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Making the Rounds with Founding Dean Dr. Barbara Atkinson
 Issue 163 - September 18, 2018
Even though many of our students are from Southern Nevada, some of them have never been to the more economically challenged neighborhoods of Las Vegas. One of the first things the UNLV School of Medicine does is send our students out in small groups to all corners of the community. By doing this, they get to know the residents and the challenges they face. Our students learn why so many Las Vegans struggle to find a doctor and then have difficulty getting to appointments. Thousands lack convenient access to healthy food and are afraid to go outside to exercise. These are all factors a thoughtful physician needs to consider when treating an individual. We want our students to understand the medical needs of their community - to have their eyes wide open, so when they graduate and become doctors, they’ll be armed with the proper knowledge, skill and compassion.
Barbara signature, first name only
One of the M1 student groups studying Population Health L-R: Harrison Shawa, Tesfaye Yadete, Lauren Ostler, Donnis Davis, James Lovett
What five UNLV School of Medicine students found in southeast Las Vegas was a kind of homelessness that differed from what is usually seen in the media. Instead of individuals spending day after day sleeping on sidewalks or in parks, these were the working poor or people receiving government assistance who generally had enough money to spend three weeks of every month sleeping in motels along Boulder Highway.

“I was blown away, surprised to see how many people were living like that,” said Harrison Shawa, a first year student in the medical school’s second class. “I just never thought of people knowing they’d have enough money to stay in a place for three weeks and then be homeless for the rest of the month... Out of money, they’re not eating right and more apt to be a crime victim.”
“What really hit home to me is how you have to understand what people are going through to be a good family physician,” - Davis said.
Shawa was part of a team engaged in a six week course called Immersions EMT/Population Health. While all first year students are required to become certified by the end of the course as emergency medical technicians (EMTs) and then actually participate in EMT calls, they also must explore a neighborhood and learn how to conduct a community health assessment, a major tool used in Population Health to determine areas of need and possible realistic intervention targets for positive change.

Dr. Laura Culley, the UNLV School of Medicine Associate Dean for Community Engagement, notes the course exposes students to the “downstream” and “upstream” aspects of medical emergencies. Downstream refers to medical emergencies that doctors encounter, such as a sexual assault victim, and how to manage those situations. Upstream refers to the conditions that can contribute to those emergencies, such as homelessness.

Recently, during presentations in a Shadow Lane complex classroom, several teams of five students identified what they learned in each of their neighborhoods to other students, faculty and officials representing the areas the students chose to explore. Using slides they compiled during their study, the students dealt with neighborhood demographics, resources, crime, educational opportunities, safety conditions of roads and sidewalks, the presence of recreational opportunities, and the variety of food products available in stores

Shawa, along with Lauren Ostler, James Lovett, Tes Yadete, and Donnis Davis, came to understand why there were so many pedestrian accidents near Boulder Highway and E. Tropicana Ave. “Six lane crosswalks are just too wide for some people to negotiate in a hurry,” he said. “You have to keep that in mind as a physician when you tell people without a car to go to a particular store or pharmacy or whatever... And some sidewalks just end.” 

Like Shawa, Ostler said the learning exercise taught her how helpful it would be for a physician to understand the background of a patient who lived in the area.

“By understanding these people and their lifestyles, I could tailor medical treatment to them,” she said. “Say we have a patient who is overweight but is afraid to go outside and exercise because of gang activity in the area... We learned there is a lot of gang activity from people in the neighborhood. I could set up exercises for him to do at home, have him walk stairs instead of taking an elevator.. And if he’s only been getting bad processed food at a 7-11, I could let him know about healthy foods at nearby food banks.”

Davis said a physician who understood that a patient came from an impoverished background would never prescribe medications that were out of his financial reach.

“What really hit home to me is how you have to understand what people are going through to be a good family physician,” he said. “The treatment plan you’re going to have to set up is something on the less expensive end. And you’re going to have to spend a lot of time educating because you can’t assume that all people know what you mean. Many of them haven’t had the opportunity for a good education.”

Lovett said it is critical for physicians to understand the resources in a neighborhood where people often are on foot. “You don’t want to tell somebody to exercise in an area controlled by gangs. The more you know about an area, the better.”

Ostler said the area around the Whitney Recreation Center needs new affordable housing and a crackdown on sex trafficking. Shawa, who learned from one resident that one man made money off 10 year old sex slaves, said one way that physicians may be able to help change lives for individuals is to work more closely with police and to get involved with planning agencies.

“Students are trying to get themselves integrated into different planning organizations,” he said. “We want to make a difference.”
IN THE NEWS   Click to see recent stories about UNLV School of Medicine

This $20 million grant renewal from the National Institutes of Health will help UNLV lead a network of 13 universities in seven states to research ways to improve residents' health.

Las Vegas Sun, September 2, 2018

Blake Muschong’s bulging bluish-gray eyes are easily distracted by a rainbow keychain of rings. In that sense, he’s much like any other 13-week-old. But Blake, born with a cleft palate, is one of the more difficult cases because the boy was born with a clubfoot and no arms.

Las Vegas Review Journal, September 15, 2018
According to the American Society of Plastic Surgeons (ASPS), gluteal fat grafting, commonly referred to as the Brazilian Butt Lift, has resulted in an alarming rate of mortality, estimated to be as high as 1:3000, a rate of death far greater than any other cosmetic surgery. Approximately 20,300 buttock augmentation procedures using fat grafting were performed in 2017, and the number of procedures has more than doubled in the last five years. The ASPS says the reason for the high death rate is largely because non-board-certified and non-plastic surgeons are performing butt lifts.

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