Creating a new Washington State University medical school in Spokane would undermine our shared goal of bringing more doctors to underserved communities in Washington, writes guest columnist Jim McDermott.
AS the Legislature crafts a budget for the 2015-17 spending cycle, lawmakers in Olympia are going to have to make some tough choices. Our state faces a funding shortfall, and it is critical that we invest in programs and projects that are truly in the best interest of the people of Washington.
Unfortunately, Washington State University wants to establish a new medical school in Spokane, something that requires approval from the Legislature. This unwise use of our finite resources would inject destructive regional competition into what has long been a collaborative effort. It would break apart a system that serves as a model for regional medical education. And it would undermine our shared goal of bringing more doctors to underserved communities in Washington.
A better way to address the statewide need for a robust physician workforce — particularly our glaring need for more primary-care doctors in rural areas — is to support and build upon the existing WWAMI program.
This partnership between the University of Washington and universities throughout a five-state region (Washington, Wyoming, Alaska, Montana and Idaho) is one of the pre-eminent institutions of medical education in the country. Students spend their first year at their home universities, including WSU, then study at the UW in Seattle during their second year, and then perform clinical rotations at satellite locations throughout the state and region.
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Through these experiences, WWAMI students get extensive training in community settings, preparing them spectacularly for careers in primary care. This innovative model is consistently ranked by U.S. News & World Report as providing the finest training in rural health and family medicine in the nation.
Yet despite this academic excellence, the cost of educating WWAMI students is about 35 percent lower than the average American medical school. This is an exceptional return on investment.
The brilliance of WWAMI relies heavily upon the collaborative nature of the program and UW’s position as one of the world’s pre-eminent research institutions. These are advantages that a new medical school in Spokane would not be able to replicate in today’s political climate.
WWAMI was developed primarily during the 1960s and ’70s, a period in which the United States enthusiastically invested in programs to benefit the public good. Under the leadership of then U.S. Sen. Warren Magnuson — a powerful appropriator and a visionary legislator — ambitious federal initiatives brought millions of federal dollars to the state of Washington. So great was Magnuson’s impact that a biographer would later describe the UW School of Medicine as “the college that Maggie built.”
Thanks to these seeds planted decades ago, the University of Washington has grown into a research powerhouse. The No. 1 public recipient of federal research dollars, the UW received more than $600 million in federal research grants from the U.S. Department of Health and Human Services in 2012 alone.
In an era of sequestration and federal budget cuts, a new WSU medical school would struggle to achieve this level of funding.
Lacking strong federal support, the proposed medical school would need to rely heavily on funding from the state. This would place the cities of Seattle and Spokane into a zero-sum battle over resources. That is the battle that is playing out in Olympia right now.
Neither side would win this fight. In the meantime, we would neglect Washington’s growing health-care workforce needs.
By 2030, the state is projected to have a shortage of nearly 1,700 primary-care doctors. Rural and many poor urban areas will be hit the hardest, and it will become increasingly difficult for patients to get the care they need.
Many Washington students also lack the opportunity to attend medical school in their home state. The number of slots offered to WWAMI students has not kept pace with growth in our state’s population, and each year the program turns away many well-qualified applicants.
But rather than starting from scratch with an expensive new medical school at WSU, we can find cost-effective solutions.
We could build upon the existing infrastructure of WWAMI to expand the number of slots available in Washington beyond its current level of 120 per year. We could provide Army Reserve Officers’ Training Corps-style scholarships to medical students who commit to practicing primary care in underserved areas. We can expand opportunities for graduate medical education in settings suitable to primary care.
What we must not do is support an effort to break apart the country’s finest and most efficient program for training primary-care physicians. To spend our finite resources on such a project would be a mistake that would do long-term damage to our state’s ability to meet the health-care needs of its people.