There are a host of new or improved treatments for Nevada patients with cancer, stroke and neurological conditions, which are often treated in California, Utah and Arizona.

Health care providers say there a lot of reasons why people leave the state such as privacy, a perception of better care or a belief that their treatment is not available here.

"Las Vegas never recognizes the potential and the accomplishments of the surgeons and medical professionals that practice daily," Dr. John Thalgott said. "We've attracted very well-trained tertiary professionals from all walks of medicine. It's the older generations of Nevadans that don't understand the magnitude of the health care that can be provided here. They still have the perception as it was 20 years ago."

As Las Vegas has grown so has the medical profession, with a medical school and more complex medical services, many of which are similar to what is being provided in neighboring states, he said.

Thalgott, an orthopedic surgeon with the Western Regional Center for Brain & Spine Surgery in Las Vegas, is one of several Las Vegas Valley doctors implanting a lumbar artificial disc in younger patients that replaces torn discs and enables movement in the lower spine versus fusing the area together. The Food and Drug Administration approved the disc last year and Thalgott helped design the instruments and techniques used for the disc implantation.

"I'd like to see the residents of the valley feel more comfortable with the doctors here," said Dr. Jaswinder Grover, a Las Vegas orthopedic surgeon who implants the lumbar artificial disc.

"I do still believe many people leave with the belief that they are going to get better care in Los Angeles," he said, adding that he trained there and the care is not superior. "Sometimes when they leave, they may actually be getting inferior care."

Dr. Ben Venger, a neurosurgeon in Las Vegas and a member of the Nevada Neurosciences Institute at Sunrise Hospital, said Las Vegas is off to a good start to changing its health care perception.

He said the local media is partly to blame for the health care perception because it "emphasizes a lot of negative aspects of medicine here; people dying on the doorsteps of hospitals and things like that."

Another reason people leave the state is because they are enticed by seminars and advertisements sponsored by out-of-state companies and doctors.

"There's an economic incentive for many of these programs to market in our community," Venger said. "There's nothing wrong with that. It's perfectly legal, but unfortunately we bear the brunt of it and sometimes when they (patients) have complications we have to care for them."

In the 1960s it was the norm for patients to seek higher-level care in other states, but few need to be transferred out-of-state now, Venger said.

With Sunrise's launch of the Nevada Neurosciences Institute many of the treatments that have existed for a few years are now being highlighted, treatments such as the Gamma Knife, which provides cobalt radiation treatment using a laser to destroy abnormal tissue such as brain tumors.

St. Rose Dominican Hospitals - Siena Campus is purchasing a new biplane, flat-panel imaging machine that enables doctors to diagnose and treat head abnormalities such as aneurysms without opening the skull. The machine can also be used on some patients with stroke symptoms.

"It reduces the length of time on the table," Aimee Moran, St. Rose's lead angiography technologist, said. "For brain work, time is very important. You don't want to leave a catheter in a person's brain any longer than you have to."

St. Rose will be the first hospital in Nevada and the fifth in the nation to offer this machine and its services, which will be launched June 1, Moran said.

"It's a good service for our patients so they don't have to leave the city," said Dr. Baljit Deol, a specialist in interventional neuroradiology.

Dr. Paul Michael, a medical oncologist with Comprehensive Cancer Centers of Nevada, said there are two types of people who leave the state for medical treatment: VIPs who want privacy and insured people who want a second opinion or seek experimental therapies.

"People who are seeking experimental therapies for cancer, strokes, Parkinson's, a brand-new drug that's not approved by the FDA, those people still have to many times leave town," he said. "The one thing we still don't get enough of is experimental drugs. The FDA is very particular and careful about who gets these drugs so you have to go out of town for those things.

"As any city grows, like LV has, and expands the number of hospitals, you're going to be getting more people and services here," Michael said. "In children, there's still some children that might go out of town. (Also,) we don't do enough transplants here. The only thing we're doing here are kidney transplants."

Michelle Swafford covers health care and small business for In Business Las Vegas and its sister publication, the Las Vegas Sun. She can be reached by e-mail at swafford@ lasvegassun.com or at (702) 259-2326.