Monday, July 9, 2007

On the Explosion of New Medical Schools Nationally
and The Possibility of a New One Locally

When the University of St. Thomas and Allina first announced that they were exploring the possibility of a new medical school, Mr. B. was surprised. No doubt the administration at BigU was also surprised and perhaps a little worried?

Mr. B. noted in the announcement by UST that a Pittsburgh consulting firm, with local offices in Minneapolis, Tripp Urbach (TUBA) had been retained for the purpose of a feasibility study.

A little web checking ensued.

From the Tripp Urbach website:

“The Tripp Urbach consultants deliver premium customized market research, strategic planning and economic analysis to a broad range of client partners. Since 1990, Tripp Umbach’s accomplished and seasoned research teams have been providing the essential tools and solutions its clients need to compete and succeed in their specific business environments.”


Their client list is quite impressive and includes some heavy, heavy, hitters such as:

The Cleveland Clinic, University of Pittsburgh Medical Center, Mass General, The Mayo Clinic, The Ohio State University Medical Clinic, Lenox Hill Hospital, Children’s Hospital Pittsburgh, Children’s Hospital Boston, Children’s Hospital Chicago, a raft of other tony places and interestingly enough, The University of Minnesota Medical Center.

Noteworthy non-medical school academic clients include: Carnegie Mellon, Cornell, Penn, Virginia, Penn State, Ohio State, North Carolina, Arizona, Michigan State, Pitt, and, interestingly enough, the University of Minnesota.

With a consulting firm such as TUBA, perhaps St. Thomas doesn’t feel that the 150 years of medical school experience that BigU brags about is necessary for them to consult? Especially since BigU itself, as well as its Medical Center, goes to TUBA for advice. Our neighbors at St. Thomas are very smart, they have their own business school and appear to have hired a top notch consulting firm. Perhaps BigU's kvetching at this point appears patronizing? ("Why haven't they consulted us, we have 150 years of experience?" to approximate public statements by our administration.)

Now our leaders at BigU are famous for getting in bed with consulting firms or business school theoreticians. The way this game works is that first you decide what you want and then solicit the appropriate consultant. They tell you what you want to hear and you then go about doing it. Once they know what you want, they can even give you an economic rationalization for it. If things don’t turn out quite right, you can always blame the consultants. Or better yet, just declare the results a success, hope that no one notices, and move on.

The infamous attempt to destroy tenure via the process known as reengineering was the result of a dalliance with the Hammer/Champy crew. Driven to Discover is a commercially inspired enterprise. OurLeader finally let it drop that we are in the middle of a Kotter-inspired change mission. Kotter is a former Harvard Business School type who has decided to live off the gullible in both traditional business and in the business that education has become.

The other development that Mr. B. stumbled upon was the great number of new medical schools on the horizon. Dr. Cerra is correct that the osteopaths are responsible for some of this, but there are plenty of new allopaths (MD’s) on the horizon, much to the delight of premed wannabes and to the consternation of those already in the system who apparently fear the economic competition.

The driving force for most of these new med schools seems to be the production of family practice and internal medicine docs of the type that directly treat patients, or perhaps I should say customers?

There seems to be a feeling that we have enough specialists and researchers, but that general practice docs are in short supply. Given the agonizing experience of most of us in the clinic, perhaps there is actually something to this?

Now, as we are starting to learn at BigU, the usual behavior of the current administration, when there are problems that have been neglected in the past, is to point in some other direction and make a lot of noise.

BigU effectively axes General College, a place with high minority enrollment: “In order to keep minority enrollment up, we’re going to have to cut out of state tuition. That way we can enroll minority students from Illinois, or California, or Florida.”

BigU is at the bottom of the BigTen: “We are going to become one of the top three public research universities in the world.”

We have a shortage of family practice physicians: “The answer is not to turn out more doctors, we need to develop ‘quarterbacks’ for the healthcare system, like pharmacists or nurse practitionsers.”

Medical school tuition at BigU is obscene - the highest of any public university in the country: “We didn’t want to do this, but the legislature made us.”

Good leaders recognize problems early on and do something about them...

Eventually, though, BigU will get dragged, kicking and screaming, into facing and hopefully solving some of our problems. Maybe a kick in the pants from St. Thomas/Allina is not such a bad thing?

Maybe BigU’s medical school should cede the family practice business to St. Thomas and concentrate on turning out specialists and MD/PhDs? As the St. Thomas folks say, they don’t want to compete, just complement.

After all, no one ever became one of the top three public research universities in the world by turning out family practitioners, did they?


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