You may have played through New Vegas and made your way along each designated area, from Goodsprings to Primm, on to Nipton, and so on. However, you don't have to do this as you can seep right out of Doc Mitchell's house and head straight to the Lucky 38. You will have to be a veteran player, though, as even on the easiest difficulty, you will still have to fight Deathclaws, Cazadors, and loads of other fearsome foes. Basically, it's a higher risk for a big reward, or at the very least, a big shortcut.