Serving Medicine: The Nevada State Medical Association and the Politics of Medicine

Since 1945, medicine evolved from the world of the highly regarded general practitioner to the highly technical, sometimes impersonal, world of the specialist. As a result of this change, the Nevada State Medical Association (NSMA) competed with specialty organizations and worked to maintain its position representing Nevada’s physicians. After World War II, there were less than 50 medical doctors in the state, and they were concentrated in Reno, Carson City, and Elko. By 2001 there were approximately 3,000 practicing in Nevada, and the majority were in Las Vegas. Although physicians are not required to join the NSMA, it lobbies for and represents their interests. Serving Medicine recounts the political endeavors and efforts of the NSMA from 1875 when its predecessor, the Nevada State Medical Society, was established, until 2001. The primary focus of the book is on the interviews of twenty past presidents of the organization with emphasis on the political highlights of their terms. The first president interviewed, Ernest W. Mack, who served in 1959, describes events leading to the formation of the University of Nevada School of Medicine. In 1969, the politics of forming a medical school in Reno resulted in an accentuation of the north-south rivalry which continues today. Later presidents describe the malpractice crisis and legislation to reform Nevada’s tort laws, formation of clinics for uninsured patients, and the formation of HMOs, Medicare, and Medicaid.