James M. Alexander, M.D., an experienced leader and clinician in OB/GYN, is regularly in the room at the beginning of something new, so it’s fitting that he is one of the first jointly appointed senior clinical leaders of Nevada’s first integrated health system.
As the chair of the department of obstetrics and gynecology at the University of Nevada, Reno School of Medicine (UNR Med) and Renown Health, Dr. Alexander will lead the medical and surgical services, academic advancement, research and teaching programs for the healthcare system. A 50-year affiliation agreement signed in 2021 solidified the integration of the UNR Med, Nevada’s first medical school, with Renown, northern Nevada’s most extensive health system.
“The affiliation offers a remarkable opportunity to advance health and health care through medical education, clinical research, and patient care for our community and our state,” Dr. Alexander said. “By integrating our teaching, research, and patient care, we can make a difference for women and children in Nevada and beyond.”
He is one of the first of several planned joint-chair hires for UNR Med and Renown.
“Dr. Alexander is a dedicated obstetrician and gynecologist who takes great pride in his work as a researcher and mentor,” said Melissa Piasecki, M.D., UNR Med Acting Dean and Renown Chief Academic Officer. “He has a deep commitment to improving women's health and fostering the careers of future physicians in this specialty. Our school of medicine and health system are very fortunate to have recruited Dr. Alexander and will benefit from the growth of clinical services, medical education, and clinical research in obstetrics and gynecology under his direction.”
By advancing medical education in the state in his new role, Dr. Alexander will also help address Nevada’s physician shortage. According to the 2022 Physician Workforce in Nevada Chartbook, Nevada has fewer primary care physicians, dentists and mental health providers per capita than the United States.
“Shaping the future of healthcare in our state has never been more important than it is now,” said Rahul Mediwala, M.D., Chief Medical Officer of the Health Services Division at Renown Health. “I do not doubt that Dr. Alexander will apply his skills, enthusiasm, and guiding leadership to improve our community's health through increased access to care, innovative health care delivery, and expanding clinical research.”
Dr. Alexander has made recruiting, educating, and keeping OB/GYN specialists a top priority since, according to the chartbook, Nevada needs to hire more than 80 new OB/GYN specialists to reach the national average of doctors per 100,000 people.
“We are primary care doctors for so many women who only see an OB/GYN,” he said. “So not having enough OB/GYN doctors is a big problem, especially in rural areas. Getting more OB/GYNs here will improve women's health in Nevada—no question. And my goal is not just to stop there.”
A maternal-fetal medicine specialist, Dr. Alexander emphasized the importance of training doctors specializing in gynecologic oncology, female pelvic medicine, reconstructive surgery, reproductive endocrinology, and infertility.
“Specialists will have the latest and best treatment for health challenges such as chronic pelvic pain, endometriosis, cancer, and more,” Dr. Alexander said. “Without having access to a specialist nearby, our patients must travel to another state, which is a burden and a disincentive to get the care they need. The closer we can provide care to their homes, the better it is for everyone.”
Research is another crucial aspect of a student’s education and UNR Med's impact on the larger community. Combining the resources of UNR Med and Renown is a powerful opportunity, Dr. Alexander said, especially when considering the capacities of the Clinical Research Center.
“The Clinical Research Center can act as another bridge between UNR Med and Renown,” Dr. Alexander said. “Research projects require multi-departmental and organizational cooperation, so they can help facilitate those relationships and those interactions.”
More residents must be trained in obstetrics and gynecology to increase the number of doctors who can deliver that kind of treatment in the state. The same goes for enlisting and keeping top-notch academics, teachers and medical professionals who can mentor the next generation of practitioners.
“You can study and learn about being a doctor from the books. You can simulate certain clinical situations,” Dr. Alexander said. “But at some point, you can't go further without doing the apprenticeship known as a residency because there are so many variations to real-life medicine that simply cannot be recreated in the classroom. For our students, working with an experienced doctor is critical.”
Dr. Alexander’s career includes many examples of the connection between clinical education and practice as both a learner and a teacher.
A 1991 graduate of the University of Texas at Houston, Dr. Alexander most recently chaired the OB/GYN department at the Kirk Kerkorian School of Medicine at UNLV. He completed his residency at the University of Alabama at Birmingham and a fellowship in maternal-fetal medicine at the University of Texas Southwestern. After finishing his fellowship, he was recruited to the faculty at UTSW and held several leadership positions there, including chief of the obstetrics service.
Dr. Alexander established himself as a clinical investigator at UTSW and served as co-investigator on several studies conducted by the Maternal-Fetal Medicine Units Network of the Eunice Kennedy Shriver National Institute of Child Health and Human Development. He has published widely on obstetrics and maternal-fetal medicine topics, including cesarean delivery, prematurity, obstetric complications, labor management, and obstetric anesthesia. He has contributed to the leading textbook on obstetrics, “Williams Obstetrics.”
Following his tenure at UTSW, Dr. Alexander held the positions of division director of maternal-fetal medicine at the University of Arkansas for Medical Sciences and the director of maternal-fetal medicine and obstetrics at the Billings Clinic. He is board certified in obstetrics and maternal-fetal medicine and is currently an American Board of Obstetrics and Gynecology examiner.
But he'll also tell you that his college experience managing the lunchtime rush at a water park's food court was his first lesson in overseeing a hospital's labor and delivery unit.
“We had 10,000 visitors a day, and I was a guy that made sure the hamburgers got cooked,” he said. “At noon, it's a huge rush. It's a madhouse, and you can't keep up with it. That's not unlike labor and delivery, too. For hours there may be little going on in the unit, then suddenly, five women show up, all in labor and all needing immediate attention. You must learn how to handle that surge and ensure they get the optimal care.”
Dr. Alexander wants to convey these teachings to his students and inspire the integrated OB/GYN department.
“We have a real desire to do something special here,” he said. “The patient care in and of itself is enough to go home and call your mom, and she'll be proud of you. Or tell your family, ‘I'm making a difference.’ But I think these folks can even say something more than that at this juncture. They can say, ‘I'm part of a university-based, large, well-respected regional medical healthcare system, and we just kicked it up a notch.’”