Copyright 2000 The Buffalo News
The Buffalo News
July 28, 2000, Friday, FINAL EDITION
SECTION: EDITORIAL PAGE, Pg. 2B
LENGTH: 522 words
HEADLINE:
BUILDING HOSPITAL PARTNERSHIPS
BODY:
The
University at Buffalo has added some serious clout to its role as an agent of
community change with plans to revamp its medical school. UB's plans will have a
major impact on many area hospitals already trying to cope with basic shifts in
the way health care is provided.
A major component of the planned
restructuring is the consolidation of residents in fewer hospitals, as academic
departments and their physician leaders are centralized mainly in the Kaleida
Health System. The move is expected to have a huge financial impact on the
already-troubled Erie County Medical Center. Hospitals that provide slots for
residents - newly-minted doctors training in hospital settings - make money on
the deal. Hospitals get an average of $ 160,000 per resident from
government-managed graduate medical education funds, and the
residents earn about $ 35,000. Each lost residency position means not only a
loss of funding, but a need to replace the doctor with a staff physician at full
salary and benefits.
Although allocation of about 650 residencies is
controlled not by the medical school but by the hospital-based Graduate Medical
School Consortium, the UB decision is expected to force major change. It's part
of a medical services consolidation at a new central complex that will include
Kaleida's Buffalo General and new Children's hospitals, Roswell Park Cancer
Institute and the Hauptman-Woodward Medical Research Institute as well as UB.
The short-term impact could be a loss of at least some of the 150
residents the Erie County Medical Center trains each year. The hospital already
runs at a loss, and millions of dollars could be at stake. The impact would be
less at Catholic Health System hospitals, which contributes to doctor training
but uses fewer residents.
But UB, rightly, is focused on longer-term
needs. Medical care is shifting from hospitals to outpatient medical centers and
doctors' offices. One goal of the university plan is to encourage more
collaboration instead of competition between hospitals, and the development of
"centers of excellence" in specialized treatment instead of an array of separate
but less proficient facilities. That has to happen anyway for hospitals to
survive, and UB's role as a catalyst could help.
Moreover, the
university's prime responsibility is to refine its own role as an educator of
physicians. The medical school, which is not burdened with the costs of its own
teaching hospital as many top-flight schools are, needs to compete nationally.
UB is seeking national strength in smaller and more focused residency programs.
Dr. Michael Bernadino, UB's vice president of health affairs, sees the
process as one of gauging where medicine will be in the future, and then getting
the medical school there at the same time. While hospital administrators are
forced to focus on financial survival today, the university wants to train
doctors to meet the needs of a medical marketplace tomorrow.
It won't be
a painless process for the medical community. But it puts the focus on a cure
for the ailing medical-care system, not just on the symptoms.
LOAD-DATE: July 31, 2000 
