by William L. Henrich, MD, MACP
Funding issues have become an increasing reality for Schools of Medicine (SOMs) around the country as traditional funding streams have dried up. Public SOMs customarily receive their funding from three sources: state general revenue, grants and philanthropy.
When any one revenue stream is reduced, the SOMs are forced to find an increase in another revenue stream. The Texas Medical Association recently reported that, “State undergraduate medical education funding is now 7 percent less than in 2003 and GME funding is down 60 percent for the same period.” With the documented shortage of physicians in Texas, this is causing SOMs to seek greater efficiencies in their clinical practices as well as incremental increases in grants and philanthropy to fund their core mission.
This fiscal year the National Institutes of Health (NIH) is operating under a budget that is slightly below last year's funding level. This represents the first funding cut NIH has experienced in more than three decades. Furthermore, this year's budget continues a three year trend in which the NIH is funded at a level significantly below the Biomedical Research and Development Price Index (BRDPI). As the availability of research support tightens and competitiveness for research funding intensifies, academic institutions face heightened levels of anxiety and significant uncertainties about the availability of incoming monies to continue to support the research capacity that they have developed over time.
At the same time, necessary ‘seed money’ to fund promising new research is reduced to fund ongoing research programs.
With decreases to state funding and research funding from the NIH, we are turning to our clinical practices to help fund our missions. We are challenged with developing increased efficiencies in the operation of our programs as well as the shifting of our payer base that will allow us to become more self-sufficient.
With the recent addition of Lew Greenberg, MD, MHA to the Medical Dean’s Office, we have expertise in designing these programs. Growth in the development of patient care programs is key for the School to continue to make needed investments in education and research. Our group practice, like many around the nation, has seen an increasing trend toward multi-specialty group models such as those observed at the Mayo Clinic, the Cleveland Clinic, the Geisinger Clinic and others that have proven to be successful.
In summary, the development of articulated clinical practices has become a necessary feature at SOMs across our country. Ironically, such practices allow for an institution to grow education and research programs, the core missions of our School. We look forward to being able to contribute to our medical community and to the health of all of our citizens through our mission. And, as always, we seek and encourage new associations with all aspects of our rich and diverse medical communities in San Antonio.
Warm regards,
William L. Henrich, MD, MACP
Dean, School of Medicine; Vice President for Medical Affairs; John P. Howe, III, MD Distinguished Chair in Health Policy
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