Medical Schools Worried about the Bottom Line
LoMonte, Frank, The Florida Times Union
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
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. …