Despite being home to over 3 million people and one of the world’s biggest entertainment capitals, Nevada faces a dire healthcare crisis. The state ranks 48th in primary care doctors and 49th in general surgeons per 100,000 residents, needing an estimated 2,561 additional physicians just to meet national standards. Recent reports suggest the state needs 540 additional surgeons, 1,038 physicians in medical specialties, and many more from other fields. So how did things get this bad, and what will it take to fix it?
The Shortage by the Numbers
The scale of Nevada’s physician deficit is staggering. The state’s three medical schools — the Kirk Kerkorian School of Medicine at UNLV (class size of 66), the University of Nevada Reno School of Medicine (class size of 70), and Touro University (class size of 180) — collectively produce over 300 graduates per year. Yet there are only about 404 CMS-funded residency positions in the entire state. The result is predictable: most graduates are forced to leave Nevada to complete their training.
Making matters worse, the state’s existing physician workforce is aging rapidly. In some Nevada counties, the average age of allopathic doctors is 61.2 years — well above the national average of 52.9. The average age of osteopathic doctors in those counties is 57.7, compared to the national average of 49.7. Nearly 17% of licensed doctors in Nevada are inactive, retired or no longer practicing medicine.
The Real-World Impact on Patients
For Nevadans, these numbers translate into real suffering. Many patients wait several months or longer just to see a primary care physician. For specialty care, the wait can be even longer, assuming the specialty exists in the state at all.
Research has consistently shown that communities with more primary care physicians are healthier, and that increased access to primary care lowers the frequency of emergency department and hospital visits. One study found that the readmission rate for cardiovascular patients who had difficulty accessing preventive care was 33.3%, compared to just 17.9% for those with access to primary care. In a state with so few providers, these outcomes are not abstract statistics, they are the daily reality for millions of residents.
A Closer Look at Nevada’s Provider Landscape
The composition of Nevada’s physician workforce differs notably from national norms. Across the United States, allopathic physicians (MDs) make up about 88% of licensed physicians, with osteopathic physicians (DOs) accounting for roughly 12%. In Las Vegas (Clark County), however, the split is 83.1% MDs and 16.9% DOs — making Nevada the 6th-ranked state in the country for the highest percentage of practicing DOs.
This higher proportion of DOs is likely a reflection of the state’s physician shortage itself. Nevada is home to Touro University, an osteopathic medical school with the largest class size in the state (180 students), which contributes significantly to the local physician pipeline. As the state struggles to attract and retain enough physicians overall, DO graduates may be filling gaps that would otherwise go unmet.
The Rise of Non-Physician Providers
Perhaps the most consequential policy response to Nevada’s physician shortage has been the expansion of the role of nurse practitioners. In 2013, Nevada granted Nurse Practitioners (NPs) Full Practice Authority, allowing Advanced Practice Registered Nurses (APRNs) to independently evaluate, diagnose, and treat patients without mandatory physician supervision. This was a direct effort to combat the state’s critical primary care and behavioral health deficits.
While Full Practice Authority has helped expand access to care, particularly in rural and underserved areas, it also means that patients in Nevada are significantly more likely to receive care from a provider with less education and training than a physician. The training pathway differences are substantial:
- Physicians (MD/DO): 4 years of medical school + 3–7 years of residency training (11,000–16,000+ clinical hours)
- Nurse Practitioners: A master’s or doctoral nursing degree with approximately 500–1,500 clinical hours, depending on the program
This is not a commentary on the quality or dedication of NPs, who play a vital role in healthcare delivery. However, it underscores a structural reality: Nevada’s physician shortage has necessitated a care delivery model in which a larger share of patients are seen by providers whose training is fundamentally different in scope and duration from that of physicians. For complex or specialty care needs, this gap can be particularly meaningful.
Why Nevada Can’t Keep Its Best and Brightest
Nevada’s healthcare crisis isn’t just about having too few physicians, it’s about a structural failure to retain and attract graduates from top-tier medical programs. The state drastically lacks specialized Graduate Medical Education (GME) residency slots, and because physicians overwhelmingly tend to set up practice where they complete their residency rather than where they attended medical school, top graduates are forced to train, and ultimately settle, out of state.
This creates a devastating cycle: Nevada invests in educating medical students, only to watch them leave and serve other states’ populations.
Nearly 60% of Nevada’s own medical school graduates are forced to leave the state simply to complete their required post-graduate training. With only about 404 CMS-funded residency positions across the entire state, serving a population of over 3 million, the math simply doesn’t work. And as research consistently shows, once these graduates leave for residency elsewhere, the odds of them returning drop dramatically. A physician who completes both medical school and residency in Nevada has a greater than 70% chance of staying to practice in the state; one who leaves for residency has only about a 30% chance of coming back.
The problem is compounded by the complete absence of critical sub-specialty and fellowship training programs. There are no residency or fellowship pathways for neurosurgery, dermatology, urology, ophthalmology, hematology/oncology, or rheumatology – all fields with significant patient demand. Graduates who aspire to enter these competitive, top-ranked specialties have no choice but to leave Nevada to complete their training. Once embedded in another state’s healthcare system through years of fellowship and early practice, they rarely return.
This means Nevada isn’t just losing primary care physicians – it’s systematically losing the specialists who treat cancer, perform brain surgery, manage autoimmune diseases, and care for an aging population’s complex medical needs. The absence of these programs doesn’t just represent a training gap; it represents a permanent talent pipeline failure that compounds the state’s healthcare crisis year after year.
The Bigger Picture
Taken together, these workforce dynamics paint a picture of a state adapting to scarcity. A higher-than-average reliance on DOs, the early adoption of Full Practice Authority for NPs, and the persistent shortage of specialists all point to the same root cause – Nevada simply does not train or retain enough physicians to serve its rapidly growing population.
For patients who can afford it, the concierge model offers exactly what Nevada’s strained healthcare system struggles to provide: same-day or next-day appointments, unhurried visits, direct physician access, and the kind of proactive, preventive care that gets lost when a doctor is managing thousands of patients. In a state where finding a primary care physician accepting new patients can take months, concierge medicine delivers immediate, meaningful access – and for many Nevadans, it has been a lifeline.
But there is a troubling flip side. As more primary care physicians transition to concierge models, drawn by smaller panels, better work-life balance, and sustainable income, they are effectively discharging hundreds or even thousands of existing patients in the process. Those patients are then thrust back into an already overwhelmed system, competing for an even smaller pool of available doctors. The very physicians who were once absorbing patient volume are now serving a fraction of their former panels, deepening the drought for everyone else.
The result is a paradox: concierge medicine simultaneously solves and worsens Nevada’s primary care crisis. It offers a premium solution for some while widening the gap for many, raising urgent questions about equity, sustainability, and the future of healthcare access in the Silver State.
Sources
Do K, Do J, Kawana E, Zhang R. Nevada’s Healthcare Crisis: A Severe Shortage of Physicians and Residency Positions. Cureus. 2023 Jul 11;15(7):e41700. doi: 10.7759/cureus.41700. PMID: 37575733; PMCID: PMC10414134.
Federation of State Medical Boards. (n.d.). Physician licensure. https://www.fsmb.org/u.s.-medical-regulatory-trends-and-actions/u.s.-medical-licensing-and-disciplinary-data/physician-licensure/
Packham, J. (2024). Physician workforce in Nevada: A chartbook (2022 edition). Nevada Health Workforce Research Center, University of Nevada, Reno School of Medicine. https://www.nvhealthforce.org/wp-content/uploads/2024/03/23-Physician-Workforce-in-Nevada-a-Chartbook.pdf
VanBeuge SS, Walker T. Full practice authority–effecting change and improving access to care: the Nevada journey. J Am Assoc Nurse Pract. 2014 Jun;26(6):309-13. doi: 10.1002/2327-6924.12116. Epub 2014 Mar 31. PMID: 24688001.