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24 July, 2000 Ms. Faye Ellis Re: Ellis FJ: Florida State University Launches First New
Medical School in 20 Years, APS, July/August 2000, page 1 Dear Ms. Ellis: While there are few physicians in the State of Florida who seriously question that we need to do a better job of providing primary care in the urban and underserved areas of our State, the lead article in Academic Physician & Scientist [July/August 2000, pp. 1,9] is flawed in its attempt to explain the new medical school in the Florida State University System. FSU, an academically superb sister-campus in our State University System, is not the issue here. Rather it is the ill-considered behavior of our state legislators that ought to be focused upon. For a number of reasons, none of them well considered, the Florida Legislature voted this year to abolish the Board of Regents [BOR] of the State University System [SUS]. One of the reasons the BOR faces non-existence is that it failed to ingratiate itself with the legislators over three very specific items of pork: two new law schools and a new medical school. Why term these items "pork" ? The BOR, empowered to develop the strategic plan for the SUS' development, rejected each of them; the Florida Legislature, interposing itself into the driver's seat of our SUS, voted the BOR out of existence. While a rational discussion could be held about the need for these three schools, and while people of good will could certainly come to opposing conclusions, the actions of our legislators in eliminating the BOR and voting, over the objection of the Board, to create the new medical school threatens the viability of the State's system of higher education. The Board of Regents was written into existence in the late 1960s by the same legislative body that now seeks to disband it. Among the many reasons that the Board was created, a desire to limit politically motivated manipulation of programs and facilities was one of major significance. The heirs to that state body now seek to dismantle the only existing "buffer" that exists between the SUS and the Legislature. Since its inception, the BOR has been tasked with planning for the needs of the SUS, coordinating the development of new programs among the universities, and ensuring that educational, research, and service programs at each of our state universities are properly reviewed and evaluated. Perhaps most importantly, the BOR is charged with developing goals and objectives for the entire SUS, and creating a statewide strategic plan for the development of higher education in the State of Florida. Although all of the functions of the Board are important, it is the process of state-wide planning, with a minimum of political interference, that is put at risk by the Board's abolition. Such an action poorly-serves the people of the State of Florida. As the Chairman of the University of Florida Faculty Senate, I have disagreed with some of the Board's past actions. None the less, the Senate and its Chairman stand as one with the Board on the issue of their elimination. We have taken a public position opposing the disbanding of the BOR, we have called upon University of Florida students and alumni, as well as friends, colleagues and educators in other states, to send Governor Bush and the Florida Legislature a strong message that the State University System is no-one's "pork". The people of the State of Florida deserve better than mediocrity. Thus, despite the joy of our colleagues at FSU, the founding of a new medical school at our sister-campus under these circumstances bodes poorly for our state. Academic health care is struggling- in Florida as in much of the rest of the United States. State support for the medical programs already in existence is inadequate and will only deteriorate further if the Florida Legislature has its way. In the face of decreasing support for medical education, decreased reimbursement for trauma care, decreased reimbursement for care provided to the working poor and unemployed, the response ought to be rationalization of existing programs. Instead, the State of Florida is spreading what little monies we have ever more thinly. This, from a legislature that considers itself fiscally conservative, flies in the face of logic and economics. We do need to do a better job of providing health care for the underserved of our state and country. We do need to develop new and innovative ways to encourage students to become primary care providers. However, a physician's decision to enter practice in any given area is more related to where they completed their residency, rather than the medical school attended. Thus, the best-spent dollars would be for more residency positions, rather than for a new medical school. Investment, in this light, of the tens of millions of dollars- $ 20 million in the 2000-2001 SUS budget- needed for the new medical school at FSU is a poor investment and will provide no enhancement of care for our fellow citizens. It is pork, no more, no less. Perhaps one could argue, using data only available to the legislature, that our State actually needs another medical school. This, however, is not quite the point at this time. The central issue is that the creation of a new medical school, under the circumstances I have outlined above, ought to make my colleagues at FSU shudder. Created at the whim of the legislature, without proper guidance, planning, and funding, the "birth" of this new medical school has the potential to further mediocratize our State University System. The new medical school is not progress: It will not provide the results that are being touted as its reason for existence [see AP&S, cited above], and it will be a further drain on an already under-funded SUS. Finally, it ill serves the people of the State of Florida to have the legislature tinkering in this manner with the running of the SUS. The new medical school at FSU should be opposed as a matter of principle. Sincerely,
A. Joseph Layon, MD, FACP |