Lawmakers aim budget ax at medical training fund

Proposals would slim a state fund used to train students in medical professions.

by Kyle Potter

Proposed cuts to funding for on-site medical training have health care experts and administrators at the University of Minnesota worried about the future of the industry.
Gov. Mark Dayton and legislators at the Capitol have targeted the Medical Education Research Costs fund, which supports University health care students practicing their craft in clinics across the state, as a potential area for budget cuts.
Budget proposals from Dayton, the Senate and the House of Representatives would drastically slim state funding for MERC, if not eliminate it entirely.
Since 1998, the Legislature has funneled millions of MERC dollars to clinics and hospitals across the state in exchange for providing on-site training to students, called residencies.
About $66 million in MERC funds was distributed in 2009, according to the University.
Dean of the Medical School and Vice President for Health Sciences Aaron Friedman said the proposed cuts could be detrimental.
âÄúWeâÄôre not only making a, âÄòThis is not a lot of money, donâÄôt cut itâÄô case,âÄù Friedman said. âÄúWeâÄôre also saying that it is a relatively small investment for a long-term outcome.âÄù
State legislators are grappling to close a $5 billion budget deficit before the session ends later this month.
The proposed budgets from the Senate and Dayton would eliminate funding that flows from the state to the UniversityâÄôs Academic Health Center, which uses it to reimburse clinics that train students. The HouseâÄôs proposal would decrease some of that funding.
All three proposals would decrease the larger portion of the funding, which flows directly from the state to clinics and hospitals.
Friedman sent a letter to Dayton earlier this month to stress the impact the cuts might have on future generations of physicians, and University experts have testified at the Capitol in favor of MERC.
More than 600 sites receive MERC funds each year, from Hennepin County Medical Center to small rural clinics in northern Minnesota.
Many of those smaller clinics could not continue training students without the state funds, Friedman said, forcing trainees to move out-of-state for their residency and making it harder to recruit students to the University of Minnesota Medical School.
Students who train in Minnesota are far more likely to stay in the state, he said.
Residents at MERC-funded centers often provide medical, dental and pharmaceutical care to low-income people.
âÄúWe think itâÄôs important for every legislator, as well as the governor and his office, to understand exactly what this funding does,âÄù Friedman said.
As University senior and chemistry major Dan Murphy has looked at medical schools across the country for next year, he said most, like the University, are encountering budget cuts.
Murphy said in general, most students go through residency in the same area as their medical school.
âÄúYou get more recognition within your school when applying to residency,âÄù he said. âÄúThe people who write your letters of recommendation, they know who you are because youâÄôre at the same school.âÄù
Former Gov. Tim Pawlenty proposed an 85 percent reduction in MERC funding in 2010, but his proposal was soundly defeated.
âÄúThere was a call to arms about all the damage that would be done around the state,âÄù said Macaran Baird, head of the UniversityâÄôs Family Medicine and Community Health Department.
But the Republican-controlled Legislature is racing to finalize budget plans dominated by cuts âÄî unlike last year, the governor is not alone in proposing a cut to MERC funding.
The health and human services budget bill is slowly working its way through conference committee, where legislators hammer out the differences between House and Senate versions before sending it to DaytonâÄôs desk.
Rep. Steve Gottwalt, R-St. Cloud, said the budget crisis presents an opportunity to make necessary fiscal changes to health care systems.
âÄúThatâÄôs what this conference committee is about in my mind âÄî dealing with this fiscal reality in a very responsible way, and using that as an opportunity to improve care to people,âÄù Gottwalt said last week.
Baird isnâÄôt sure what effect the cuts may have on the University, but the hands-on training that MERC funds are used for is crucial for students, he said.
âÄúYou have to be there with an experienced clinician in order to get the job done in a way that you become competent doing this on your own,âÄù he said. âÄúFifteen years from now, we will feel the affect of these kinds of cuts.âÄù
Baird said his colleagues are preparing for another âÄúcall to armsâÄù like last year.
âÄúYou have to save your energy,âÄù he said, âÄúso you can spend it when it makes the most difference.âÄù