A warm fall greeting to you all!
Over the next few months, this column will focus on aspects of the discussion started last month: what it takes to build a medical school. This month, I am focusing on resources.
Okay, I know this may not be how you would prefer to start the discussion. But resources are the irrefutable foundation of any organization. Of course, “resources” are far more than just financial. People, and physical (and virtual) space are essential. Especially for non-profit organizations, reputation, good will and political support also are among the key resources to be stewarded. Let’s take a closer look.
By far the most important and most valuable resources are the people who make up the organization. The talents and dedication of the faculty, residents, staff and students are what enables a medical school to carry out its four missions of education, research, clinical care and community outreach.
The collective range of skills required to be effective is remarkably broad, and includes modern educational methods in the classroom, clinic and online, research skill, research infrastructure, clinical expertise, clinical management and community relations.
All this talent comes at a price. Consider competitive salaries for expert faculty who can lead our medical students into a cutting edge world of medical innovations, faculty who will commit to the community and embrace the area’s challenges and gifts. Consider the pursuit of multiple education and research missions that require a higher faculty-to-student ratio.
Our goal is to attract the best talent – from the Valley, the state, the country and beyond – for staff positions that require specialized skills and experience, and we are fortunate to have laid some of this groundwork over the past 15 years through the Regional Academic Health Centers in Harlingen and Edinburg.
So where does the money come from? According to the Association of American Medical Colleges, U.S. medical school revenue sources in 2013-14 broke down as follows:
Noteworthy is the heavy reliance on clinical income, up from 6 percent over the past 50 years. Because the current figure of 58 percent includes academic medical centers that own hospitals, those like UTRGV that do not are even more dependent on the remaining sources. This places a premium on revenue from the faculty’s clinical practice, external research support, philanthropy, and the support of state and local government.
The UTRGV School of Medicine is fortunate to have received excellent support from the University of Texas System and the State of Texas, as well as pledges of support from a number of local governments. Given our start-up nature, the 10 to 20 percent success rate of National Institutes of Health research grant proposals, and the realities of the clinical practice environment in an area dominated by for-profit hospitals, our ability to fulfill our mission of serving the health needs of the Rio Grande Valley will depend on optimized support from all the sources available to us, and a careful approach to how we use that support.
The saying “no margin, no mission” may be distasteful for those of us who are driven by a desire to help the underserved – and there are many of us at the UTRGV School of Medicine – but it is an undeniable reality. If we each contribute to our shared need to “take care of business” by optimizing revenues and carefully managing expenses, then the margin (revenue minus expenses) will grow and we will be able to do more for the community we are here to serve.