Medical Schools Worried about the Bottom Line

Article excerpt

There's only so much medical school students can do with

frogs and fetal pigs.

Sooner or later, they've got to have patients -- and Francis

J. Tedesco is fast running out of patients. Pun in tended.

"Medical education funding is being cut dramatically at both

the federal and state level," said Tedesco, who as president of

the Medical College of Georgia oversees the state's only

full-time public teaching hospital.

"I'm sure their priority is delivery of medical services, but

that's shortterm correct and long-term incorrect," he said of

government budgetwriters. "If you undermine the medical

education programs, you are eating your seed corn."

The latest blow to medical schools came in the new federal

budget, which aims to cut back on a glut of resident or trainee

physicians, especially those studying high-cost specialties such

as anesthesiology and radiology.

Regulators are concerned that, rather than competition driving

down costs, overproduction of specialists leads to over-use of

medical services.

So Medicare, which last year paid hospitals $9 billion to train

98,076 residents, is capping residencies at 1996 levels and

offering to let hospitals eliminate trainee slots with no loss

of federal money.

By itself, the change is no disaster. But the Medical College

of Georgia and other schools already were reeling from the new

wave of cut-rate managed-care contracts that threaten the

livelihood of teaching hospitals.

Medicare and its sister program, Medicaid, pay a premium for

care rendered by a teaching hospital on the assumption that more

people will be involved and efficiency might be sacrificed for

the sake of learning. But private health-maintenance

organizations generally won't match those payments.

Meanwhile, advances in health care -- and in health coverage --

have driven down the length of hospital stays industrywide. …

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