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11 October, 2000 Professor Layon, Thanks for your note. I hope our paths cross some time so that we can talk further about this. I clearly saw the politics that were at work but I believe that this legislation was done on the merits and was done because we demonstrated that the model we offered had a better chance of educating doctors for rural and other underserved areas. I would be happy to go through the data and also try to convince you that there are places in this country where the medical schools have actually achieved this result. Our model is closely drawn on that experience. As to process, you probably know this but no medical school in Florida has ever been approved by the Board of Regents. You know the story of Sen. Shands and his determination that there would be a large medical complex located in a most unlikely place. At least in this case, the Board decided that there was a need to add 150 new medical students each year and did not object when the Governor and then the legislature adopted the plan we put forward rather than the idea of spreading the new positions among existing medical schools. The FSU plan brought forward the concept of expanding a thirty year old program in medical science, adding the second year of academic medicene and then providing clinical experiences in community based settings of the types that primary care physicians practice. This model is used by about 17 other medical schools and our teams visited many of those. After we produced the alternative model, the only regents to speak to this issue publicly also supported the FSU model so this is as close as the Regents have ever been to endorsing a medical education program in Florida. I talked to the majority of the Board and I always felt that, if the plan developed in our 1999 report could have been brought before the Regents, we would have had board approval with maybe one or two dissenting votes. Because of the press of other business, the Board did not take this up and I am sure that you remember the timing of this: The One Florida controversy began to get very hot just after our November 1999 report. I simply do not see the process issue the same way you see it even though I very much agree with you on the desirablility of a Board process. There were just special circumstances in this situation but hardly the kind to write off a carefully studied and documented plan as pork. On your point about reallocating resources to assure that we do indeed produce the physicians that the rural and underserved areas need, I join you in that thought. I believe that there needs to be a very close examination of the resources placed into residency programs and some focus on support for those programs which are producing health care providers for the places which have such obvious need. Our medical school will, I believe, produce graduates who will want these experiences and further training and some study of how we can make this work would be worth our time and effort. We look forward to working with you and others interested in improving medical education and health care for Floridians. Sandy Talbot D'Alemberte |