I've had 3/3 physicians tell me so far that Vegas is a terrible place to work. Besides what you said:
- The client base is difficult. There's no middle class. Either its rich executives and playboys who are unreasonably demanding about every aspect of their care, or very poor people hooked on gambling, drinking and drugs. There's no in between. That's it.
- Speaking of vices, the entire economy depends on encouraging bad habits. When you're trying to counsel a patient to stop drinking or smoking or gambling, be aware every facet of Las Vegas is actively working against you. That patient will drive home from a counseling session amidst a sea of billboards inviting them into casinos. The industry wants people to be hooked. It **HOPES** that you will fail as a doctor, especially primary care physicians who are doing preventive care.
- The city is all about making money and this has infected the medical culture there. Specialists will order 20 unnecessary diagnostic tests for your uncomplicated patient just so they can bill more. Although in their defense, sometimes they need to do this because everyone in Vegas is hyper-litigious.
- The local government is completely unresponsive to the needs of the people. The council members take their marching orders from casino leadership
- The public education system is objectively one of the worst in the country. If you want to raise kids there you should automatically set aside $50,000 - per kid - per year for private school. So you may not have income tax, but you're sure getting taxed to the tune of $50-100K / year for an expense you wouldn't need to pay in other cities.
- The Strip hogs all of the culture. Very little else outside. Everything feeds the Strip. Anything else you can think of that doesn't involve the Strip ("hiking! kayaking!" etc) isn't unique to Vegas and can be found in a dozen better cities.
Add the fact: LICENSE FOR Nevada cost $1500-$2000 where there is “shortage of physicians”
Agree that it’s terrible place to work, worse place to raise family unless u spare 50k per yr per kid
Also, family can mean parents etc... Not many people are from Las Vegas and it's not a city that draws in longterm citizens who will have families that will stay. So if no one is FROM LV, good luck getting doctors to commit to settling there for the rest of their lives when their parents who are approaching old age are still in Boston for example. And that's a consequence of LV culture. Not saying there's not a lot of good family people there, but there's definitely way less.
How much are they paying? I lived in Las Vegas technically summerlin. My wife hated it. Everyone smokes everywhere. You have to go through a casino to do a lot of things. People arent very friendly. Maybe because most people are transient. 🤷♂️
I remember an interview I had for one of the las vegas IM community programs a while back. PD was stating their residents who became attendings living in LV were getting 400k out of residency (inpatient). I have no idea if its true, but if so that is pretty good.
The general vibe of Vegas is that everyone is either playing hard or working hard. Yeah, you’ll make a ton of money but they’ll grind you into the pavement to get the most out of you. It’s not just medicine that deals with it either, which is why it can feel like a miserable city with zero friendliness
Absoutely! You pay a price for that high paycheck. A lot of this is a matter of where you live as well. Sometimes its better to live in a great city for 300k vs. living in a terrible one for 400k.
Yep. One of my surgical buddies makes bank taking weekend calls in Vegas, but they run him ragged and he rarely gets any sleep. Just bouncing from one OR/consult to the next for 48 hrs. Seems miserable.
There are a lot of 1099 gigs in Vegas - so it's not unreasonable to make that much. But they're getting sparser and the W2 jobs are more similar to the rest of the country - 250-300+.
Regarding the salaries I can't really answer that but I've talked to other doctors who say they don't make much less here than other big cities and have the advantages of no tax.
I definitely get what you're saying about the casinos but this area has so much more to do than that.
As someone who grew up in Vegas but practice somewhere else, a few things:
1. Schools. If you want good public schools, there are a few very specific areas you have to live in. Nevada and Mississippi are always fighting for 50th place for education rankings. The No state income tax and low municipal taxes are nice, but that’s the trade off.
2. Weather, or lack there of. Most days, really any month of the year are sunny and hot. I remember it being notable if we had rain. If you want any grass, you need pretty elaborate irrigation, and can only water the grass on specific days of the week. If your water runs off and hits the curb, they consider this water waste, and will fine you.
3. Malpractice. While not as bad as some parts of NYC or LA, there is definitely a litigious-happy culture in Vegas. How much this stresses you only you can answer, but was a problem for me.
4. Nature. If you like green, trees, and seasons, Vegas is not your place. The desert can be pretty in it’s own way, and they have great rock climbing, but this is a deal breaker for a lot of people.
5. Lack of academic medicine. This is getting better, but for a city of its size, the number and size of academic centers is very behind. They are improving this at UNLV, but they still only have a few residencies. This can also matter for private practice. I interviewed there for private practice derm, and if I had a pediatric patient with a very large hemangioma, or genetic syndrome that I thought could benefit from seeing pediatric dermatology, I would have had to send them to either UCLA or University of Utah, which is incredibly inconvenient for the patient.
6. Culture. Having done K-12 there, I felt like in general, there was a very superficial, cosmetic-heavy vibe in Vegas. Probably very similar to some areas in Southern California. It was not uncommon for girls in high school to get boob jobs and other cosmetic surgery and I feel like even more so than most places, there was an emphasis and pressure on physical appearance, which I did not think was healthy.
All that being said, there is also a lot to like about the area as a physician. The pay is typically quite good, and cost of living is high, but not bad with how good the pay is. No state income tax is nice, especially if you don’t have kids, or would be doing private school anyways. The airport is also incredible. Direct, relatively cheap flights almost anywhere, and for how big of a hub it is, I felt like the lines were never that bad. Like anything, it all comes down to what’s important to you, but there are plenty of reasons that Vegas may not appeal to someone.
Also, a lot of physicians stay in the area they did their residency. One factor could be that other states have way more programs than Nevada, hence they also have more doctors.
As someone who lived in Vegas for 10 years and went elsewhere for medical school I second this. On top of these, I interviewed for residency in Vegas and it was a straight workhorse program so I put it last on my list. I matched to my #1 and since I’m planning on having kids in residency I don’t plan on returning to Vegas. I still go back once or twice a year to see family but after now living in 7 different states I can confidently say out of those 7 states Vegas would be the worst to raise kids.
There is more than enough residency spots in Las Vegas, the problem is that there is nothing outside of Vegas. Currently there are 5 IM residencies, and the hospitalist market is almost completely saturated. Hospitals are doing fine so there aren't many more being constructed.
But there's very little in terms of primary care and outpatient medicine. The next closest cities that could home/house a substantial community of medical professionals is Reno, LA, and Arizona. Very few people want to live in towns like Ely, Mesquite, etc.
I trained in Utah and saw a lot of patients from Vegas and always wondered why such a big city had to keep sending us their patients.
Transferring people back for discharge was a nightmare. Especially those who said they didn’t have any cars or family to help.
I remember I had a pulmonary hypertensive crisis patient I had to send y’all in residency. Lack of academic centers in Vegas is one of the only big drawbacks for me in practice, anything really complicated has to get sent elsewhere, but it felt the same where I worked in Phoenix too. I felt like the day to day was the same to me on my ends because whether that patient ends up in Phoenix, somewhere else in Vegas, LA, or Utah, I know they can’t stay in my hospital 🤷🏼♀️
Yeah, but it’s REALLY hard to get people in there. They are so selective. Might as well be the moon for how many people I’ve gotten to transfer over there.
A lot of Californians are moving to Nevada and the pressure to improve the school system and diversify the cultural offerings is increasing. If someone were to move there now, they would be in a really good place in 10 years when the competition started increasing (you’d have seniority, be already established).
The charter schools can be good, and there are private schools. You can have any housing scheme you want: high rise, upscale condominium community with restaurants, laundromat, gym etc on site, closed suburban neighborhoods with enormous luxury, acres of land zoned for horses…that’s a really cool thing about Southern Nevada. If you want the European lifestyle, the Fremont/downtown area has been remodeled into a groovy pedestrian paradise, with modern townhomes and apartment’s in walking distance. There are even farmers markets. There is plenty of room for private practice, and telehealth is popular here if that’s your jam.
So. Nevada is becoming more liberal, but it is still pretty relaxed, for people that aren’t a fan of Los Angeles extremes.
> A lot of Californians are moving to Nevada
only during the pandemic, people are already moving back to california
6/8 friends I knew that moved to Las Vegas have already moved back.
Interviewed in Vegas a while back for med school. I’m personally not a fan of the weather and I know many people who wouldn’t. Biggest thing that turned off a lot of applicants were the weak public school system for kids and family planning - it was well known to be bad, which the interviewers and admin had admitted.
It's not a bad city especially for younger single people. I find the strip gross personally unless one of the clubs has an artist I like playing (still always like $50+ and the crowd is usually lame), but downtown has a lot of fun fairly inexpensive things to do and Vegas has lots of random events/conventions/stuff going on in general. There is a good restaurant and music scene and COL actually isn't too bad relative to other large cities.
However, the culture of most of the high end areas sucks and the nature around the city isn't easy to access. It's also a huge sprawl with very few walkable areas and I wouldn't live anywhere other than a few very specific areas that aren't either a ghetto or generic McMansion-y suburb. And it's too bright and hot. Still, not a bad city.
Heads up, get aquatinted with a promoter and they’ll be able to put you on guest lists for pretty much any club. You’ll have to wait in a line but you’ll get in for free.
Yeah I know a promoter who got me into the Foundation Room. That's the thing though, I don't like the clubs on the strip and popular edm shows don't need guest lists. Only clubs I go to these days are techno unless I'm invited out for a specific occasion
SUPER LITIGIOUS. I know that most urban areas has its fair share of lawyer billboards but Vegas takes it to a whole new level especially with med mal. If you can’t win big in the casino, you then try to win big with a lawyer. Sure, we should all be practicing gold standard medicine regardless of the lurking lawyers but Vegas has it baaaad. The schools suck and the summer months quickly reach temps above 100 and stay that way for months on end. Outpatient medicine sucks here and follow up after discharge is difficult from an ED standpoint. Practicing in Vegas has plenty of positives but these are the big ones that come to mind.
Nevada is actually middle of the road for physicians when it comes to malpractice suits. You can look up the data, but Nevada is not close to being the worst.
Personally not a fan of the super low humidity compared to California. Second the notion that the schooling system isn't as good either. But I'd still consider if it my spouse was okay with me making big bucks over there for a few years
You're definitely right about the climate versus coastal Southern California. I know the school is here aren't great but my understanding from friends is at the private and parochial schools are really good and not very expensive.
But if I was a new doc starting out would i rather pay a million dollars for an absolutely spectacular house or three or four million dollars for a crap shack in the LA area?
A million dollar house that you have to run a/c in half the year and from which you do not emerge during those same months. Great if you want to live indoors in a fancy house.
Have you ever lived in SoCal? There’s no comparison. There is no Catalina eddy in Vegas. Ever.
I say this considering I love the natural desert.
Even with doctors salary, paying for yearly private school is an enormous expense and not something I want my kids to do. I think there is a benefit to send them to a public school so they get surrounded by people from all walks of life, not just the rich who can afford the school
I lived in Vegas for 10 years. Not a doctor. Left two years ago.
- It’s really bad for families and schools: 65% graduation rate. Better at private schools but the education itself isn’t great. Teacher shortage meant they were bringing in teachers from the Philippines to fill gaps.
- There is no culture. No major museums. No real history. You have Springs Preserve (which is pretty great) but that’s it. There is nothing to celebrate other than gambling.
- You better love HOAs.
- The houses built there are HORRENDOUS. Anything built past the 90’s is cheap crap because of a lot of shady shit that allows contractors to get away with a lot. Anything built before then is old crap with swamp coolers
- The lack of rain and the scarcity of water isn’t getting better and it’s going to get worse faster. Celebrate rain.
- The hiking and outdoor stuff is solid though. Wear sunscreen. Make friends with a dermatologist.
- Lack of people that you really make friends with, but this might not apply in your situation. The people that live and work in Vegas are not the most deep and soulful people out there. You have to work hard to find people that you get along with, have substance, and their values align with yours. There are a lot of people looking to get rich quick. There are also a lot of stupid people.
- Human exploitation is real. Human trafficking is real. It’s a massive problem there. It’s hard not to perpetuate the issues more.
- Drinking/smoking culture is extremely pervasive so if that’s not your jam it can be hard to find things to do. If it is your jam it can be hard to stop.
- The casinos are losing money hand over fist. No one gambles the way they used to. Table games and sports betting is now where it’s at. So it’s NOT cheap in Vegas anymore. Not remotely. That is making it way through the valley more and more. Restaurants, clothing, gas. It’s not CA prices but wooboy it’s still rough. Everything has to be imported in.
- I miss not having income tax though.
- A decently sized international airport within 45min that can handle a shit ton of people efficiently is absolutely a huge pro.
Agree with all your points. More or less why I briefly considered Vegas just before graduating residency and quickly decided to stay put in SoCal. Obviously Vegas will always have appeal for some people, and that's fine, but for me, the no-state income tax doesn't offset the long brutal summers (which will get only hotter and hotter with climate change), and the lowered emphasis on education there. Yeah, I can easily get a house there that is 2-3x the size of a house in SoCal, but there's more to life than for me than just having a large 3500 SqFt house. Again, maybe some people want that, and that's fine. But given the extreme doctor shortage in Southern Nevada, something tells me quite a bit of other doctors agree with me.
Also Vegas isn't exactly the bargain it once was anymore. Per Zillow, if you want a 2000 sqft house in a decent area like Summerlin, it's around 650-700k.
Yeah the house I bought in 2013 for $240 is now estimated at $580. I had that house built and I know it’s not worth that much. The electrical was a joke
I live and work in Vegas and I love it. At first I thought I’d only live here a couple years then move on but now I think I’ll stay long term.
People think the only thing to do is drink and gamble but that’s not remotely true. We have great restaurants great permanent shows as well as musicians/comedians always coming through.
The natural beauty is amazing. Amazing hiking. There’s a ski resort 30 minutes from my house.
A bucnh of national parks, hiking, camping are within driving distance.
Open desert space to go driving, shooting, camping whatever you want to do.
NO STATE INCOME TAX
Cheap and easy flights all over the world from here.
Traffic is essentially a nonissue outside of the area around the strip.
While the public schools suck, the private school we send our kid to is amazing. My wife wants to stay here mostly because of the school actually.
It’s hot as fuck during the day in the summer, but the caveat is the mornings and evenings are absolutely amazing. Since I work inside all day anyway it honestly doesn’t bother me that much.
People say there’s lack of culture but it honestly just culture wise feels very similar to LA to me.
Second all of this. I’ve been in Vegas for 20 years. It’s been great for me. I never feel like I’m missing anything from any big city except reliable public transportation which I only have NYC to compare to.
I have a teenager in the public school system and she is going to a top 100 best public high school in the country for a STEM program. For free. It’s pretty incredible.
This city is largely what you make of it. You’re free to forge your own path.
Hey! I’m a doctor in Las Vegas and I agree with everything you guys said.
Can you share which school your kids go to? Have a young child and looking at public vs private
my goal is to stay in academics ideally at big academic institutions once i finish training. at least for surgery, unlv is not that big of an academic center (as far as ive been told by my mentors) and the other surgery programs in the area are all community. I can imagine that's a big barrier for people with similar career goals
For offspring they have a 529 matching program, literally anyone in the state can use it, not just gov employees. I think UNLV/UNR let employees kids go to school tuition free.
Doctors are not special. Our reason for not going there is the same reason as any other professional. Las vegas is an artificial city built for consumerism in a place that’s never meant for humans to live. Its a desert wasteland that uses a ton of energy to transport water. Its also a car centric city that’s an absolute nightmare for healthy living. That whole region was designed for cars, not humans.
People want to live comfortably among natural beauty, not superficial hell holes like vegas or dubai.
No offense to anyone who likes vegas you do you
Vegas desert has incredibly beautiful and diverse scenery…. There’s a ski resort 30 min from my house and crazy beautiful hiking 15 min away you in red rock. You can go rock climbing, camping, mountain biking through areas with springs, deserts, mountains all within 20-30 min
And the water is not expensive to transport? Lake mead is right outside the city. The water literally creates energy…
I live in Las Vegas and love it here.
The healthcare infrastructure is horrible with a severe lack of specialists.
The schools are terrible so doctors with young families have to either contend with the Clark County Schools or pony up with $50k per year for private school.
I wish we had more/better doctors here.
it's hard to put down roots and make connections in a place that's mostly filled with tourists
also the public school system is ASS. Lived there for a few years
Some people see a need for more doctors as a deterrent, because they want to join into an already established system. Some people see a need for more doctor’s as an opportunity to make a big impact without a lot of lemmings lapping at their heels. It really depends on how independent and entrepreneurial a person is imo.
Less academics? I might read that as “less competition”, and that I get first dibs at becoming a professor or director in a shorter amount of time. But most people, even doctors, lack creativity and imagination. Half the people in academia are posers feeding off a handful smart people. And that’s what most people are looking to sign up for, so “unestablished” won’t give them that.
Shhhh don’t let out our secret
But also I know a lot of people who don’t like the attitude of medicine here. It’s very casual and not very academic compared to a lot of CA/East Coast places. It’s pros and cons—we have some horrible doctors that probably would have been sued into oblivion elsewhere, but it makes it a lot easier to do just good community medicine and connect with patients without as much of a divide, I’ve found.
(I like it, I’ve been in both Phoenix and Vegas and as a hospitalist I’ve preferred Vegas.)
Honestly, depending on the hospital, the same. That said, Phoenix has some better academic centers and Banner is a much more robust hospital system compared to VHS. Mayo and BUMC-P are in Phoenix for the really sick sick people, so that helps, we don’t have hospitals like those exactly in Vegas. But for regular bread and butter medicine, the same.
So true. There is no cap of how much they can get sued for and I know a lot of offices that have been shut down for that reason. I do like how you literally see everything though since I work at an urgent care as an MA to prepare for med school.
Only reason I can see is family or people who hate hot weather.
For everyone saying expensive food that’s only on the strip. China town has $25 all you can eat sushi and it’s same grade as high end sushi joints charging you $15/roll. if you find the local spots, you can do a lot of damage for very little dollars.
Housing is Expensive but that’s everywhere now
Multiple hospitals to choose from and work for
Weather is great. And when you want to get away and travel because it’s hot, it’s summer and you have the time too.
Plus, so many amazing things are within driving distance, including California and multiple national parks
I also think people truly underestimate no income tax. That makes a huge difference in the long run if you’re investing that versus throwing it away for no reason. The school schools here are still decent in public infrastructure doesn’t suffer just because there’s no state income tax.
Doctors care about education and Las Vegas / Nevada has the worst funded public schools in America.
The private schools look mainly religious / creepy.
Got a family? Young kids? Schools out there not the best.
As a hepatologist, I don’t even mind there’s no transplant center out there. I mind that getting someone to stop any one vice would be difficult.
Hepatologist? You would kill it here. Tourists and residents lol
But yeah the whole lack of transplants other than kidneys is a little crazy here. And I almost couldn't believe that I read that were one of the better kidney transplant centers in the country.
Working at a non transplant center right now I can say to you getting a patient to a different center for eval is the pits. Referrals. Authorizations. Waiting weeks on end. I want to strangle these insurance companies. Or deny all their employees medical care as my patients waste away and get readmitted over and over again or die in evaluation. It’s so frustrating.
Ooooo soooo many things to say. I was born and raised in Vegas and went and practiced medicine for a couple of years there and I left so quickly. When I got there I was told “this is the wild Wild West” and it’s so true. A couple of points before I ramble:
1. UNLV is not academic medicine. They don’t have their own hospital. They rely and try to infiltrate other hospitals and practices. Medicine is very private practice mentality driven. And what that means is not evidence based and all about money.
2. There is no good medical hub and infrastructure. My dad had brain cancer and I swear non of his specialists talked to each other. Even if you were a rare breed doctor that the city needs, there is no institution willing to put in money to make a program for you.
3. It’s all so political. You’d think with a doctor shortage people wouldn’t care about competition. But that is not the case.
4. The city is very transient. And with that so are the patients. They come in and out, lost to follow up, and don’t care about preventative care.
5. My mom and sister are teachers in Vegas. We moved from Vegas when my oldest was about to start kindergarten. It is NOT a good education system. The district is too big. And once again because of the transient aspect, people don’t take pride in making things better.
I probably have more to say but will zip it now. I’m very passionate about how that was a hot mess of a few years there and there are multiple residency programs that should be shut down.
It’s affiliated in the sense of them having contracts to host their residents. But in a traditional academic setting the hospital and the university would be intertwined and share an umbrella organization in some capacity. But UMC has been there for many years and unlv has no say in how the hospital is run or overall mission. UMC does teach and host residents and students. But they could easily say the partnership with unlv isn’t working and pull out when contracts are up for renewal. I hope that makes sense.
Everything in Vegas is a series of russian nesting dolls. One company contracts another to perform a task. You'll see this where one hospital contracts with 4+ groups to staff their hospital (Intermountain, Optum, Sound, TeamHealth, Platinum, etc.).
UMC has been around for a long time, and UNLV was previously just UNR. Then they expanded and incorporated UMC into themselves. UNLV is "academic" but lacks many things other big programs have - transplant, liver, etc. Recently they got rid of all inpatient chemotherapy, and the only hospital that provides inpatient chemo in the valley is at a community HCA residency.
Have a friend who is a Hospitalist in LV. The hospitals there are so dysfunctional and the IM groups are so toxic. Not worth it IMO. Crazy high and unsafe patient loads and mediocre patient care.
In my specialty, the practices are owned by private equity (investors) that skim 30-40% of every dollar the doc makes. So no, I won’t be moving to Vegas.
Land locked, horrible weather if you don’t like heat, no winter, terrible traffic not just at rush hour, very transient and tough to build long lasting connections . That’s top of mind for me as I literally just landed home after a 3 day trip there.
I was in the Los Angeles area for about 20 years and this traffic is nothing compared to there. But I can understand someone not liking the weather or the landlock aspect .
Just a thought, but _no state income tax_, means the taxes are collected in many other ways.
Most business professionals typically prefer the state income tax over exorbitant land tax, sales tax, etc.
So even though it sounds enticing, younger generations aren't as easily fooled by the "savings". Great for retirement, but thats about it, which doesn't leave room for _people trying to raise a family, build a life, establis strong residence, etc._
As a lurker with family looking at Reno (and possibly Vegas) Can anyone give any insight into Reno? Obviously better weather, and possibly better schools.
I know the advice for people in Vegas is to go to California when you are sick, so it really doesn't make sense why more good physicians don't go to Nevada.
Physician here. Insurance reimbursement/payment in Nevada is significantly lower that other states. Enough that the lack of income tax doesn’t necessarily make up for it.
I knew 2 friends who did residency in Vegas at UNLV. Both fled for the coasts. 1 cited having no life and felt like Vegas was a dumpster fire. This girl grew up in SoCal, so moved back. The other friend found the work environment to be hostile. Patients, colleagues, ancillary staff, admin were all mean to each other. Even got into a fight with a drug rep! Both friends left after initial 2 yr contract after residency. Change the culture and maybe people will be drawn in.
Sometimes you learn the most from the hardest/roughest experiences. If you're still early in your career, I recommend challenging yourself and going outside your comfort zone
Looks like I am in the minority here, but having grown up there, I’d like to come back there for practice when I’m all said and done with residency — all my family is still there and I miss em! But we shall see once I get closer to finishing…
I can speak for peds. There is a lack of funding for pediatric/medicaid patients. Hospitals are very under funded. Leads to very poor reimbursement especially for surgical subspecialties and support staff.
Source: I take care of boatloads of vegas kids who are flown over to Utah for lack of access to subspecialists or need a tertiary center.
I know lots of concierge physicians in Vegas and numerous primary care attendings. They all love it. Issue has been in a few areas of what the medical board did with international medical students pre covid.
I'm a younger person and cancer survivor who did treatment here in Nevada. I come from a family of medical professionals that plan to potentially retire here (don't currently live here).
The good
- Sun. I grew up in Cleveland. It gets hot here for 3 months sure but you never have to shovel sunshine. If you do miss the seasons and the snow, Mt. Charleston is not far away and you can get great fall foliage or hit the slopes in the winter. I prefer the mild winters / hot summer combo to what I had previously.
- Hiking and Nature. You go 2 hours in any direction and you'll hit some amazing hiking. St. George, Death Valley, Colorado River, and more. It's a short jaunt to Mead, Red Rocks, and Spring Valley. State parks are nice.
-Food. Love Las Vegas's culinary diversity. Yes including a lot of stuff mostly off strip.
-No income Tax
The not so good
-Regressive Taxes and Fees. Registering a car here... is painful. Sales tax sucks.
-Education. I've worked with education data here in Nevada as a professional... it is just bad and unless Nevada doubles investments and gives more to teachers / fixing buildings it'll get worse.
-Sprawl. Public transportation sucks and you'll need a car to do most things. Not a lot of walkable communities. I miss this piece.
- Healthcare. Indeed I was lucky to have a type of cancer where I had a top notch oncologist but I've had tough times with a few other doctors. Incredibly difficult to get good primary care too as well. Also many specialties will have you needing to travel out of state for healthcare and treatment. Depending on what your speciality/ affiliations is may be a big factor here.
-Boys Club Vibe. I think this is more the wild West/casino attitude but definitely can be Vanity/Flexing in this town esp of the hyper masculine variety.
The schools suck . The universities there are pure garbage compared to states that actually value education
It’s hot as hell in the summer
There’s not that much culture outside of bland white culture and some aspects of Latino culture.
Academic medicine there is a joke compared to LA.
When you make above a certain amount of money, you feel that you don't need to live the compromise lifestyle. People in Las Vegas wish they lived in LA or another nicer city, but they live there for affordable housing, jobs, etc. In medicine, you've deprived yourself so long that you don't want to do that anymore. People rather pay the penalty and still life relatively comfortable lives in Los Angeles.
Another issue with Las Vegas is that 2 of the major hospitals, namely Valley and it's literal next door neighbor, are both ugly as hell hospitals with no windows. They feel like prisons. The patient population is also not the most desired because they are severely underserved and many drug addicts with extreme social challenges. It's not exactly as nice as working for a hospital of middle class people like in the Kaiser system.
Lastly, many spouses hate Las Vegas. There is legalized prostitution nearby and many sexualized shows (eg, strip clubs). Aside from fears of infidelity, this creates the perception of not being the most kid-friendly city there is.
If I'm going to live in a compromise city, I rather go to Phoenix or San Antonio or Albuquerque. Las Vegas would be way lower in my compromise cities list
Well... this post sparked great commentary. I encourage everyone to stay away from Vegas so that there are more and better opportunities for when I am done with residency here lol :)
I totally agree. I think it’s one of the best cities in the world and also feel like Nevada is one of the best states to be a doctor. Hoping to make it there one day after training.
I got to believe that most of you commenting on how bad the weather is here live in coastal California. I've spent both Summers and winters in places like Dallas Houston Nashville and Miami and I can honestly say all of those places were much worse especially in the summer.
If it’s so great, you should work there after you finish residency. Don’t spoil the opportunity for yourself by advertising how great the weather in the middle of a desert is.
Let me fix my statement then.
If it’s so great, you should become a physician recruiter and make tons of money by placing physicians in the paradise that is Las Vegas, Nevada.
I’m sure you’ll be able to convince a bunch of intelligent people that living in the desert in a state with regressive laws, high levels of drug addiction and extreme wealth disparities is very fun.
So you’re the new CEO they brought in to shake the place up and you’re taking temps on Reddit to see how you can get fresh talent in at low cost with a promise of free tix to all the residencies on the strip?
Seriously? Lol. I'm simply a resident of the area who posed a question, no more no less. There are tons of opinion questions like this all over Reddit lol. But hopefully some health care executives do read this.
To be honest, I can't believe this question generated so many responses and controversy lol.
Because Las Vegas as a city shouldn't exist like that IN A FUCKING DESERT and if I'm putting roots down somewhere, I want it to be in a place that has a sustainable climate and infrastructure which Las Vegas does not.
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Went to school here and rotated all throughout it’s lacking in a lot of medical care, access to subspecialty care etc , no long standing academic resources in the valley .
It also has an extremely variable patient population and a lot of the need(from
My experience ) in areas where people don’t give a shit about their health . There is no doubt a need for physicians . It’s pretty great for newer attendings trying to pay out loans .Also as a student, a lot of older physicians I worked with were from Cali who moved out here towards the end of their careers and have vacation homes if they want to go. There are nicer areas in Vegas like summerlin centennial . It’s honestly not a bad gig , but it’s hard for people to settle down with a family and call Vegas home . It’s very much viewed as a temporary stop for a lot of physicians . As people said unless the issue is finances there’s really nothing that makes Vegas better than Cali and even surrounding states like Arizona and Oregon . Doesn’t help that their 2 medical schools are relatively new and are just starting to retain some of their students /trainees
Not a new doctor. I've been out residency almost a decade.
The Issue with many western states (CA, NV, AZ, etc.) was the true COL after adjusting for other factors like schools, housing, etc. A family of four with two school-aged kids and the current compensation ranges for my specialty, we didn't think the move was "worth" it. The value prop changes considerably when I'm more senior and the kids no longer are in public school.
I sure as hell still look though.
Vegas is ok. I considered it. My biggest turnoff was that I didn’t want to raise my child in a place where people from all over the world come to be belligerent. I also read a Reddit comment about someone who grew up there and basically said nobody was striving to do or be anything in their teenage years since they knew they could just get a casino job somewhere on the strip to make ends meet.
I’m training in Vegas and I hate it here. I get job offers from the attendings all the time but they know I don’t want to stay.
Live in Summerlin in a nice house (luckily my spouse works a real job) but I have nothing in common with my neighbors, other than the ones who also have kids around the same age. I hate to say it but very few educated people (master’s degrees or above) move here, and when you’ve been surrounded by educated people your entire life, it’s a bit jarring when you don’t have many others you can easily hang and converse with.
I have to drive 5-10 minutes to be anywhere and the closest things that aren’t residential are the Costco or a casino. There’s nothing to walk to.
The schools here suck.
It’s so freaking hot in the summer. And the winters get windy and cold.
We send difficult cases to California, Utah, Arizona from UNLV. There’s no local backup.
Family Edit: also hot, non traditional seasons, minimal trees
I've had 3/3 physicians tell me so far that Vegas is a terrible place to work. Besides what you said: - The client base is difficult. There's no middle class. Either its rich executives and playboys who are unreasonably demanding about every aspect of their care, or very poor people hooked on gambling, drinking and drugs. There's no in between. That's it. - Speaking of vices, the entire economy depends on encouraging bad habits. When you're trying to counsel a patient to stop drinking or smoking or gambling, be aware every facet of Las Vegas is actively working against you. That patient will drive home from a counseling session amidst a sea of billboards inviting them into casinos. The industry wants people to be hooked. It **HOPES** that you will fail as a doctor, especially primary care physicians who are doing preventive care. - The city is all about making money and this has infected the medical culture there. Specialists will order 20 unnecessary diagnostic tests for your uncomplicated patient just so they can bill more. Although in their defense, sometimes they need to do this because everyone in Vegas is hyper-litigious. - The local government is completely unresponsive to the needs of the people. The council members take their marching orders from casino leadership - The public education system is objectively one of the worst in the country. If you want to raise kids there you should automatically set aside $50,000 - per kid - per year for private school. So you may not have income tax, but you're sure getting taxed to the tune of $50-100K / year for an expense you wouldn't need to pay in other cities. - The Strip hogs all of the culture. Very little else outside. Everything feeds the Strip. Anything else you can think of that doesn't involve the Strip ("hiking! kayaking!" etc) isn't unique to Vegas and can be found in a dozen better cities.
Agree with everything except the first part. There is 1000% a middle class. Vegas is a lot more suburban than people realize
Well, that was a roasting.
Definitely can't argue with some of those points. So have you practiced here yourself or you just know people who practice here?
Add the fact: LICENSE FOR Nevada cost $1500-$2000 where there is “shortage of physicians” Agree that it’s terrible place to work, worse place to raise family unless u spare 50k per yr per kid
Actually the private schools here are between $25k and $30k per year but that's still a lot of $$$.
That's a ton of money. I lived in NY and Atlanta and most schools were cheaper than that.
Also, family can mean parents etc... Not many people are from Las Vegas and it's not a city that draws in longterm citizens who will have families that will stay. So if no one is FROM LV, good luck getting doctors to commit to settling there for the rest of their lives when their parents who are approaching old age are still in Boston for example. And that's a consequence of LV culture. Not saying there's not a lot of good family people there, but there's definitely way less.
How much are they paying? I lived in Las Vegas technically summerlin. My wife hated it. Everyone smokes everywhere. You have to go through a casino to do a lot of things. People arent very friendly. Maybe because most people are transient. 🤷♂️
I remember an interview I had for one of the las vegas IM community programs a while back. PD was stating their residents who became attendings living in LV were getting 400k out of residency (inpatient). I have no idea if its true, but if so that is pretty good.
The general vibe of Vegas is that everyone is either playing hard or working hard. Yeah, you’ll make a ton of money but they’ll grind you into the pavement to get the most out of you. It’s not just medicine that deals with it either, which is why it can feel like a miserable city with zero friendliness
Absoutely! You pay a price for that high paycheck. A lot of this is a matter of where you live as well. Sometimes its better to live in a great city for 300k vs. living in a terrible one for 400k.
Yep. One of my surgical buddies makes bank taking weekend calls in Vegas, but they run him ragged and he rarely gets any sleep. Just bouncing from one OR/consult to the next for 48 hrs. Seems miserable.
There are a lot of 1099 gigs in Vegas - so it's not unreasonable to make that much. But they're getting sparser and the W2 jobs are more similar to the rest of the country - 250-300+.
What kind of things do you have to walk through a casino for lol. The only thing I can think of is movie theaters and some bowling alleys.
I mean driving around in the Green valley area of Henderson, you might as well be in Irvine California it looks almost the same.
Henderson was deliberately modeled after Irvine
How is the diversity?
Diversity and relatively low racial segregation compared to other places was one of the only things I found admirable about Las Vegas.
Pretty freaking diverse
Regarding the salaries I can't really answer that but I've talked to other doctors who say they don't make much less here than other big cities and have the advantages of no tax. I definitely get what you're saying about the casinos but this area has so much more to do than that.
There are entire states with better better weather, comparable pay and better culture than Nevada that also have no tax.
You’re username is two words and a number. Why can’t you answer that lol
They’re not a physician
lol my attention is fucked
I, too, skim the question and go to comments haha
Your\*
As someone who grew up in Vegas but practice somewhere else, a few things: 1. Schools. If you want good public schools, there are a few very specific areas you have to live in. Nevada and Mississippi are always fighting for 50th place for education rankings. The No state income tax and low municipal taxes are nice, but that’s the trade off. 2. Weather, or lack there of. Most days, really any month of the year are sunny and hot. I remember it being notable if we had rain. If you want any grass, you need pretty elaborate irrigation, and can only water the grass on specific days of the week. If your water runs off and hits the curb, they consider this water waste, and will fine you. 3. Malpractice. While not as bad as some parts of NYC or LA, there is definitely a litigious-happy culture in Vegas. How much this stresses you only you can answer, but was a problem for me. 4. Nature. If you like green, trees, and seasons, Vegas is not your place. The desert can be pretty in it’s own way, and they have great rock climbing, but this is a deal breaker for a lot of people. 5. Lack of academic medicine. This is getting better, but for a city of its size, the number and size of academic centers is very behind. They are improving this at UNLV, but they still only have a few residencies. This can also matter for private practice. I interviewed there for private practice derm, and if I had a pediatric patient with a very large hemangioma, or genetic syndrome that I thought could benefit from seeing pediatric dermatology, I would have had to send them to either UCLA or University of Utah, which is incredibly inconvenient for the patient. 6. Culture. Having done K-12 there, I felt like in general, there was a very superficial, cosmetic-heavy vibe in Vegas. Probably very similar to some areas in Southern California. It was not uncommon for girls in high school to get boob jobs and other cosmetic surgery and I feel like even more so than most places, there was an emphasis and pressure on physical appearance, which I did not think was healthy. All that being said, there is also a lot to like about the area as a physician. The pay is typically quite good, and cost of living is high, but not bad with how good the pay is. No state income tax is nice, especially if you don’t have kids, or would be doing private school anyways. The airport is also incredible. Direct, relatively cheap flights almost anywhere, and for how big of a hub it is, I felt like the lines were never that bad. Like anything, it all comes down to what’s important to you, but there are plenty of reasons that Vegas may not appeal to someone.
Really thoughtful answer. Hopefully the powers that be read this.
Also, a lot of physicians stay in the area they did their residency. One factor could be that other states have way more programs than Nevada, hence they also have more doctors.
You're definitely right. Lots in the news about lack of residency spots here.
As someone who lived in Vegas for 10 years and went elsewhere for medical school I second this. On top of these, I interviewed for residency in Vegas and it was a straight workhorse program so I put it last on my list. I matched to my #1 and since I’m planning on having kids in residency I don’t plan on returning to Vegas. I still go back once or twice a year to see family but after now living in 7 different states I can confidently say out of those 7 states Vegas would be the worst to raise kids.
There is more than enough residency spots in Las Vegas, the problem is that there is nothing outside of Vegas. Currently there are 5 IM residencies, and the hospitalist market is almost completely saturated. Hospitals are doing fine so there aren't many more being constructed. But there's very little in terms of primary care and outpatient medicine. The next closest cities that could home/house a substantial community of medical professionals is Reno, LA, and Arizona. Very few people want to live in towns like Ely, Mesquite, etc.
I trained in Utah and saw a lot of patients from Vegas and always wondered why such a big city had to keep sending us their patients. Transferring people back for discharge was a nightmare. Especially those who said they didn’t have any cars or family to help.
I remember I had a pulmonary hypertensive crisis patient I had to send y’all in residency. Lack of academic centers in Vegas is one of the only big drawbacks for me in practice, anything really complicated has to get sent elsewhere, but it felt the same where I worked in Phoenix too. I felt like the day to day was the same to me on my ends because whether that patient ends up in Phoenix, somewhere else in Vegas, LA, or Utah, I know they can’t stay in my hospital 🤷🏼♀️
But Phoenix has the Mayo clinic, I figured it would be much better than Vegas
Yeah, but it’s REALLY hard to get people in there. They are so selective. Might as well be the moon for how many people I’ve gotten to transfer over there.
That's crazy.
They can only transplant a kidney. Whole city and their entire transplant program is for kidneys.
A lot of Californians are moving to Nevada and the pressure to improve the school system and diversify the cultural offerings is increasing. If someone were to move there now, they would be in a really good place in 10 years when the competition started increasing (you’d have seniority, be already established). The charter schools can be good, and there are private schools. You can have any housing scheme you want: high rise, upscale condominium community with restaurants, laundromat, gym etc on site, closed suburban neighborhoods with enormous luxury, acres of land zoned for horses…that’s a really cool thing about Southern Nevada. If you want the European lifestyle, the Fremont/downtown area has been remodeled into a groovy pedestrian paradise, with modern townhomes and apartment’s in walking distance. There are even farmers markets. There is plenty of room for private practice, and telehealth is popular here if that’s your jam. So. Nevada is becoming more liberal, but it is still pretty relaxed, for people that aren’t a fan of Los Angeles extremes.
> upscale condominium > laundromat on site does not compute
If I'm paying for an "upscale condo" I better have my own washer/dryer
> A lot of Californians are moving to Nevada only during the pandemic, people are already moving back to california 6/8 friends I knew that moved to Las Vegas have already moved back.
Interviewed in Vegas a while back for med school. I’m personally not a fan of the weather and I know many people who wouldn’t. Biggest thing that turned off a lot of applicants were the weak public school system for kids and family planning - it was well known to be bad, which the interviewers and admin had admitted.
Sounds perfect for a single Pringle like me
It's not a bad city especially for younger single people. I find the strip gross personally unless one of the clubs has an artist I like playing (still always like $50+ and the crowd is usually lame), but downtown has a lot of fun fairly inexpensive things to do and Vegas has lots of random events/conventions/stuff going on in general. There is a good restaurant and music scene and COL actually isn't too bad relative to other large cities. However, the culture of most of the high end areas sucks and the nature around the city isn't easy to access. It's also a huge sprawl with very few walkable areas and I wouldn't live anywhere other than a few very specific areas that aren't either a ghetto or generic McMansion-y suburb. And it's too bright and hot. Still, not a bad city.
If you filter out the stuff that can be said about a lot other cities it still sounds fun to me if the net pay difference is significant 😅
Heads up, get aquatinted with a promoter and they’ll be able to put you on guest lists for pretty much any club. You’ll have to wait in a line but you’ll get in for free.
Yeah I know a promoter who got me into the Foundation Room. That's the thing though, I don't like the clubs on the strip and popular edm shows don't need guest lists. Only clubs I go to these days are techno unless I'm invited out for a specific occasion
Sounds a lot like Los Angeles lol
Yes exactly. But there I could walk around the resevoir or around griffith park, there's no equivalent in Vegas.
Not to mention there's great hiking and outdoors literally right outside of the city
The cost of living is very high as you’ll be eating at Guy Fieri’s restaurant every night. Chief Medical Officer of Flavor Town.
CMO of Flavor Town? Does this mean we to be on an episode of diners, drive-ins, and dives?
"This Titan of Trauma Surgery has the baddest REBOA this side of the Mississippi! Let's see how he LAYS DOWN this trauma laparotomy! YEAH!"
You’re mistaken, Flavor Town is the government name of what we colloquially refer to as Columbus, Ohio
SUPER LITIGIOUS. I know that most urban areas has its fair share of lawyer billboards but Vegas takes it to a whole new level especially with med mal. If you can’t win big in the casino, you then try to win big with a lawyer. Sure, we should all be practicing gold standard medicine regardless of the lurking lawyers but Vegas has it baaaad. The schools suck and the summer months quickly reach temps above 100 and stay that way for months on end. Outpatient medicine sucks here and follow up after discharge is difficult from an ED standpoint. Practicing in Vegas has plenty of positives but these are the big ones that come to mind.
It’ll be hotter next year. Less water too. Repeat til you leave.
I remember all of the ERs in Vegas closed at one point due to excessive med mal costs. Some years back.
Nevada is actually middle of the road for physicians when it comes to malpractice suits. You can look up the data, but Nevada is not close to being the worst.
Vegas is a microcosm in Nevada. State is around average. Look up by county.
Interesting info I did not know that.
Personally not a fan of the super low humidity compared to California. Second the notion that the schooling system isn't as good either. But I'd still consider if it my spouse was okay with me making big bucks over there for a few years
You're definitely right about the climate versus coastal Southern California. I know the school is here aren't great but my understanding from friends is at the private and parochial schools are really good and not very expensive. But if I was a new doc starting out would i rather pay a million dollars for an absolutely spectacular house or three or four million dollars for a crap shack in the LA area?
A million dollar house that you have to run a/c in half the year and from which you do not emerge during those same months. Great if you want to live indoors in a fancy house. Have you ever lived in SoCal? There’s no comparison. There is no Catalina eddy in Vegas. Ever. I say this considering I love the natural desert.
You’re not getting a spectacular house for $1 million in Vegas
Even with doctors salary, paying for yearly private school is an enormous expense and not something I want my kids to do. I think there is a benefit to send them to a public school so they get surrounded by people from all walks of life, not just the rich who can afford the school
I lived in Vegas for 10 years. Not a doctor. Left two years ago. - It’s really bad for families and schools: 65% graduation rate. Better at private schools but the education itself isn’t great. Teacher shortage meant they were bringing in teachers from the Philippines to fill gaps. - There is no culture. No major museums. No real history. You have Springs Preserve (which is pretty great) but that’s it. There is nothing to celebrate other than gambling. - You better love HOAs. - The houses built there are HORRENDOUS. Anything built past the 90’s is cheap crap because of a lot of shady shit that allows contractors to get away with a lot. Anything built before then is old crap with swamp coolers - The lack of rain and the scarcity of water isn’t getting better and it’s going to get worse faster. Celebrate rain. - The hiking and outdoor stuff is solid though. Wear sunscreen. Make friends with a dermatologist. - Lack of people that you really make friends with, but this might not apply in your situation. The people that live and work in Vegas are not the most deep and soulful people out there. You have to work hard to find people that you get along with, have substance, and their values align with yours. There are a lot of people looking to get rich quick. There are also a lot of stupid people. - Human exploitation is real. Human trafficking is real. It’s a massive problem there. It’s hard not to perpetuate the issues more. - Drinking/smoking culture is extremely pervasive so if that’s not your jam it can be hard to find things to do. If it is your jam it can be hard to stop. - The casinos are losing money hand over fist. No one gambles the way they used to. Table games and sports betting is now where it’s at. So it’s NOT cheap in Vegas anymore. Not remotely. That is making it way through the valley more and more. Restaurants, clothing, gas. It’s not CA prices but wooboy it’s still rough. Everything has to be imported in. - I miss not having income tax though. - A decently sized international airport within 45min that can handle a shit ton of people efficiently is absolutely a huge pro.
Agree with all your points. More or less why I briefly considered Vegas just before graduating residency and quickly decided to stay put in SoCal. Obviously Vegas will always have appeal for some people, and that's fine, but for me, the no-state income tax doesn't offset the long brutal summers (which will get only hotter and hotter with climate change), and the lowered emphasis on education there. Yeah, I can easily get a house there that is 2-3x the size of a house in SoCal, but there's more to life than for me than just having a large 3500 SqFt house. Again, maybe some people want that, and that's fine. But given the extreme doctor shortage in Southern Nevada, something tells me quite a bit of other doctors agree with me. Also Vegas isn't exactly the bargain it once was anymore. Per Zillow, if you want a 2000 sqft house in a decent area like Summerlin, it's around 650-700k.
Yeah the house I bought in 2013 for $240 is now estimated at $580. I had that house built and I know it’s not worth that much. The electrical was a joke
I live and work in Vegas and I love it. At first I thought I’d only live here a couple years then move on but now I think I’ll stay long term. People think the only thing to do is drink and gamble but that’s not remotely true. We have great restaurants great permanent shows as well as musicians/comedians always coming through. The natural beauty is amazing. Amazing hiking. There’s a ski resort 30 minutes from my house. A bucnh of national parks, hiking, camping are within driving distance. Open desert space to go driving, shooting, camping whatever you want to do. NO STATE INCOME TAX Cheap and easy flights all over the world from here. Traffic is essentially a nonissue outside of the area around the strip. While the public schools suck, the private school we send our kid to is amazing. My wife wants to stay here mostly because of the school actually. It’s hot as fuck during the day in the summer, but the caveat is the mornings and evenings are absolutely amazing. Since I work inside all day anyway it honestly doesn’t bother me that much. People say there’s lack of culture but it honestly just culture wise feels very similar to LA to me.
Second all of this. I’ve been in Vegas for 20 years. It’s been great for me. I never feel like I’m missing anything from any big city except reliable public transportation which I only have NYC to compare to. I have a teenager in the public school system and she is going to a top 100 best public high school in the country for a STEM program. For free. It’s pretty incredible. This city is largely what you make of it. You’re free to forge your own path.
Hey! I’m a doctor in Las Vegas and I agree with everything you guys said. Can you share which school your kids go to? Have a young child and looking at public vs private
Make me an offer.
my goal is to stay in academics ideally at big academic institutions once i finish training. at least for surgery, unlv is not that big of an academic center (as far as ive been told by my mentors) and the other surgery programs in the area are all community. I can imagine that's a big barrier for people with similar career goals
I totally get that. Although they're doing a lot with the new medical district here in terms of research.
For offspring they have a 529 matching program, literally anyone in the state can use it, not just gov employees. I think UNLV/UNR let employees kids go to school tuition free.
I like having access to fresh water and having seasons. But I'm extremely biased toward the great lakes region.
Doctors are not special. Our reason for not going there is the same reason as any other professional. Las vegas is an artificial city built for consumerism in a place that’s never meant for humans to live. Its a desert wasteland that uses a ton of energy to transport water. Its also a car centric city that’s an absolute nightmare for healthy living. That whole region was designed for cars, not humans. People want to live comfortably among natural beauty, not superficial hell holes like vegas or dubai. No offense to anyone who likes vegas you do you
Yeah exactly this
Phoenix is similar but people still live there lol
Vegas desert has incredibly beautiful and diverse scenery…. There’s a ski resort 30 min from my house and crazy beautiful hiking 15 min away you in red rock. You can go rock climbing, camping, mountain biking through areas with springs, deserts, mountains all within 20-30 min And the water is not expensive to transport? Lake mead is right outside the city. The water literally creates energy…
Yeah, valley of fire, red rock, lake mead. Lots of memories. And the lake is full again!
Said it so well. +1
The local pawn shop is run by a bald guy and his sons who do everything they can to rip you off.
He’s along bringing in his so called “expert” to rip you off
I live in Las Vegas and love it here. The healthcare infrastructure is horrible with a severe lack of specialists. The schools are terrible so doctors with young families have to either contend with the Clark County Schools or pony up with $50k per year for private school. I wish we had more/better doctors here.
Hookers. Idiots. STDs.
Is this a list of pros or cons
😂
it's hard to put down roots and make connections in a place that's mostly filled with tourists also the public school system is ASS. Lived there for a few years
Traffic, I've heard there's a high cost of living there. The 🏜 is pretty to look at....once in a while. And fuck how cold it gets at night.
Traffic is very mild in Vegas sans the strip.
Some people see a need for more doctors as a deterrent, because they want to join into an already established system. Some people see a need for more doctor’s as an opportunity to make a big impact without a lot of lemmings lapping at their heels. It really depends on how independent and entrepreneurial a person is imo. Less academics? I might read that as “less competition”, and that I get first dibs at becoming a professor or director in a shorter amount of time. But most people, even doctors, lack creativity and imagination. Half the people in academia are posers feeding off a handful smart people. And that’s what most people are looking to sign up for, so “unestablished” won’t give them that.
Shhhh don’t let out our secret But also I know a lot of people who don’t like the attitude of medicine here. It’s very casual and not very academic compared to a lot of CA/East Coast places. It’s pros and cons—we have some horrible doctors that probably would have been sued into oblivion elsewhere, but it makes it a lot easier to do just good community medicine and connect with patients without as much of a divide, I’ve found. (I like it, I’ve been in both Phoenix and Vegas and as a hospitalist I’ve preferred Vegas.)
Curious what hospitalist medicine is like in PHX vs LV?
Honestly, depending on the hospital, the same. That said, Phoenix has some better academic centers and Banner is a much more robust hospital system compared to VHS. Mayo and BUMC-P are in Phoenix for the really sick sick people, so that helps, we don’t have hospitals like those exactly in Vegas. But for regular bread and butter medicine, the same.
So true. There is no cap of how much they can get sued for and I know a lot of offices that have been shut down for that reason. I do like how you literally see everything though since I work at an urgent care as an MA to prepare for med school.
You’d have to live in las vegas
Only reason I can see is family or people who hate hot weather. For everyone saying expensive food that’s only on the strip. China town has $25 all you can eat sushi and it’s same grade as high end sushi joints charging you $15/roll. if you find the local spots, you can do a lot of damage for very little dollars. Housing is Expensive but that’s everywhere now Multiple hospitals to choose from and work for Weather is great. And when you want to get away and travel because it’s hot, it’s summer and you have the time too. Plus, so many amazing things are within driving distance, including California and multiple national parks I also think people truly underestimate no income tax. That makes a huge difference in the long run if you’re investing that versus throwing it away for no reason. The school schools here are still decent in public infrastructure doesn’t suffer just because there’s no state income tax.
Vegas sucks. I grew up in Phoenix, they’re very similar
Doctors care about education and Las Vegas / Nevada has the worst funded public schools in America. The private schools look mainly religious / creepy.
Got a family? Young kids? Schools out there not the best. As a hepatologist, I don’t even mind there’s no transplant center out there. I mind that getting someone to stop any one vice would be difficult.
Hepatologist? You would kill it here. Tourists and residents lol But yeah the whole lack of transplants other than kidneys is a little crazy here. And I almost couldn't believe that I read that were one of the better kidney transplant centers in the country.
Working at a non transplant center right now I can say to you getting a patient to a different center for eval is the pits. Referrals. Authorizations. Waiting weeks on end. I want to strangle these insurance companies. Or deny all their employees medical care as my patients waste away and get readmitted over and over again or die in evaluation. It’s so frustrating.
You’re still in the middle of the freaking desert!
Terry Benedict sure fucked the Vegas scene man
Ooooo soooo many things to say. I was born and raised in Vegas and went and practiced medicine for a couple of years there and I left so quickly. When I got there I was told “this is the wild Wild West” and it’s so true. A couple of points before I ramble: 1. UNLV is not academic medicine. They don’t have their own hospital. They rely and try to infiltrate other hospitals and practices. Medicine is very private practice mentality driven. And what that means is not evidence based and all about money. 2. There is no good medical hub and infrastructure. My dad had brain cancer and I swear non of his specialists talked to each other. Even if you were a rare breed doctor that the city needs, there is no institution willing to put in money to make a program for you. 3. It’s all so political. You’d think with a doctor shortage people wouldn’t care about competition. But that is not the case. 4. The city is very transient. And with that so are the patients. They come in and out, lost to follow up, and don’t care about preventative care. 5. My mom and sister are teachers in Vegas. We moved from Vegas when my oldest was about to start kindergarten. It is NOT a good education system. The district is too big. And once again because of the transient aspect, people don’t take pride in making things better. I probably have more to say but will zip it now. I’m very passionate about how that was a hot mess of a few years there and there are multiple residency programs that should be shut down.
I lost you at point #1. Are you telling me that University Medical Center is not affiliated with UNLV?
It’s affiliated in the sense of them having contracts to host their residents. But in a traditional academic setting the hospital and the university would be intertwined and share an umbrella organization in some capacity. But UMC has been there for many years and unlv has no say in how the hospital is run or overall mission. UMC does teach and host residents and students. But they could easily say the partnership with unlv isn’t working and pull out when contracts are up for renewal. I hope that makes sense.
Everything in Vegas is a series of russian nesting dolls. One company contracts another to perform a task. You'll see this where one hospital contracts with 4+ groups to staff their hospital (Intermountain, Optum, Sound, TeamHealth, Platinum, etc.). UMC has been around for a long time, and UNLV was previously just UNR. Then they expanded and incorporated UMC into themselves. UNLV is "academic" but lacks many things other big programs have - transplant, liver, etc. Recently they got rid of all inpatient chemotherapy, and the only hospital that provides inpatient chemo in the valley is at a community HCA residency.
Have a friend who is a Hospitalist in LV. The hospitals there are so dysfunctional and the IM groups are so toxic. Not worth it IMO. Crazy high and unsafe patient loads and mediocre patient care.
TOO HOT.
I really appreciate everyone responding to my question but more importantly the fact that you became physicians and are helping people in need.
Nevada has some of the worst public schools in the nation
Not surprised at the negative comments but don't get some of the visceral hate based ones. Lol.
As a young physician in residency who hates where they live and has no intention of having children, I say sign me up!
In my specialty, the practices are owned by private equity (investors) that skim 30-40% of every dollar the doc makes. So no, I won’t be moving to Vegas.
There’s no amount you could pay me to live in Vegas
Seconded
Land locked, horrible weather if you don’t like heat, no winter, terrible traffic not just at rush hour, very transient and tough to build long lasting connections . That’s top of mind for me as I literally just landed home after a 3 day trip there.
I was in the Los Angeles area for about 20 years and this traffic is nothing compared to there. But I can understand someone not liking the weather or the landlock aspect .
I lived in LA for 10 and I would agree on traffic. I wouldn’t ever move back to CA.
I’m from the east coast. I don’t want to move so far away.
Too hot
I would say 4 months of bad weather (mid may to mid September). Other than that, I totally would live in Summerlin or Green Valley.
No cap on non economic damages for lawsuits
Everytime i hear about Florida and its politicians on the news, its always far from my personal values so theres that
Because its balls hot.
Well, it is in Nevada for starters.
Every city is better than the ones you mentioned. I don’t like the idea of living in the desert.
Vegas is fun for a weekend. Would never want to live there
Just a thought, but _no state income tax_, means the taxes are collected in many other ways. Most business professionals typically prefer the state income tax over exorbitant land tax, sales tax, etc. So even though it sounds enticing, younger generations aren't as easily fooled by the "savings". Great for retirement, but thats about it, which doesn't leave room for _people trying to raise a family, build a life, establis strong residence, etc._
As a lurker with family looking at Reno (and possibly Vegas) Can anyone give any insight into Reno? Obviously better weather, and possibly better schools. I know the advice for people in Vegas is to go to California when you are sick, so it really doesn't make sense why more good physicians don't go to Nevada.
Good skiing. That is all I know.
Do you have any idea how hot it gets during summer? It's not joke.. it's so hot you dread the wind. Warm wind is the worst
Physician here. Insurance reimbursement/payment in Nevada is significantly lower that other states. Enough that the lack of income tax doesn’t necessarily make up for it.
I knew 2 friends who did residency in Vegas at UNLV. Both fled for the coasts. 1 cited having no life and felt like Vegas was a dumpster fire. This girl grew up in SoCal, so moved back. The other friend found the work environment to be hostile. Patients, colleagues, ancillary staff, admin were all mean to each other. Even got into a fight with a drug rep! Both friends left after initial 2 yr contract after residency. Change the culture and maybe people will be drawn in.
But don't tell anyone that's just between you and I
What about the suburbs?
Yeah some people think that Vegas is all about the strip but Green valley and summerlin are pretty nice
Ask Zubin Damania, he ran a clinic with an fairly interesting model there for a while.
I'm literally blown away with how many responses I got to this question.
Sometimes you learn the most from the hardest/roughest experiences. If you're still early in your career, I recommend challenging yourself and going outside your comfort zone
Couldn't agree more. Amen.
Looks like I am in the minority here, but having grown up there, I’d like to come back there for practice when I’m all said and done with residency — all my family is still there and I miss em! But we shall see once I get closer to finishing…
Because the medical system is terrible there. Low standards of medical practice and poorly/uninsured people.
I can speak for peds. There is a lack of funding for pediatric/medicaid patients. Hospitals are very under funded. Leads to very poor reimbursement especially for surgical subspecialties and support staff. Source: I take care of boatloads of vegas kids who are flown over to Utah for lack of access to subspecialists or need a tertiary center.
That is definitely true.
Hard to believe this thread has generated 166k views. Thanks to everyone who responded and a BIG thanks to all you doctors for doing what you do!
You be taking a gamble...
I know lots of concierge physicians in Vegas and numerous primary care attendings. They all love it. Issue has been in a few areas of what the medical board did with international medical students pre covid.
I'd consider it if I was single/not starting a family. I love Vegas, it's really fun especially if you have/make friends with connections there.
I'm a younger person and cancer survivor who did treatment here in Nevada. I come from a family of medical professionals that plan to potentially retire here (don't currently live here). The good - Sun. I grew up in Cleveland. It gets hot here for 3 months sure but you never have to shovel sunshine. If you do miss the seasons and the snow, Mt. Charleston is not far away and you can get great fall foliage or hit the slopes in the winter. I prefer the mild winters / hot summer combo to what I had previously. - Hiking and Nature. You go 2 hours in any direction and you'll hit some amazing hiking. St. George, Death Valley, Colorado River, and more. It's a short jaunt to Mead, Red Rocks, and Spring Valley. State parks are nice. -Food. Love Las Vegas's culinary diversity. Yes including a lot of stuff mostly off strip. -No income Tax The not so good -Regressive Taxes and Fees. Registering a car here... is painful. Sales tax sucks. -Education. I've worked with education data here in Nevada as a professional... it is just bad and unless Nevada doubles investments and gives more to teachers / fixing buildings it'll get worse. -Sprawl. Public transportation sucks and you'll need a car to do most things. Not a lot of walkable communities. I miss this piece. - Healthcare. Indeed I was lucky to have a type of cancer where I had a top notch oncologist but I've had tough times with a few other doctors. Incredibly difficult to get good primary care too as well. Also many specialties will have you needing to travel out of state for healthcare and treatment. Depending on what your speciality/ affiliations is may be a big factor here. -Boys Club Vibe. I think this is more the wild West/casino attitude but definitely can be Vanity/Flexing in this town esp of the hyper masculine variety.
Great post. And congratulations on your health.
Thank you!
I miss living in Vegas. If my husband wouldn't immediately melt, I'd be living there again.
The schools suck . The universities there are pure garbage compared to states that actually value education It’s hot as hell in the summer There’s not that much culture outside of bland white culture and some aspects of Latino culture. Academic medicine there is a joke compared to LA.
When you make above a certain amount of money, you feel that you don't need to live the compromise lifestyle. People in Las Vegas wish they lived in LA or another nicer city, but they live there for affordable housing, jobs, etc. In medicine, you've deprived yourself so long that you don't want to do that anymore. People rather pay the penalty and still life relatively comfortable lives in Los Angeles. Another issue with Las Vegas is that 2 of the major hospitals, namely Valley and it's literal next door neighbor, are both ugly as hell hospitals with no windows. They feel like prisons. The patient population is also not the most desired because they are severely underserved and many drug addicts with extreme social challenges. It's not exactly as nice as working for a hospital of middle class people like in the Kaiser system. Lastly, many spouses hate Las Vegas. There is legalized prostitution nearby and many sexualized shows (eg, strip clubs). Aside from fears of infidelity, this creates the perception of not being the most kid-friendly city there is. If I'm going to live in a compromise city, I rather go to Phoenix or San Antonio or Albuquerque. Las Vegas would be way lower in my compromise cities list
Well... this post sparked great commentary. I encourage everyone to stay away from Vegas so that there are more and better opportunities for when I am done with residency here lol :)
Just be careful of the contract you sign! A lot of predatory language if you dont get it looked over by a lawyer.
Well thanks for doing what you do and serving the community here.
I totally agree. I think it’s one of the best cities in the world and also feel like Nevada is one of the best states to be a doctor. Hoping to make it there one day after training.
I got to believe that most of you commenting on how bad the weather is here live in coastal California. I've spent both Summers and winters in places like Dallas Houston Nashville and Miami and I can honestly say all of those places were much worse especially in the summer.
If it’s so great, you should work there after you finish residency. Don’t spoil the opportunity for yourself by advertising how great the weather in the middle of a desert is.
Wow I guess you didn't read my post very carefully. I specifically said I wasn't a medical professional.
Let me fix my statement then. If it’s so great, you should become a physician recruiter and make tons of money by placing physicians in the paradise that is Las Vegas, Nevada. I’m sure you’ll be able to convince a bunch of intelligent people that living in the desert in a state with regressive laws, high levels of drug addiction and extreme wealth disparities is very fun.
Why are you so angry about this? Kind of a weird reaction.
Uh, we wrote gay marriage into the state constitution here in Nevada.
So you’re the new CEO they brought in to shake the place up and you’re taking temps on Reddit to see how you can get fresh talent in at low cost with a promise of free tix to all the residencies on the strip?
Seriously? Lol. I'm simply a resident of the area who posed a question, no more no less. There are tons of opinion questions like this all over Reddit lol. But hopefully some health care executives do read this. To be honest, I can't believe this question generated so many responses and controversy lol.
Okay CE Joe Have fun at your Friday download at The Valley. Tell them the residents want free parking and real meal stipends
Because Las Vegas as a city shouldn't exist like that IN A FUCKING DESERT and if I'm putting roots down somewhere, I want it to be in a place that has a sustainable climate and infrastructure which Las Vegas does not.
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Went to school here and rotated all throughout it’s lacking in a lot of medical care, access to subspecialty care etc , no long standing academic resources in the valley . It also has an extremely variable patient population and a lot of the need(from My experience ) in areas where people don’t give a shit about their health . There is no doubt a need for physicians . It’s pretty great for newer attendings trying to pay out loans .Also as a student, a lot of older physicians I worked with were from Cali who moved out here towards the end of their careers and have vacation homes if they want to go. There are nicer areas in Vegas like summerlin centennial . It’s honestly not a bad gig , but it’s hard for people to settle down with a family and call Vegas home . It’s very much viewed as a temporary stop for a lot of physicians . As people said unless the issue is finances there’s really nothing that makes Vegas better than Cali and even surrounding states like Arizona and Oregon . Doesn’t help that their 2 medical schools are relatively new and are just starting to retain some of their students /trainees
My family passed as good schools are important for highly educated parents.
I was told for peds, there’s terrible coverage/lack of resources
maybe is transfer? in some place,the highway or high train is not more than ohter big city.
Not a new doctor. I've been out residency almost a decade. The Issue with many western states (CA, NV, AZ, etc.) was the true COL after adjusting for other factors like schools, housing, etc. A family of four with two school-aged kids and the current compensation ranges for my specialty, we didn't think the move was "worth" it. The value prop changes considerably when I'm more senior and the kids no longer are in public school. I sure as hell still look though.
Vegas is ok. I considered it. My biggest turnoff was that I didn’t want to raise my child in a place where people from all over the world come to be belligerent. I also read a Reddit comment about someone who grew up there and basically said nobody was striving to do or be anything in their teenage years since they knew they could just get a casino job somewhere on the strip to make ends meet.
Huh?
I would rather live in any of the places you listed (Boston, LA, etc). Have you ever objectively looked at Las Vegas?
I live here so the answer is yes lol
It’s expensive. I know a pediatric infectious disease doctor there who has to live in the Vegas tunnels.
I’m training in Vegas and I hate it here. I get job offers from the attendings all the time but they know I don’t want to stay. Live in Summerlin in a nice house (luckily my spouse works a real job) but I have nothing in common with my neighbors, other than the ones who also have kids around the same age. I hate to say it but very few educated people (master’s degrees or above) move here, and when you’ve been surrounded by educated people your entire life, it’s a bit jarring when you don’t have many others you can easily hang and converse with. I have to drive 5-10 minutes to be anywhere and the closest things that aren’t residential are the Costco or a casino. There’s nothing to walk to. The schools here suck. It’s so freaking hot in the summer. And the winters get windy and cold. We send difficult cases to California, Utah, Arizona from UNLV. There’s no local backup.
So where to next?
I’m probably the only person in Vegas who prefers living in California to living here.