACGME). The number of MDs includes MDs from international medical schools. Rates are calculated using the U.S. Census estimates for July 1, 2015. 72 Office of Statewide Initiatives Physician Workforce in Nevada – 2016 Edition Section Four: Active Physicians by Degree Type (MDs & DOs) Executive Summary and Key Findings Currently, 27.9% of physicians with an active license in Nevada are “international medical graduates” (IMGs) – that is, they received their undergraduate medical education in another country. In 2013, Nevada ranked 8th among US states in the percentage of physicians who are IMGs (Table 60). There are currently 5,604 total active physicians in Nevada, including 4,999 allopathic physicians (MDs) and 605 osteopathic physicians (DOs). In 2013, Nevada ranked 47th among US states in the number of active physicians (MD and DO) per capita. Nevada has 197.4 active physicians per 100,000 population, as compared to the US rate of 265.5 active physicians per 100,000 population (Table 61). There are currently 5,101 total active patient care physicians in Nevada, including 4,594 allopathic physicians (MDs) and 507 osteopathic physicians (DOs). In 2013, Nevada ranked 49th among US states in the number of active patient care physicians (MD and DO) per capita. Nevada has 179.7 active patient care physicians per 100,000 population, as compared to the US rate of 234.7 active patient care physicians per 100,000 population (Table 62). There are currently 1,982 total active primary care physicians in Nevada, including 1,736 allopathic physicians (MDs) and 246 osteopathic physicians (DOs). In 2013, Nevada ranked 48th among US states in the number of active primary care physicians (MD and DO) per capita. Nevada has 69.8 active primary care physicians per 100,000 population, as compared to the US rate of 91.1 active primary care physicians per 100,000 population (Table 63). There are currently 1,804 total active patient care primary care physicians in Nevada, including 1,579 allopathic physicians (MDs) and 225 osteopathic physicians (DOs). In 2013, Nevada ranked 48th among US states in the number of active patient care primary care physicians (MD and DO) per capita. Nevada has 63.5 active patient care primary care physicians per 100,000 population, as compared to the US rate of 82.5 active patient care primary care physicians per 100,000 population (Table 64). In 2013, the total number of active physicians in Nevada (MDs & DOs) was 6,996. Of this number, 5,210 were male (74.5%). Inversely, 1,786 active physicians were female – or 25.5% (Table 65). Currently, 80.2% of active female physicians (MDs & DOs) in Nevada report that their major professional activity is patient care (either office-based or hospital-based) as compared to Office of Statewide Initiatives 73 Physician Workforce in Nevada – 2016 Edition 76.1% of active male physicians (MDs & DOs) who report that their major professional activity is patient care (Table 66). Currently, 38.7% of active physicians (MDs & DOs) in Nevada report that their self-designated practice specialty is in primary care – family medicine, general practice, internal medicine, obstetrics/gynecology, or pediatrics – or a primary-care sub-specialty (Table 67). Currently, there are 6,996 physicians (MDs and DOs) in the physician workforce in Nevada, including 5,395 physicians in patient care and 169 physicians in non-patient care activities (Table 68). 74 Office of Statewide Initiatives Physician Workforce in Nevada – 2016 Edition Table 60: Active Physicians by Medical School Type in Nevada and Neighboring States – 2014 Total Active Physicians Number Percent Number Percent Arizona California Idaho Nevada Oregon Utah 15,751 101,857 3,099 5,604 11,567 6,106 9,987 71,151 2,549 3,387 9,388 5,054 63.4 69.9 82.3 60.4 81.2 82.8 1,822 4,563 360 605 837 438 11.6 4.5 11.6 10.8 7.2 7.2 Region Subtotal Region Subtotal – CA United States 143,984 42,127 846,626 101,516 30,365 569,633 70.5 72.1 67.3 8,625 4,062 62,644 6.0 9.6 7.4 State/Region MDs DOs IMGs Number Percent Rank 3,671 24,721 154 1,561 1,156 553 23.3 24.3 5.0 27.9 10.0 9.1 16 14 49 8 44 46 31,816 7,095 205,053 22.1 16.8 24.2 - Source: AAMC. State Physician Workforce Data Book. Center for Workforce Studies, 2015. Notes: “Active physicians” refer to those physicians who report working in administration, direct patient care, medical research, medical teaching, or other non-patient care activities. Physicians whose major professional activity is unclassified are also considered active “U.S. MDs” are physicians who received their Doctor of Medicine (M.D.) degree from a medical school in the United States or Puerto Rico accredited by the Liaison Committee on Medical Education. Graduates of Canadian medical schools are not counted as U.S. MDs. “DOs” refer to physicians with a Doctor of Osteopathy degree. “IMGs” refer to physicians who graduated from a medical school outside of the United States, Puerto Rico, or Canada, including U.S. citizens who completed their medical education outside of the United States, Puerto Rico, or Canada. “Total active physicians” includes 9,403 physicians who are graduates of Canadian medical schools, as well as 9,839 physicians who are graduates of Puerto Rican medical schools. Office of Statewide Initiatives 75 Physician Workforce in Nevada – 2016 Edition Table 61: Active Physicians per 100,000 Population by Degree Type in Nevada and Neighboring States – 2014 State/Region Total Population Total Active Physicians 6,731,484 38,802,500 1,634,464 2,839,099 3,970,239 2,942,902 15,754 101,859 3,099 5,604 11,567 6,107 Rate per 100,000 234.0 262.5 189.6 197.4 291.3 207.5 Region Subtotal 56,920,688 Region Subtotal – CA 18,118,188 United States 318,857,056 143,990 42,131 846,686 253.0 232.5 265.5 Arizona California Idaho Nevada Oregon Utah Number Active MDs 32 20 49 47 11 43 13,929 97,294 2,739 4,999 10,730 5,668 Rate per 100,000 206.9 250.7 167.6 176.1 270.3 192.6 - 135,359 38,065 783,982 237.8 210.1 245.9 Rank Number Active DOs Number 1,822 4,563 360 605 837 438 8,625 4,062 62,644 Rate per 100,000 27.1 11.8 22 21.3 21.1 14.9 15.2 22.4 19.6 Source: AAMC. State Physician Workforce Data Book. Center for Workforce Studies, 2015. Notes: “Active physicians” refer to those physicians who report working in administration, direct patient care, medical research, medical teaching, or other non-patient care activities. Physicians whose major professional activity is unclassified are also considered active. Physicians who are classified as retired, semi-retired, temporarily not in practice, or not active for other reasons are excluded. Residents and fellows are also excluded. “MDs” refer to physicians with a Doctor of Medicine degree. “DOs” refer to physicians with a Doctor of Osteopathy degree. Rates are calculated using the U.S. Census estimates for July 1, 2015. 76 Office of Statewide Initiatives Physician Workforce in Nevada – 2016 Edition Table 62: Active Patient Care Physicians per 100,000 Population by Degree Type in Nevada and Neighboring States – 2014 State/Region Arizona California Idaho Nevada Oregon Utah Region Subtotal Region Subtotal – CA United States Total Population 6,731,484 38,802,500 1,634,464 2,839,099 3,970,239 2,942,902 56,920,688 18,118,188 318,857,056 Total Active Patient Care Physicians (MDs & DOs) Number Rate per 100,000 14,558 90,159 2,953 5,101 10,443 5,649 216.3 232.4 180.7 179.7 263.0 192.0 128,863 38,704 748,340 226.4 213.6 234.7 Rank 31 23 48 49 10 41 - Active Patient MDs Active Patient Care DOs Number Rate per 100,000 Number Rate per 100,000 12,830 86,077 2,618 4,594 9,693 5,223 190.6 221.8 160.2 161.8 244.1 177.5 1,726 4,082 335 507 750 426 25.6 10.5 20.5 17.9 18.9 14.5 121,035 34,958 691,086 212.6 192.9 216.7 7,826 3,744 57,232 13.7 20.7 17.9 Source: AAMC. State Physician Workforce Data Book. Center for Workforce Studies, 2015. Notes: “Active physicians” refer to those physicians who report working in administration, direct patient care, medical research, medical teaching, or other non-patient care activities. Physicians whose major professional activity is unclassified are also considered active. “Active patient care physicians” are a subset of active physicians comprised only of those physicians whose self-reported type of practice is direct patient care. Physicians who are classified as retired, semi-retired, temporarily not in practice, or not active for other reasons are excluded. Residents and fellows are also excluded. “MDs” refer to physicians with a Doctor of Medicine degree. “DOs” refer to physicians with a Doctor of Osteopathy degree. Rates are calculated using the U.S. Census estimates for July 1, 2015. Office of Statewide Initiatives 77 Physician Workforce in Nevada – 2016 Edition Table 63: Active Primary Care Physicians per 100,000 Population by Degree Type in Nevada and Neighboring States – 2014 State/Region Arizona California Idaho Nevada Oregon Utah Region Subtotal Region Subtotal – CA United States Total Population Total Active Primary Care Physicians (MDs & DOs) 6,731,484 5,306 Rate per 100,000 78.8 38,802,500 1,634,464 2,839,099 3,970,239 2,942,902 56,920,688 35,725 1,179 1,982 4,264 1,914 50,370 18,118,188 318,857,056 14,645 290,396 Number Active Primary Care MDs Active Primary Care DOs 39 4,548 Rate per 100,000 67.6 92.1 72.1 69.8 107.4 65.0 88.5 23 46 48 9 49 - 33,450 997 1,736 3,865 1,716 46,312 86.2 61.0 61.1 97.3 58.3 81.4 2,274 182 246 399 198 4,056 5.9 11.1 8.7 10.0 6.7 7.1 80.8 91.1 - 12,862 263,176 71.0 82.5 1,782 27,195 9.8 8.5 Rank Number Number 757 Rate per 100,000 11.2 Source: AAMC. State Physician Workforce Data Book. Center for Workforce Studies, 2015. Notes: “Active physicians” refer to those physicians who report working in administration, direct patient care, medical research, medical teaching, or other non-patient care activities. Physicians whose major professional activity is unclassified are also considered active. “Primary care physicians” refer to physicians whose self-designated primary specialty is one of the following: adolescent medicine, family medicine, general practice, geriatric medicine, internal medicine, internal medicine/pediatrics, or pediatrics. Rates are calculated using the U.S. Census estimates for July 1, 2015. 78 Office of Statewide Initiatives Physician Workforce in Nevada – 2016 Edition Table 64: Active Patient Care Primary Care Physicians per 100,000 Population by Degree Type in Nevada and Neighboring States – 2014 State/Region Arizona California Idaho Nevada Oregon Utah Total Population 6,731,484 38,802,500 1,634,464 2,839,099 3,970,239 2,942,902 Region Subtotal 56,920,688 Region Subtotal – CA 18,118,188 United States 318,857,056 Total Active Patient Care Primary Care Physicians (MDs & DOs) Active Primary Care MDs Active Primary Care DOs Rate per 100,000 Rank Number Rate per 100,000 Number Rate per 100,000 4,946 3,284 1,114 1,804 3,947 73.5 84.2 68.2 63.5 99.4 38 22 46 48 7 4,216 30,557 941 1,579 3,571 62.6 78.8 57.6 55.6 89.9 726 2,127 173 225 376 10.8 5.5 10.6 7.9 9.5 1,812 16,907 13,623 263,159 61.6 29.7 75.2 82.5 49 - 1,615 42,479 11,922 237,370 54.9 74.6 65.8 74.4 197 3,824 1,697 25,770 6.7 6.7 9.4 8.1 Number Source: AAMC. State Physician Workforce Data Book. Center for Workforce Studies, 2015. Notes: “Active physicians” refer to those physicians who report working in administration, direct patient care medical research, medical teaching, or other non-patient care activities. Physicians whose major professional activity is unclassified are also considered active. “Active patient care primary care physicians” are a subset of active physicians comprised only of those physicians whose self-reported type of practice is direct patient care and whose self-designated primary specialty is one of the following: adolescent medicine, family medicine, general practice, geriatric medicine, internal medicine, internal medicine/pediatrics, or pediatrics. Rates are calculated using the U.S. Census estimates for July 1, 2015. “Total Active Patient Care Primary Care Physicians” include physicians whose school type was unavailable (n=12). Office of Statewide Initiatives 79 Physician Workforce in Nevada – 2016 Edition Table 65: Total MD and DO Physicians by Gender and Age in Nevada – 2013 MD & DO Physicians Age Category < 35 35 – 44 45 – 54 55 – 64 ≥ 65 Total MDs & DOs Male Female Total Number Percent Number Percent Number Percent 332 1,018 1,240 1,092 1,528 5,210 6.4 19.5 23.8 21.0 29.3 100.0 249 532 471 284 250 1,786 13.9 29.8 26.4 15.9 14.0 100.0 581 1,550 1,711 1,376 1,778 6,996 8.3 22.2 24.5 19.7 25.4 100.0 Source: AMA. Physician Characteristics and Distribution in the U.S., 2015. Table 66: Total MD and DO Physicians by Gender and Major Professional Activity in Nevada – 2013 MD & DO Physicians Major Professional Activity Patient Care Office-based Hospital-based Residents & Hospital-based MD & DO Staff Fellows Subtotal - Patient Care Other Professional Activity Administration Medical Teaching Medical Research Other Subtotal – Other Prof Activity Not Classified MDs & DOs Inactive MDs & DOs Total MDs & DOs Male Female Total Number Percent Number Percent Number Percent 3,344 237 382 3,963 64.2 4.5 7.3 76.1 1,142 171 119 1,432 63.9 9.6 6.7 80.2 5,250 408 501 5,395 75.0 5.8 7.2 77.1 53 39 14 22 128 126 912 5,210 1.0 0.7 0.3 0.4 2.5 2.4 17.5 100.0 15 18 5 3 41 88 197 1,786 0.8 1.0 0.3 0.2 2.3 4.9 11.0 100.0 68 57 19 25 169 214 1,109 6,996 1.0 0.8 0.3 0.4 2.4 3.1 15.9 100.0 Source: AMA. Physician Characteristics and Distribution in the U.S., 2015. Notes: Physicians in “Patient Care” refers to physicians whose principal professional activity is the provision of patient care in an office- based setting or hospital. “Other” includes other, inactive, and not classified physicians. 80 Office of Statewide Initiatives Physician Workforce in Nevada – 2016 Edition Table 67: Total MD and DO Physicians by Self-Designated Primary Care Specialty in Nevada and the U.S. – 2013 Specialty MD & DO Physicians in Nevada MD & DO Physicians in the United States Number Percent Number Percent 701 59 885 267 313 2,225 10.0 0.8 12.7 3.8 4.5 31.8 107,924 8,966 127,361 42,599 63,028 349,878 9.6 0.8 11.4 3.8 5.6 31.3 484 6.9 93,851 8.4 2,855 40.8 475,608 42.5 283 4.0 46,842 4.2 Inactive or Address Unknown 1,149 16.4 152,904 13.7 Total MDs & DOs 6,996 100.0 1,119,083 100.0 Primary Care Specialties Family Medicine General Practice Internal Medicine Obstetrics/Gynecology Pediatrics Total Primary Care MD & DO Physicians Primary Care Sub – specialties All Other Specialties Not Classified MDs & DOs Source: AMA. Physician Characteristics and Distribution in the U.S., 2015. Notes: See Appendix for sub-specialty classification by major specialty categories. Figures exclude MD and DO physicians whose address is unknown. Office of Statewide Initiatives 81 Physician Workforce in Nevada – 2016 Edition Table 68: Total MD and DO Physicians by Self-Designated Specialty and Major Professional Activity in Nevada – 2013 Total MD & DO Physicians Major Specialty Number Percent 753 697 56 11.0 10.2 0.8 Medical Specialties Allergy & Immunology Cardiovascular Disease Dermatology Gastroenterology Internal Medicine Pediatric Cardiology Pediatrics Pulmonary Disease 1,935 19 131 64 82 1,153 16 411 59 Surgical Specialties Colon & Rectal Surgery General Surgery Neurological Surgery Obstetrics & Gynecology Ophthalmology Orthopedic Surgery Otolaryngology Plastic Surgery Thoracic Surgery Urology Surgery Other Specialties Aerospace Medicine Anatomic/Clinical Pathology Anesthesiology Child & Adolescent Psychology Diagnostic Radiology Emergency Medicine Forensic Medicine General Prev Medicine Medical Genetics Neurology General and Family Practice Family Medicine General Practice 82 Patient Care Non-Patient Care Number Total Percent Number Percent 23 20 3 13.6 11.8 1.8 776 717 59 11.1 10.2 0.8 28.3 0.3 1.9 0.9 1.2 16.9 0.2 6.0 0.9 66 1 4 0 6 46 0 14 1 39.1 0.6 2.4 0.0 3.6 27.2 0.0 8.3 0.6 2,001 20 135 64 88 1,199 16 425 60 28.6 0.3 1.9 0.9 1.3 17.1 0.2 6.1 0.9 1,049 9 236 30 298 110 161 52 64 27 62 15.4 0.1 3.5 0.4 4.4 1.6 2.4 0.8 0.9 0.4 0.9 20 0 3 1 6 3 1 2 1 0 3 11.8 0.0 1.8 0.6 3.6 1.8 0.6 1.2 0.6 0.0 1.8 1,069 9 239 31 304 113 162 54 65 27 65 15.3 0.1 3.4 0.4 4.3 1.6 2.3 0.8 0.9 0.4 0.9 1,658 1 77 408 33 162 324 6 13 1 85 24.3 0.0 1.1 6.0 0.5 2.4 4.7 0.1 0.2 0.0 1.2 60 1 6 3 3 4 2 2 3 2 4 35.5 0.6 3.6 1.8 1.8 2.4 1.2 1.2 1.8 1.2 2.4 1,718 2 83 411 36 166 326 8 16 3 89 24.6 0.0 1.2 5.9 0.5 2.4 4.7 0.1 0.2 0.0 1.3 Office of Statewide Initiatives Physician Workforce in Nevada – 2016 Edition Nuclear Medicine Occupational Medicine Other Specialty Physical Med & Rehabilitation Psychiatry Public Health & Gen Prev Med Radiation Oncology Radiology Transplant Surgery Unspecified 5 10 28 85 189 1 32 62 1 135 0.1 0.1 0.4 1.2 2.8 0.0 0.5 0.9 0.0 2.0 0 3 7 2 11 2 1 4 0 0 0.0 1.8 4.1 1.2 6.5 1.2 0.6 2.4 0.0 0.0 5 13 35 87 200 3 33 66 1 135 0.1 0.2 0.5 1.2 2.9 0.0 0.5 0.9 0.0 1.9 5,395 100.0 - - 5,395 77.1 Active MDs & DOs – Non-Patient Care - - 169 100.0 169 2.4 Not Classified MDs & DOs - - - - 283 4.0 Inactive MDs & DOs - - - - 1,149 16.4 Total MDs & DOs - - - - 6,996 100.0 Active MDs & DOs - Patient Care Source: AMA. Physician Characteristics and Distribution in the U.S. 2015. Notes: See Appendix for sub-specialty classification by major specialty categories. Figures exclude MD and DO physicians whose address is unknown. Office of Statewide Initiatives 83 Physician Workforce in Nevada – 2016 Edition Section Five: Osteopathic Physicians (DOs) Executive Summary and Key Findings According to the American Medical Association (AMA), there are 697 osteopathic physicians currently licensed to practice in Nevada, including 533 male DOs (76.5%) and 164 female DOs (23.5%) (Table 69). Currently, 41.3% of male DOs in Nevada are over the age of 55, as compared to only 27.4% of female DOs who are over the age of 55 in 2013. Conversely, 50.0% of female DOs in Nevada are under the age of 45, as compared to 35.3% of male DOs who are under the age of 45 (Table 69). Currently, 576 DOs or 82.6% of DOs in Nevada are in patient care, including 431 DOs in officebased practice and 145 DOs in hospital-based practice (Table 70). In 2013, there were a total of 253 osteopathic physicians (DOs) in Nevada with a selfdesignated primary care specialty or sub-specialty. This number represents 36.3% of the total number of DOs in Nevada. By comparison, 41.0% of the DO workforce in the US had a selfdesignated primary care specialty or sub-specialty in 2013 (Table 71). Currently, 658 or 94.4% of all licensed DOs in Nevada are based in a metropolitan county of Nevada (Table 72). In 2013, 576 or 82.6% of all licensed DOs report patient care as their major professional activity (Table 73). The top three self-designated specialties of osteopathic physicians (DOs) in Nevada are: family medicine (19.1%), internal medicine (10.0%), and emergency medicine (6.7%) (Table 73). Office of Statewide Initiatives 85 Physician Workforce in Nevada – 2016 Edition Table 69: Osteopathic Physicians (DOs) by Gender and Age in Nevada – 2013 Osteopathic Physicians (DOs) Age Category < 35 35 – 44 45 – 54 55 – 64 ≥ 65 Total DOs Male Female Total Number Percent Number Percent Number Percent 55 133 125 107 113 533 10.3 25.0 23.5 20.1 21.2 100.0 32 50 37 22 23 164 19.5 30.5 22.6 13.4 14.0 100.0 87 183 162 129 136 697 12.5 26.3 23.2 18.5 19.5 100.0 Source: AMA. Physician Characteristics and Distribution in the U.S., 2015. Table 70: Osteopathic Physicians (DOs) by Gender and Major Professional Activity in Nevada – 2013 Osteopathic Physicians (DOs) Major Professional Activity Patient Care Office-based Hospital-based Residents & Fellows Hospital-based DO Staff Subtotal – Patient Care Other Professional Activity Administration Medical Teaching Medical Research Other Subtotal – Other Prof Activity Total DOs Male Female Total Number Percent Number Percent Number Percent 338 54 49 441 63.4 10.1 9.2 82.7 93 33 9 135 56.7 20.1 5.5 82.3 431 87 58 576 61.8 12.5 8.3 82.6 5 5 0 1 11 533 0.9 0.9 0.0 0.2 2.1 100.0 0 1 0 0 1 164 0.0 0.6 0.0 0.0 0.6 100.0 5 6 0 1 12 697 0.7 0.9 0.0 0.1 1.7 100.0 Source: AMA. Physician Characteristics and Distribution in the U.S., 2015. Notes: Physicians in “Patient Care” refers to physicians whose principal professional activity is the provision of patient care in an office-based setting or hospital. “Other” includes other, inactive, and not classified physicians. Office of Statewide Initiatives 87 Physician Workforce in Nevada – 2016 Edition Table 71: Osteopathic Physicians (DOs) by Self-Designated Primary Care Specialty in Nevada and the U.S. – 2013 Specialty Physicians (DOs) in Nevada Physicians (DOs) in the United States Number Percent Number Percent 127 30 59 15 22 253 18.2 4.3 8.5 2.2 3.2 36.3 16,309 2,283 6,234 2,554 2,617 29,997 22.3 3.1 8.5 3.5 3.6 41.0 20 2.9 3,704 5.1 315 45.2 30,938 42.3 Not Classified DOs 69 9.9 3,306 4.5 Inactive or Address Unknown DOs 40 5.7 5,228 7.1 697 100.0 73,173 100.0 Primary Care Specialties Family Medicine General Practice Internal Medicine Obstetrics/Gynecology Pediatrics Total Primary Care DOs Primary Care Subspecialties All Other Specialties Total DOs Source: AMA. Physician Characteristics and Distribution in the U.S., 2015. Notes: See Appendix for sub-specialty classification by major specialty categories. Figures exclude DO physicians whose address is unknown. 88 Office of Statewide Initiatives Physician Workforce in Nevada – 2016 Edition Table 72: Osteopathic Physicians (DOs) by Major Professional Activity in Metropolitan/Micropolitan Areas in Nevada – 2013 Major Professional Activity Metropolitan Number Percent Office-based Practice Family Medicine/General Medical Practice Specialties Surgical Specialties Other Specialties Subtotal Office-based 118 81 42 157 398 17.9 12.3 6.4 23.9 60.5 Practice Hospital-based Practice 143 Total Patient Care DOs Micropolitan Number Neither Metro or Micro Total Percent Number Percent Number Percent 16 3 3 8 30 44.4 8.3 8.3 22.2 83.3 1 0 0 2 3 33.3 0.0 0.0 66.7 100.0 135 84 45 167 431 19.4 12.1 6.5 24.0 61.8 21.7 2 5.6 0 0.0 145 20.8 541 82.2 32 88.9 3 100.0 576 82.6 Physicians Other Professional Activity 11 1.7 1 2.8 0 0.0 12 1.7 DOs Not Classified DOs 69 10.5 0 0.0 0 0.0 69 9.9 Inactive or Address 37 5.6 3 8.3 0 0.0 40 5.7 658 100.0 36 100.0 3 100.0 697 100.0 Unknown Total DOs Source: AMA. Physician Characteristics and Distribution in the U.S., 2015. Notes: Physicians in “Patient Care” refers to physicians whose principal professional activity is the provision of patient care in an officebased setting or hospital. Other includes other, inactive, and not classified physicians. Metropolitan cities are in Carson City, Clark, and Washoe counties. Micropolitan cities are in Churchill, Douglas, Elko, Humboldt, Lyon, and Nye counties. Neither Metro nor Micro are the remaining rural counties: Esmeralda, Eureka, Lander, Lincoln, Mineral, Pershing, Storey, and White Pine. Office of Statewide Initiatives 89 Physician Workforce in Nevada – 2016 Edition Table 73: Osteopathic Physicians (DOs) by Self-Designated Specialty and Major Professional Activity in Nevada – 2013 Major Specialty Number Percent General and Family Practice Family Medicine General Practice 159 130 29 27.6 22.6 5.0 Medical Specialties Allergy & Immunology Cardiovascular Disease Dermatology Gastroenterology Internal Medicine Pediatric Cardiology Pediatrics Pulmonary Disease 111 1 2 10 4 69 0 25 0 Surgical Specialties Colon & Rectal Surgery General Surgery Neurological Surgery Obstetrics & Gynecology Ophthalmology Orthopedic Surgery Otolaryngology Plastic Surgery Thoracic Surgery Urology Surgery Other Specialties Aerospace Medicine Anatomic/Clinical Pathology Anesthesiology Child & Adolescent Psychology Diagnostic Radiology Emergency Medicine Forensic Medicine General Prev Medicine Medical Genetics Neurology 90 Patient Care Non-Patient Care Number Total Percent Number Percent 4 3 1 33.3 25.0 8.3 163 133 30 23.4 19.1 4.3 19.3 0.2 0.3 1.7 0.7 12.0 0.0 4.3 0.0 2 0 0 0 6 1 0 1 0 16.7 0.0 0.0 0.0 50.0 8.3 0.0 8.3 0.0 113 1 2 10 10 70 0 26 0 16.2 0.1 0.3 1.4 1.4 10.0 0.0 3.7 0.0 51 0 8 1 15 9 10 6 2 0 0 8.9 0.0 1.4 0.2 2.6 1.6 1.7 1.0 0.3 0.0 0.0 2 0 0 0 1 0 1 0 0 0 0 16.7 0.0 0.0 0.0 8.3 0.0 8.3 0.0 0.0 0.0 0.0 53 0 8 1 16 9 11 6 2 0 0 7.6 0.0 1.1 0.1 2.3 1.3 1.6 0.9 0.3 0.0 0.0 255 0 5 45 1 3 46 2 0 0 5 44.3 0.0 0.9 7.8 0.2 0.5 8.0 0.3 0.0 0.0 0.9 4 1 0 0 0 0 1 0 1 0 0 33.3 8.3 0.0 0.0 0.0 0.0 8.3 0.0 8.3 0.0 0.0 259 1 5 45 1 3 47 2 1 0 5 37.2 0.1 0.7 6.5 0.1 0.4 6.7 0.3 0.1 0.0 0.7 Office of Statewide Initiatives Physician Workforce in Nevada – 2016 Edition Nuclear Medicine Occupational Medicine Other Specialty Physical Med & Rehabilitation Psychiatry Public Health & Gen Prev Med Radiation Oncology Radiology Transplant Surgery Unspecified Vascular Surgery 0 1 3 9 19 0 1 5 0 110 0 0.0 0.2 0.5 1.6 3.3 0.0 0.2 0.9 0.0 19.1 0.0 0 0 0 0 0 1 0 0 0 0 0 0.0 0.0 0.0 0.0 0.0 8.3 0.0 0.0 0.0 0.0 0.0 0 1 3 9 19 1 1 5 0 110 0 0.0 0.1 0.4 1.3 2.7 0.1 0.1 0.7 0.0 15.8 0.0 Not Classified DOs 69 12.0 0 0.0 69 9.9 Inactive DOs 40 6.9 0 0.0 40 5.7 576 100.0 12 100.0 697 100.0 Total DOs Source: AMA. Physician Characteristics and Distribution in the U.S., 2015. Notes: See Appendix for sub-specialty classification by major specialty categories. Figures exclude DO physicians whose address is unknown. Office of Statewide Initiatives 91 Physician Workforce in Nevada – 2016 Edition Section Six: Physician Workforce Rankings Executive Summary and Key Findings In 2013, there were 226 allopathic physicians (MDs) per 100,000 population. Among US states, Nevada ranks 47th in number of physicians per capita (Table 74). In 2013, there were 173 MDs in patient care per 100,000 population. Among US states, Nevada ranks 48th in number of physicians in patient care per capita (Table 75). Over the past three decades, among US states, Nevada rank decreased from 36th in 1980 to 47th in 2013 resulting in drop of 11 positions in number of MDs per 100,000 population (Table 76). Over the past three decades, among US states, Nevada rank decreased from 36 th in 1980 to 48th in 2013 resulting in drop of 12 positions in number of MDs in patient care per 100,000 population (Table 77). Office of Statewide Initiatives 93 Physician Workforce in Nevada – 2016 Edition Table 74: Nevada’s Rank Among the U.S. States in Physicians per 100,000 Population – 2013 State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Rank Estimated Number of Physicians per 100,000 42 40 33 45 18 20 7 28 1 21 39 8 51 15 41 46 34 38 22 14 3 2 24 12 49 29 32 30 47 11 10 27 4 26 31 17 50 13 9 6 35 37 25 43 44 5 19 16 36 23 48 253 262 276 243 329 324 449 294 905 319 265 369 208 342 256 228 274 270 314 349 487 556 312 358 217 293 278 290 226 364 365 295 464 303 285 331 209 357 365 457 274 273 311 252 249 461 328 332 274 313 221 State District of Columbia Massachusetts Maryland New York Vermont Rhode Island Connecticut Hawaii Pennsylvania New Jersey New Hampshire Minnesota Oregon Maine Illinois Washington Ohio California Virginia Colorado Florida Louisiana Wisconsin Michigan Tennessee North Carolina New Mexico Delaware Missouri Nebraska North Dakota Montana Arizona Kansas South Carolina West Virginia South Dakota Kentucky Georgia Alaska Indiana Alabama Texas Utah Arkansas Iowa Nevada Wyoming Mississippi Oklahoma Idaho Rank Estimated Number of Physicians per 100,000 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 905 556 487 464 461 457 449 369 365 365 364 358 357 349 342 332 331 329 328 324 319 314 313 312 311 303 295 294 293 290 285 278 276 274 274 274 273 270 265 262 256 253 252 249 243 228 226 221 217 209 208 Source: AMA. Physician Characteristics and Distribution in the U.S., 2015. Notes: All figures exclude physicians whose address is unknown. Office of Statewide Initiatives 95 Physician Workforce in Nevada – 2016 Edition Table 75: Nevada’s Rank Among the U.S. States in Physicians in Patient Care per 100,000 Population – 2013 State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Rank 42 36 38 45 21 20 7 30 1 26 39 12 51 14 40 46 35 32 16 15 4 2 24 9 47 28 41 27 48 11 8 31 5 25 29 17 50 13 10 3 34 33 19 43 44 6 18 22 37 23 49 Estimated Number of Physicians in Patient Care per 100,000 205 214 213 197 250 251 344 227 647 235 211 275 164 266 208 176 215 222 259 262 353 418 246 283 175 235 206 235 173 280 284 222 351 238 233 258 168 269 281 355 219 219 252 205 201 345 252 250 213 249 170 State District of Columbia Massachusetts Rhode Island Maryland New York Vermont Connecticut New Jersey Minnesota Pennsylvania New Hampshire Hawaii Oregon Illinois Maine Louisiana Ohio Virginia Tennessee Colorado California Washington Wisconsin Michigan North Carolina Florida Nebraska Missouri North Dakota Delaware New Mexico Kentucky South Dakota South Carolina Kansas Alaska West Virginia Arizona Georgia Indiana Montana Alabama Texas Utah Arkansas Iowa Mississippi Nevada Wyoming Oklahoma Idaho Rank 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 Estimated Number of Physicians in Patient Care per 100,000 647 418 355 353 351 345 344 284 283 281 280 275 269 266 262 259 258 252 252 251 250 250 249 246 238 235 235 235 233 227 222 222 219 219 215 214 213 213 211 208 206 205 205 201 197 176 175 173 170 168 164 Source: AMA. Physician Characteristics and Distribution in the U.S., 2015. Notes: All figures exclude physicians whose address is unknown. 96 Office of Statewide Initiatives Physician Workforce in Nevada – 2016 Edition Table 76: Nevada’s Rank Among the U.S. States in the Number of Allopathic Physicians (MDs) per 100,000 Population – 1980 to 2013 Rank in the Number of Total MDs per 100,000 Population State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming 1980 1985 1993 1998 2003 2008 2013 46 43 12 47 6 10 5 24 1 11 35 9 50 18 42 45 26 41 32 25 3 2 27 14 51 21 40 34 36 20 13 28 4 31 37 22 44 16 15 8 38 49 30 33 23 7 19 17 39 29 48 42 43 14 44 7 15 5 21 1 11 34 8 50 17 45 46 32 40 27 24 2 3 29 16 51 23 41 36 37 20 10 25 4 31 38 22 47 19 12 9 39 48 26 33 30 6 18 13 35 28 49 42 49 20 43 11 15 5 21 1 12 35 10 50 16 41 44 32 38 29 25 3 2 30 13 51 24 37 33 46 18 8 28 4 26 34 23 47 17 9 7 40 45 22 39 31 6 19 14 36 27 48 42 50 32 43 13 17 5 22 1 11 35 10 51 12 41 45 34 37 20 24 4 2 28 14 49 27 39 30 47 15 8 31 3 25 29 23 48 21 9 6 36 44 19 38 40 7 18 16 33 26 46 43 40 37 45 18 20 6 25 1 19 38 8 51 17 41 47 36 35 21 12 3 2 31 11 49 32 30 28 48 16 9 27 4 24 29 23 50 15 10 7 33 39 22 44 42 5 14 13 34 26 46 42 38 39 45 18 21 6 27 1 19 41 8 50 17 40 48 35 36 24 14 3 2 26 11 49 31 32 29 47 12 9 28 5 25 30 20 51 13 10 7 34 37 23 43 44 4 16 15 33 22 46 42 40 33 45 18 20 7 28 1 21 39 8 51 15 41 46 34 38 22 14 3 2 24 12 49 29 32 30 47 11 10 27 4 26 31 17 50 13 9 6 35 37 25 43 44 5 19 16 36 23 48 Change in Rank – 1980 to 2013 4 3 -21 2 -12 -10 -2 -4 0 -10 -4 1 -1 3 1 -1 -8 3 10 11 0 0 3 2 2 -8 8 4 -11 9 3 1 0 5 6 5 -6 3 6 2 3 12 5 -10 -21 2 0 1 3 6 0 Source: AMA. Physician Characteristics and Distribution in the U.S., 2015; AMA. Physician Characteristics and Distribution in the U.S., 2009; AMA. Physician Characteristics and Distribution in the U.S., 2005; AMA. Physician Characteristics and Distribution in the U.S., 1999; AMA. Physician Characteristics and Distribution in the U.S., 1995; Physician Characteristics and Distribution in the U.S., 1987; AMA. Physician Characteristics and Distribution in the U.S., 1982. Notes: Figures for 1980 and 1985 include nonfederal physicians only. All figures exclude physicians whose address is unknown. Change in Rank reflects the increase or decrease in rank for that state since 1980. Office of Statewide Initiatives 97 Physician Workforce in Nevada – 2016 Edition Table 77: Nevada’s Rank Among the U.S. States in the Number of Allopathic Physicians (MDs) in Patient Care per 100,000 Population – 1980 to 2013 Rank in the Number of MDs in Patient Care per 100,000 Population State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Change in Rank – 1980 to 2013 1980 1985 1993 1998 2003 2008 2013 46 44 12 47 6 10 5 24 1 11 35 9 50 18 42 45 29 41 32 25 3 2 28 14 51 23 40 34 36 20 13 27 4 31 38 22 43 16 15 8 37 49 30 33 21 7 19 17 39 26 48 43 48 19 45 6 17 5 20 1 16 33 10 50 13 41 46 30 39 25 28 4 2 26 12 51 23 42 38 37 22 9 34 3 31 32 21 44 18 11 8 40 47 24 35 29 7 15 14 36 27 49 41 48 26 43 11 14 5 21 1 17 34 10 50 13 42 46 35 36 24 31 4 2 28 12 51 23 40 32 45 20 7 30 3 27 29 22 47 19 9 6 39 44 18 38 33 8 16 15 37 25 49 41 45 37 43 17 19 5 22 1 16 33 10 51 11 44 49 36 34 14 28 4 2 30 15 50 25 40 29 46 18 9 32 3 23 24 21 48 27 7 6 35 39 13 38 42 8 12 20 31 26 47 41 36 43 45 22 20 6 25 1 26 39 8 50 15 40 49 38 34 17 13 3 2 33 11 48 30 29 27 47 14 9 31 4 24 28 23 51 18 10 7 32 37 19 44 42 5 12 16 35 21 46 40 34 43 44 22 23 6 27 1 26 41 8 51 16 39 48 38 32 18 14 3 2 29 11 49 30 37 28 47 12 9 31 4 25 24 21 50 13 10 5 33 36 19 42 45 7 15 17 35 20 46 42 36 38 45 21 20 7 30 1 26 39 12 51 14 40 46 35 32 16 15 4 2 24 9 47 28 41 27 48 11 8 31 5 25 29 17 50 13 10 3 34 33 19 43 44 6 18 22 37 23 49 4 8 -26 2 -15 -10 -2 -6 0 -15 -4 -3 -1 4 2 -1 -6 9 16 10 -1 0 4 5 4 -5 -1 7 -12 9 5 -4 -1 6 9 5 -7 3 5 5 3 16 11 -10 -23 1 1 -5 2 3 -1 Source: AMA. Physician Characteristics and Distribution in the U.S., 2015; AMA. Physician Characteristics and Distribution in the U.S., 2009; AMA. Physician Characteristics and Distribution in the U.S., 2005; AMA. Physician Characteristics and Distribution in the U.S., 1999; AMA. Physician Characteristics and Distribution in the U.S., 1995; Physician Characteristics and Distribution in the U.S., 1987; AMA. Physician Characteristics and Distribution in the U.S., 1982. Notes: Figures for 1980 and 1985 include nonfederal physicians only. All figures exclude physicians whose address is unknown. Change in Rank reflects the increase or decrease in rank for that state since 1980. 98 Office of Statewide Initiatives Appendix of Self-Designated Practice Specialties Physician Workforce in Nevada – 2016 Edition Allergy & Immunology (AI) Allergy (A) Allergy & Immunology/Clinical & Laboratory Immunology (ALI) Immunology (IG) Aerospace Medicine (AM) Anesthesiology (AN) Adult Cardiothoracic Anesthesiology (ACA) Pain Medicine (Anesthesiology) (APM) Critical Care (Anesthesiology) (CCA) Hospice and Palliative Medicine (Anesthesiology) (HPA) Obstetric Anesthesiology (Anesthesiology) (OAN) Pain Management (PME) Cardiovascular Disease (CD) Child & Adolescent Psychiatry (CHP) Colon & Rectal Surgery (CRS) Proctology (PRO) Dermatology (D) Clinical & Laboratory Dermatological Immunology (DDL) Procedural Dermatology (PRD) Diagnostic Radiology (DR) Cardiothoracic Radiology (CTR) Emergency Medicine (EM) Critical Care Medicine (Emergency Medicine) (CCE) Emergency Medical Services (EMS) Sports Medicine (Emergency Medicine) (ESM) Medical Toxicology (Emergency Medicine) (ETX) Hospice and Palliative Medicine (Emergency Medicine) (HPE) Pediatric Emergency Medicine (Emergency Medicine) (PE) Urgent Care Medicine (UCM) Underseas Medicine (Emergency Medicine) (UME) Forensic Pathology (FOP) Family Medicine (FM) Adolescent Medicine for Family Practice (AMF) Family Medicine/Preventive Medicine (FMP) Geriatric Medicine (Family Medicine) (FPG) Sports Medicine (Family Medicine) (FSM) Hospice and Palliative Medicine (Family Medicine) (HPF) Gastroenterology (GE) General Practice (GP) General Preventive Medicine (GPM) Clinical Informatics (Preventive Medicine) (CIM) Medical Toxicology (Preventive Medicine) (PTX) Underseas Medicine (Preventive Medicine) (UM) Office of Statewide Initiatives General Surgery (GS) Abdominal Surgery (AS) Complex General Surgical Oncology (Surgery) (ASO) Surgical Critical Care (Surgery) (CCS) Craniofacial Surgery (CFS) Dermatologic Surgery (DS) Head & Neck Surgery (HNS) Hand Surgery (HS) Hospice and Palliative Medicine (Surgery) (HPS) Hand Surgery (Surgery) (HSS) Oral & Maxillofacial Surgery (OMF) Pediatric Cardiothoracic Surgery (PCS) Pediatric Surgery (Surgery) (PDS) Surgical Oncology (SO) Trauma Surgery (TRS) Vascular Surgery (VS) Internal Medicine (IM) Advanced Heart Failure & Transplant Cardiology (Internal Medicine) (AHF) Adolescent Medicine (AMI) Critical Care Medicine (Internal Medicine) (CCM) Diabetes (DIA) Endocrinology, Diabetes & Metabolism (END) Hematology (Internal Medicine) (HEM) Hepatology (HEP) Hepatology/Oncology (HO) Hospitalist (HOS) Hospice and Palliative Medicine (Internal Medicine) (HPI) Interventional Cardiology (IC) Cardiac Electrophysiology (ICE) Infectious Diseases (ID) Clinical & Laboratory Immunology (Internal Medicine) (ILI) Geriatric Medicine (IMG) Sports Medicine (Internal Medicine) (ISM) Nuclear Cardiology (NC) Nephrology (NEP) Nutrition (NTR) Medical Oncology (ON) Rheumatology (RHU) Sleep Medicine (Internal Medicine) (SMI) Transplant Hepatology (Internal Medicine) (THP) Medical Genetics (MG) Clinical Biochemical Genetics (CBG) Clinical Cytogenetics (CCG) Clinical Genetics (CG) Clinical Molecular Genetics (CMG) Medical Biochemical Genetics (MBG) Molecular Genetics Pathology (Medical Genetics) (MGG) Neurology (N) Child Neurology (CHN) Clinical Neurophysiology (CN) A-1 Physician Workforce in Nevada – 2016 Edition Endovascular Surgical Neuroradiology (Neurology) (ENR) Epilepsy (Neurology) (EPL) Hospice and Palliative Medicine (Psychiatry & Neurology) (HPN) Pain Medicine (Neurology) (PMN) Sleep Medicine (Psychiatry & Neurology) (SMN) Vascular Neurology (VN) Nuclear Medicine (NM) Neurological Surgery (NS) Endovascular Surgical Neuroradiology (ES) Endovascular Surgical Neuroradiology (ESN) Pediatric Surgery (Neurology) (NSP) Obstetrics & Gynecology (OBG) Female Pelvic Medicine & Reconstructive Surgery (Obstetrics & Gynecology) (FPR) Gynecological Oncology (GO) Gynecology (GYN) Hospice & Palliative Medicine (Obstetrics & Gynecology) (HPO) Maternal & Fetal Medicine (MFM) Obstetrics (OBS) Critical Care Medicine (Obstetrics & Gynecology) (OCC) Reproductive Endocrinologist (REN) Occupational Medicine (OM) Ophthalmology (OPH) Ophthalmic Plastic and Reconstructive Surgery (OPR) Pediatric Ophthalmology (PO) Orthopedic Surgery (ORS) Hand Surgery (Orthopedic Surgery) (HSO) Adult Reconstructive Orthopedics (OAR) Orthopedics, Foot & Ankle (OFA) Osteopathic Manipulative Medicine (OMM) Musculoskeletal Oncology (OMO) Pediatric Orthopedics (PO) Sports Medicine (Orthopedic Surgery) (OSM) Orthopedic Surgery of the Spine (OSS) Orthopedic Trauma (OTR) Other Specialty (OS) Addiction Medicine (ADM) Pediatric Psychiatry/Child Psychiatry (CPP) Emergency Medicine/Family Medicine (EFM) Pediatrics/Emergency Medicine (EMP) Epidemiology (EP) Family Medicine/Psychiatry (FPP) Hospice & Palliative Medicine (HPM) Internal Medicine/Emergency Medicine/Critical Care Medicine (IEC) Internal Medicine/Family Medicine (IFP) Internal Medicine/Dermatology (IMD) A-2 Internal Medicine (Preventive Medicine) (IPM) Legal Medicine (LM) Internal Medicine/Medical Genetics (MDG) Medical Management (MDM) Internal Medicine (Emergency Medicine) (MEM) Internal Medicine & Neurology (MN) Internal Medicine/Psychiatry (MP) Internal Medicine/Physical Medicine & Rehabilitation (MPM) Neurology/Diagnosis Radiology/Neuroradiology (NRN) Clinical Pharmacology (PA) Pediatrics/Dermatology (PDM) Phlebology (PHL) Pharmaceutical Medicine (PHM) Palliative Medicine (PLM) Pediatrics/Medical Genetics (PMG) Pediatrics/Physical Medicine & Rehabilitation (PPM) Psychiatry/Neurology (PYN) Sleep Medicine (SME) Otolaryngology (OTO) Otology/Neurotology (NO) Pediatric Otolaryngology (PDO) Plastic Surgery within the Head & Neck (Otolaryngology) (PSO) Sleep Medicine (Otolaryngology) (SMO) Psychiatry (P) Addiction Psychiatry (ADP) Neurodevelopmental Disabilities (Psychiatry & Neurology) (NDN) Neuropsychiatry (NUP) Forensic Psychiatry (PFP) Pain Medicine (Psychiatry) (PPN) Psychoanalysis (PYA) Geriatric Psychiatry (PYG) Psychosomatic Medicine (PYM) Pediatrics (PD) Adolescent Medicine (ADL) Child Abuse Pediatrics (CAP) Pediatric Critical Care Medicine (CCP) Developmental/Behavioral Pediatrics (DBP) Hospice & Palliative Medicine (Pediatrics) (HPP) Internal Medicine/Pediatrics (MPD) Neurodevelopmental Disabilities (Pediatrics) (NDP) Neonatal Perinatal Medicine (NPM) Pediatric Anesthesiology (PAN) Pediatric Allergy (PDA) Pediatric Dermatology (PDD) Pediatric Endocrinology (PDE) Pediatric Infectious Disease (PDI) Pediatric Pulmonology (PDP) Medical Toxicology (Pediatrics) (PDT) Office of Statewide Initiatives Physician Workforce in Nevada – 2016 Edition Pediatric Emergency Medicine (Pediatrics) (PEM) Pediatric Gastroenterology (PG) Pediatric Hematology/Oncology (PHO) Clinical & Laboratory Immunology (Pediatrics) (PLI) Pain Management (Physical Medicine & Rehabilitation) (PMP) Pediatric Nephrology (PN) Pediatric Rheumatology (PPR) Sports Medicine (Pediatrics) (PSM) Pediatric Transplant Hepatology (PTP) Pediatric Rehabilitation Medicine (RPM) Sleep Medicine (Pediatrics) (SMP) Pediatric Cardiology (PDC) Public Health & General Preventive Medicine (PHP) Physical medicine &Rehabilitation (PM) Hospice & Palliative Medicine (Physical Medicine & Rehabilitation) (HPR) Neuromuscular Medicine (NMN) Neuromuscular Medicine (Physical Medicine & Rehabilitation) (NMP) Pain Medicine (PMM) Sports Medicine (Physical Medicine & Rehabilitation) (PRS) Spinal Cord Injury (SCI) Radiology (R) Abdominal Radiology (AR) Hospice & Palliative Medicine (Radiology) (HPD) Musculoskeletal Radiology (MSR) Nuclear Radiology (NR) Radiology (PDR) Neuroradiology (RNR) Radiological Physics (RP) Vascular & Interventional Radiology (VIR) Radiation Oncology (RO) Thoracic Surgery (TS) Congenial Cardiac Surgery (Thoracic Surgery) (CHS) Thoracic Surgery – Integrated (TSI) Transplant Surgery (TTS) Urology (U) Pediatric Urology (UP) Vascular Medicine (VM) Unspecified (US) Plastic Surgery (PS) Cosmetic Surgery (CS) Facial Plastic Surgery (FPS) Surgery of the Hand (Plastic Surgery) (HSP) Plastic Surgery within the Head & Neck (PSH) Plastic Surgery – Integrated (PSI) Plastic Surgery within the Head & Neck (Plastic Surgery) (PSP) Anatomic/Clinical Pathology (PTH) Anatomic Pathology (ATP) Blood Banking/Transfusion Medicine (BBK) Clinical Informatics (Pathology) (CIP) Clinical Pathology (CLP) Dermatopathology (DMP) Hematology (HMP) Molecular Genetic Pathology (MGP) Medical Microbiology (MM) Neuropathology (NP) Chemical Pathology (PCH) Cytopathology (PCP) Pediatric Pathology (PP) Selective Pathology (SP) Pulmonary Disease (PUD) Pulmonary Critical Care Medicine (PCC) Office of Statewide Initiatives A-3
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