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Originally published September 16, 2014 at 5:12 PM | Page modified September 17, 2014 at 11:16 AM

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Guest: Why a WSU medical school would not address doctor shortage in rural areas

Building a new medical school in Spokane would not address the doctor shortage in rural areas of Washington, writes guest columnist Robert P. Gibb.


Special to The Times

The other perspective

Read a guest column in favor of building a medical school at WSU at seati.ms/pro-wsu-med-school

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THE University of Washington School of Medicine created the WAMI program with the federal Washington-Alaska Regional Medical Program in 1971. One of its purposes was to address the physician shortage and distribution of doctors in four states.

Now called WWAMI for the five states it works in, the UW medical program trains physicians in Washington, Wyoming, Alaska, Montana and Idaho in conjunction with other educational institutions and rural medical groups.

Washington State University, a participating school, is now considering building a new medical school in Spokane to address the shortage of doctors in rural areas.

The question that has not been addressed is why the WWAMI program has not been successful and how an expensive new medical school in Spokane would solve the physician-distribution issue.

There are frustrations in rural practice associated with the lack of modern technologies readily available to practitioners and their patients, compared with doctors in more populated environments. Coverage for attendance at medical conferences, vacations and the 24/7 demands of medical practice are major issues.

The business management confrontations with insurance companies, litigators and bureaucratic government regulators are an increasingly time-consuming, major frustration that will worsen with the Affordable Care Act.

Not addressed is the spousal factor. Even though WWAMI students are exposed to small rural communities and might enjoy benefits practicing there, spouses find employment opportunities difficult and cultural living options limited.

In Whatcom and Skagit counties, some of the frustrations of rural practice are being addressed by the Family Care Network. The network’s chief executive, Marcy Hipskind, is a WSU graduate. She, one of her sisters and I are graduates of the private Washington University School of Medicine in St. Louis, at great savings to Washington state taxpayers.

The network’s members total more than 75 family physicians. Billings, contractual agreements with insurance carriers and regulators are conducted for the members by the network. All are on electronic medical records. For members who are retiring, Family Care Network recruits replacements and provides coverage for conferences, vacations and on-call care.

In response to the shortage of family physicians, nurses and other ancillary nursing personnel now dominate the office rosters and groups of physicians share their services.

Would a new medical school in Spokane solve physician-distribution issues in Pierce and Snohomish counties? Probably not. The not-always-friendly Washington state Legislature, dominated by the west side of the state, would have to be convinced that a very costly medical school would have statewide impact.

Funding for a WSU medical school would compete with existing academic programs at WSU. Expanding existing WWAMI programs in Pullman and Spokane would be considerably less costly and competitive for those funds.

The community-based medical school being proposed at WSU is public and appears to be directed at producing family physicians who would hopefully practice in rural areas.

The residencies to adequately prepare them for this specialty are not addressed. They do not exist, to great extent because the private institutions and the hospitals affiliated with them do not support them. In WSU’s feasibility study, only two residency partners were named.

Perhaps the current discussions about a second medical school in the state has caused the UW to increase the number of students and the number of classes in Spokane. Both are long overdue. That would be positive.

There are more prudent ways to meet the state’s health-care needs than creating a medical school that would be difficult to fund. The costly proliferation of medical schools elsewhere has not solved the major national problem, which is a shortage of family-practice physicians.

WWAMI, more attentively administered, has the potential to address the shortage, but neither it nor a new medical school would solve the distribution issue.

Robert P. Gibb is a former Washington State University regent, former member of the Washington-Alaska Regional Medical Program Advisory Board and University of Washington emeritus professor of pathology.



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