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Spokane medical education is a must

SUNDAY, JUNE 20, 2010

The University of Washington School of Medicine has the best program in the United States for primary care doctors, the front line in the diagnosis and treatment of disease. The same rankings put UW sixth among all U.S. medical schools for research.

Yet for all its excellence, the school this year graduated 167 doctors, a mere Band-Aid for treating the physician needs of not only Washington, but also the four other states – Wyoming, Alaska, Montana and Idaho – that participate in the WWAMI medical education program. Almost every other state graduates more doctors practicing within its borders.

In medicine, as in high technology, Washington is sorely dependent on the skills of professionals trained in other states, or other countries.

The expansion of the WWAMI program to the Washington State University Riverpoint campus two years ago was a first step toward a remedy. The 21 first-year WWAMI students have already increased the potential size of UW graduating classes to 210.

The dream of the Spokane medical and business community is a four-year school with as many as 120 students that in 20 years would become the heart of an Academic Health Science Center and related research facilities employing more than 9,000 and adding $1.6 billion to Spokane’s economy.

The centerpiece of the scaled-up program would be a $75 million biomedical building already on the drawing board. If the Legislature approves construction funding, the building would house the medical program and WSU’s School of Pharmacy, which would be uprooted from Pullman.

With the WSU School of Nursing, WSU Sleep and Performance Research Center, the RIDE UW/Eastern Washington University dental school and other health-related activity, supporters of an expanded medical school say the elements would be there for the kind of interdisciplinary instruction and treatment that will characterize future disease diagnosis and treatment.

But research is the real economic plum. Citing home-grown biotech companies like Signature Genomics Laboratories and GenPrime, consultant TrippUmbach says the school would not only spin off more new companies based on local research, it would attract new companies hoping to tap new ideas and graduates.

If that’s how it all plays out.

State Sen. Lisa Brown, D-Spokane and majority leader, poured some cold coffee at the recent breakfast unveiling of the TrippUmbach report. Yes, the capital might be there for the biomed building, but squeezing operating funds from the state’s stressed-out budget is another matter.

Brian Pitcher, chancellor of WSU’s Spokane campus, agrees. He says officials are working on a business plan that incorporates local, state, federal and private sector contributions. “Our goal is to present a compelling case,” he says.

Dr. David Goodman, director of the Center for Health Policy at the Dartmouth Institute, has his doubts despite the reputations of WWAMI and UW, which he calls “the nation’s powerhouse” in combining teaching and research.

The institute has become the apostate among observers of the U.S. health care system by arguing that less is more in medical practice, and health care spending.

Goodman says medical schools fan concerns about possible doctor shortages because they want to grow. Payback in the form of new research is the promise used to justify the costs.

He says the U.S. does not need more doctors; it needs better-trained primary care doctors who can monitor the long-term health of their patients without relying on specialists who garner a disproportionate share of the health care dollar. Getting students into under-served areas for training – a component of the WWAMI program – would help correct the current misallocation of quality care, he says, as would more widespread use of electronic medical records. Again, thanks to Inland Northwest Health Services, a regional strength.

Decisions regarding health care are tough, as the national debate over reform amply demonstrated. The discussion over creating a full-fledged medical school in Spokane will be a replay, in miniature. One suggestion: Focus on health, not the economic spinoffs.


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