Shawn Vestal: WSU, UW med school tiff confounding

Washington State University President Elson Floyd came out recently with some “clarifying” remarks about his university’s plan to go it alone on medical education.

He emphasized the ways that WSU’s pursuit of state dollars to train doctors in Spokane would differ from the University of Washington’s pursuit of state dollars to train doctors in Spokane.

“The single most important differentiator in Washington State University’s pursuit of a separately accredited medical school in Spokane is the community-based model,” Floyd wrote in his Nov. 7 statement. “Wildly successful elsewhere in the United States, it is a model that hinges on partnering with, rather than competing against, the existing health care providers in the community.”

So, partnering is good. Competition is bad.

Only when it comes to the hospitals, apparently.

The tiff between WSU and UW has escalated to the point that one has to ask: Is this the best route for the state, its taxpayers and the future of medical care in small towns? To have two major universities spending time, money, resources and public blabity-blah in pursuit of separate visions of training doctors in Spokane? Two distinct sets of lobbyists competing for the valuable and limited meal times of lawmakers? All in pursuit of a goal that has so far struggled to attract students – let alone to persuade them to hang out their shingles in the towns that have such a tough time attracting and keeping doctors?

Floyd, who knows quite a bit about medical education, says it is. The UW’s president, Michael K. Young, who knows quite a bit about medical education, says it isn’t.

A survey commissioned by WSU says it is.

A survey commissioned by UW says it isn’t.

At this point, the only term of agreement is that they will not interfere with each other’s pursuit of legislative dollars to operate separate medical programs.

We’re pretty well through the looking glass here, Alice. It’s enough to make one yearn for a single university system with a single set of goals, rather than fiefdoms with competing visions and lordships. But that seems roughly as realistic as the notion of two separate and thriving medical programs in Spokane, offering alternatives for the would-be doctors clamoring to work in Rosalia.

Perhaps it’s a failure of vision to say that. The need for more primary care doctors in Eastern Washington is very real. Floyd has insisted that the twin tracks taken by the universities are both needed, and he’s been saying this for a while now.

He also has been painting the need for a standalone Spokane medical school – a full-blown, four-year WSU program, and not just a wing of UW’s regional program – as the centerpiece of an ambitious vision for the Riverpoint campus as a health sciences center. This vision sometimes sounds like a plan for meeting a true need, and it sometimes sounds like a dream of academic empire.

In 2010, Floyd spoke to Greater Spokane Incorporated about establishing an academic health center in Spokane – bringing together nursing and pharmaceutical education along with other health sciences, and partnering with both the UW and Eastern Washington University at Riverpoint.

For such a campus to work, “it must have in its midst, a medical school,” Floyd said.

“One could say that’s a very bold and very audacious goal,” he added. “This academic health center can indeed become the model for health centers all over this country.”

The UW has been less energized by Floyd’s bold and audacious goal. It runs the WWAMI program, which trains doctors in five Western states. It has established a program in Spokane, and has pledged to make it bigger – a pledge that has intensified since the two schools stopped working together. It argues that it can provide the best medical training, at a lower cost and with less administrative buildup, than starting from scratch with a WSU medical school – which would need to undergo an extensive accreditation process, to say nothing of the cost.

Floyd has argued that there aren’t enough spots in the WWAMI program to meet the need, and has complained that UW hasn’t tried hard enough to direct students into its Spokane wing. He says the universities split up over the UW’s refusal to accept WSU pursuing its own separate med school.

“We’ll have two different approaches,” he told the Puget Sound Business Journal. “We’ve said all along it will take two different approaches to meet primary care needs. I think in many approaches, we will have a better shot at meeting those needs with an expanded WWAMI program and a medical school. There’s a compelling case why both should be continued.”

There is indeed a compelling case that Eastern Washington needs more primary care docs. Is there a compelling case that shared custody between warring parents is the way to do it?