Arrow-right Camera
The Spokesman-Review Newspaper
Spokane, Washington  Est. May 19, 1883

Endorsements and editorials are made solely by the ownership of this newspaper. As is the case at most newspapers across the nation, The Spokesman-Review newsroom and its editors are not a part of this endorsement process. (Learn more.)

Editorial: Regardless of who runs medical school, goal is more physicians

The Spokesman-Review

In medicine, the goal is coordinated care. In politics, supplying doctors in the places they’re most needed begins with tying shoelaces together.

The upshot of this clumsiness produces battles like the one between Huskies and Cougars. No offense to the alums of the University of Washington or Washington State University, but we need more medical school graduates, regardless of the tassel’s hue. And we need them to locate in rural and other underserved settings as primary care doctors.

Washington State University says it has the plan to accomplish that, and it starts with an independent medical school. University leaders say it would be more cost-effective than the WWAMI program, which serves Washington, Wyoming, Alaska, Montana and Idaho and is run by the University of Washington School of Medicine. Plus, Spokane and the Inland Northwest would reap the economic windfall that comes with a full-blown medical research institution.

UW disputes WSU’s medical school study and claims it can expand medical education and boost the local economy under an effort called Next Generation WWAMI.

Legislators, who ultimately must come up with the money to finance expansion, shouldn’t interpret this dispute as a reason to do nothing. They should push for a solution. The governor must become engaged, too. The need is obvious. The facts are embarrassing.

Because of a paucity of in-state slots, WWAMI rejects about 85 percent of Washington applicants. Twice as many Washingtonians study out of state than in-state. Once they leave, the odds of them returning to practice here diminish. The state ranks near the bottom on this score. King County, with 29 percent of the state’s population, has half the state’s doctors. Meanwhile, rural counties struggle to attract physicians.

By 2030, the state will need 4,000 more doctors, including 1,700 in primary care. We are not prepared.

The problem in Washington is much the same elsewhere. Congress passed the Affordable Care Act and an expansion of veterans’ care, while also rejecting a bill to increase the number of doctors. The feds have also failed to fix the geographical imbalance in funding graduate medical education slots, though it knows that where medical students complete their residencies is a good indicator of where they’ll practice. Those positions are scarce in underserved areas of the country, such as Eastern Washington. Western Washington has all but 100 of the state’s 1,600 slots.

Florida State University could be a study site for lawmakers. Its medical school gained accreditation in 2001. The University of Florida objected; turf battles ensued. But 13 years later, FSU boasts clinical campuses in six cities, two rural areas and one in a migrant worker village. It’s produced 680 graduates, with 61 percent of them in primary care. Fifty-eight percent have stayed in Florida, with 22 percent in rural settings (more than double the national average).

Those are the outcomes Washington should shoot for. That’s what our leaders should demand.