LAS VEGAS — Nevada’s chief medical officer, Ihsan Azzam, has been one of the state’s highest-paid employees for years.

He also doesn’t have a medical license in Nevada. And unlike some neighboring states, Nevada doesn’t require it for his position as a top public health officer.

Azzam, who works in the Division of Public and Behavioral Health, made about $319,081 in total compensation last year, highest among state employees, according to payroll data the Las Vegas Review-Journal obtained through a public records request.

He oversees public health surveillance, epidemiology and disease control activities, according to his official bio. His pay package topped the list among state workers in 2021 as well and was second-highest in 2022 and 2020, payroll data shows.

Azzam earned his medical degree in Romania, practiced medicine as an obstetrician gynecologist in Africa and completed both his master’s of public health and PhD at the University of Nevada, Reno, according to court records and his bio.

State records do not show a medical license for him in Nevada.

In 2018, he testified at a court hearing — in a case centered around Nevada’s death-penalty drugs — that he does not have any board certifications and that he is not licensed to practice medicine in the U.S.

He also confirmed in court that the last time he treated patients was around 1991, according to a transcript of the hearing.

Promotes ‘health of the population and communities’

Azzam has been Nevada’s chief medical officer since 2018. Despite his elevated position in public health, he kept a low profile throughout the COVID-19 pandemic.

He did not appear on weekly video calls between reporters and state health officials, nor did he give interviews or appear at news conferences.

Natalie Yanish, public information officer for the Division of Public and Behavioral Health, said in a statement that its mission is to protect and improve people’s health and safety, and that Azzam supports these efforts “through his expertise in the areas of public health surveillance, disease investigation and prevention.”

Azzam has spent 28 years with the division, including as the state epidemiologist, according to the statement.

“He is not a licensed physician in Nevada as he has worked in the field of public health to promote the health of the population and communities,” Yanish said.

She also noted that board certification is not a requirement for the chief medical officer under state law.

Throughout the pandemic, she added, Azzam was issuing updates and recommendations to healthcare providers and working with local, state, regional and federal officials.

Among other things, Azzam was chair of the COVID-19 medical advisory team formed by then-Gov. Steve Sisolak, Yanish noted.

The Nevada State Medical Association said the state’s chief medical officer should be a physician licensed in Nevada and board certified in their specialty.

“Providing care in the state of Nevada is the most effective way to ensure that this physician understands the unique problems in Nevada,” association President Joey Adashek, an OB/GYN, said in a statement.

Job requirements

Nevada lawmakers in 2013 approved a bill that replaced the state health officer position with a chief medical officer.

The measure, Assembly Bill 488, says the chief medical officer must be a U.S. citizen and have at least five years of management experience in behavioral or public health.

The chief medical officer must also be licensed or “eligible for a license” as a physician or administrative physician, or be a physician or administrative physician with an advanced degree in public health or a related field.

By comparison, the Review-Journal confirmed that top public-health officers in at least six Western states — California, Utah, Arizona, Washington, Colorado and New Mexico — hold a medical license.

California, Utah, Colorado and Washington law require the license for the position. New Mexico statute does not, but having a license was a required part of the chief medical officer’s job description, said New Mexico Department of Health spokesman David Barre.

Arizona’s chief medical officer position is not outlined in state law and is not a mandated position for the Department of Health Services, spokeswoman Magda Rodriguez said.

Oregon’s former chief medical officer, who held the post from 2018 to 2023, has a medical license, state records show.

But there is no legal requirement for the job-holder to have one, said Oregon Health Authority spokeswoman Franny White, who noted state officials are looking to fill the chief medical officer position.

Here’s a look at Nevada’s top-paid state government employees in 2023, as measured by total compensation, according to the Nevada Department of Administration:

• Azzam: $319,080.73.

• Leon Ravin, statewide psychiatric medical director, Division of Public and Behavioral Health: $315,103.20.

• Mario Gomez, deputy director of operations and maintenance, Department of Transportation: $301,696.83.

• Thomas Kim, senior psychiatrist, Division of Public and Behavioral Health: $300,138.89.

• Theodore Parento, senior psychiatrist, Department of Corrections: $294,369.66.

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