Medical education cuts at HCMC ‘on the table’

Some clinical programs that train residents may be cut.

by Jessica Van Berkel

One of the biggest teaching hospitals in Minnesota as well as a major provider of care to the poor, Hennepin County Medical Center will have to face $43 million in cuts in 2010. The hospital announced last week medical education is one area that could see cuts with the loss of the General Assistance Medical Care program (GAMC), which provides state-subsidized insurance for the poor. The program was cut during Gov. Tim PawlentyâÄôs unallotments . However, officials and students at HCMC said medical education is vital to the hospitalâÄôs mission, and the hospital could not function without it. There are 95 University of Minnesota medical students training at the hospital, and about 100 of the hospitalâÄôs 285 residents are from the University, Dr. Michael Belzer, medical director at HCMC, said. The residency program costs about $35 to 40 million a year, Belzer said. âÄúThe hospital has no plans to eliminate residency positions, or to change or limit our training of medical students … it never even crossed our mind,âÄù he said. But cuts to medical education could result from eliminating clinical programs that train residents, Belzer said. âÄúWeâÄôd have to think about how to transfer those residents in a program that was cut to another facility,âÄù he said. However, other teaching hospitals that usually coordinate with the University, like Regions Hospital, are also facing cuts from the loss of GAMC, which put them âÄúdeeply in the red,âÄù Vince Rivard, director of communications at Regions, said . Regions reduced staff and implemented a salary freeze earlier this year, but will still have to cut âÄúdeeper and wider,âÄù Rivard said. âÄúEverything is on the table,âÄù including specialized clinics like the Burn Center and Behavioral Health Services, as well as medical education, he said. The economic crisis is impacting the UniversityâÄôs Medical School and all related hospitals, Lindsey Henson, vice dean for education at the Medical School, said. She said the relationship between the University and the hospitals is âÄúreally heavily dependent,âÄù and the Dean of the Medical School Frank Cerra may have spoken with heads of some hospitals to design a cost efficient program to work with financial stresses. Exactly where cuts at HCMC will be made is âÄúspeculation at this point,âÄù but like running a business, some things have to be cut, Henson said. HCMC officials are looking over what clinical programs and services could be cut, and will have a âÄúvery good idea,âÄù in the next few months, Belzer said. The University has not maximized utilization of hospitals and clinics in the Twin Cities that are interested and willing to take students, Henson said. Pilot programs are in place at Broadway Clinic and being discussed at Allina Hospitals & Clinics, Henson said. But HCMC provides an âÄúunbelievably high-quality education,âÄù she said. Mike Lawson, a first-year internal medicine resident at HCMC, said the range of experience at HCMC is not available at hospitals like the VA Medical Center which sees a âÄúhomogenous group,âÄù or the University of Minnesota Medical Center, Fairview which sees mainly âÄúsuper complex patients.âÄù On Friday, an arrested man who was taken to the hospital said he used the bathroom, and then escaped into the ceiling and police dogs found him four hours later, Lawson said. âÄúItâÄôs never dull.âÄù For now, HCMC has no plans to back off on medical education. âÄúIf we just looked at the training program as its own product line … we expect to be in that business forever,âÄù Belzer said.