(Editor's note: On Monday, UC Davis Medical Center Chief Executive Officer Robert Chason sent to employees a letter reviewing pressing issues regarding the center's future. His letter is reprinted here.)
Dear Colleagues,
You may know that with the most recent round of budget cuts, state support for the School of Medicine will decline to approximately 13 percent of the school's budget.
Additionally, students in professional schools, including the School of Medicine, are increasingly required to pay a much greater share of the cost for their education. Already tuition for our medical school has increased by $5,000 a year.
Many medical students graduate with significant debt, and in today's marketplace, physicians' income potential is limited by increasingly inadequate reimbursements, especially for physicians in the primary-care specialties. Perhaps that's one reason many medical schools are having difficulty filling their residency programs in family practice, general internal medicine and other primary-care specialties.
What impact is this having on health care and academic medicine? I believe it has serious implications for our education mission. And in future letters, I'll talk about how these cuts may also impact our clinical and research missions. Finally, I will offer some recommendations for how we might begin to resolve these problems.
As California continues to cut funding for its UC medical schools, and we are forced to move towards operating more like a "private" institution, it will be increasingly difficult to support our educational programs while maintaining the level of public service this community has come to expect of us.
Unfortunately, we cannot be all things to all people. We are an academic medical center. Our primary mission is to train excellent physicians and bring medical discoveries to the people of California.
Our educational mission provides tremendous benefit to this region. By some estimates, well over half the physicians currently practicing in the Sacramento area were trained right here at UC Davis. That means that even if you don't get your medical care here, chances are good that your doctor is a "UC Davis doctor" having gone to medical school or completed residency training here in our institution.
Our Family Nurse Practitioner and Physician Assistant training program is among the largest in California and the nation. Our FNP/PA graduates provide essential primary care to patients throughout this state, especially in under-served areas.
The continuing medical education courses, consultation services and telemedicine linkages we offer physicians in this region mean that patients throughout Northern California have better access to better care, thanks to UC Davis School of Medicine.
We cannot compromise our education mission, particularly now when more physicians, family nurse practitioners and other health professionals will be required to meet the needs of this region's rapidly growing, and rapidly aging, population.
The aging of our population, combined with the fact that many retired persons don't have adequate health insurance coverage, will cause increasing strain on the health-care system and state and federal budgets. Add to that the increasing number of uninsured patients and the very serious shortage of physicians willing to provide care for them. Virtually every aspect of health care is threatened: home health, skilled nursing, long-term care and many others are all suffering from lower reimbursement and shortages of skilled employees.
Hospitals already are subsidizing the cost of education for nurses, med techs, radiology techs and others. We and the other local hospitals provide millions of dollars to community colleges (which don't have enough state funding, either) to allow them to train health-care workers. And then, making the financial burden even worse, we are forced to compete for the paucity of graduates by paying increasingly higher salaries.
We are rapidly approaching a time as a nation when we can no longer afford to "waste" the ability and potential of a single person. We must support the education of our citizenry. It is essential in all sectors of our economy, not just health care. But academic medical centers, where education and health care come together, are among the most vulnerable institutions threatened by our current economic problems.
As we look to the future, Californians, particularly those of us who can afford it, must find ways to support education and health care for everyone. And we at UC Davis must find ways to maintain and strengthen our educational mission.
-- Robert Chason