UMC in need of quick solutions to problems

By Joseph Altman Jr.

Arizona Daily Wildcat

The University Medical Center will have a "major problem" by July if no support arrives to replace lost contracts to serve indigent patients.

Evan Kligman, family and community medicine department head, said some specialties at UMC risk losing their accreditation unless some kind of change is made.

Kligman said projections based on October and November show a 10 percent drop in patients each month.

At the current rate, UMC will have only 5,000 Arizona Health Care Cost Containment System patients those whose medical bills are paid by the state by June, down from 22,000 two years ago, he said.

"If the trends continue and nothing kicks in over the next several months, then we face a major problem by July '95," Kligman said.

Those problems include maintaining accreditation with a low patient count and maintaining faculty as funds dwindle, he said.

He said accreditation, which varies for different residency programs, mandates that residents and students need a certain number of patients in their panel and two to five sessions per week in clinic.

Nancy Koff, assistant dean of curricular affairs at the College of Medicine, said she is concerned about the College of Medicine's future as a result of UMC's loss of AHCCCS patients.

"Clearly, the quality of our clinical program for medical students is the availability of a wide variety of patients and a sufficient number of patients," Koff said. "If it became serious enough, it clearly could compromise the quality of education for the medical students."

She said a large problem with the number of patients available at UMC could do harm to the medical school's accreditation because the medical school relies on UMC for much of its students' clinical training. The college is due for reaccreditation in January 1998.

Kligman said primary care, such as obstetrics, pediatrics and family medicine, will have the worst problems because they depend on the AHCCCS program for more than 50 percent of their patients.

House Bill 2392, a new state law, mandates training more residents in primary care.

"We have communicated to AHCCCS and government offices as well as members of the state legislature our major concern about the viability and survival of teaching programs as we try to meet the mandate of House Bill 2392," Kligman said.

Rep. Andy Nichols, D-Tucson, said he has heard that legislation may be introduced to give more patients to UMC, but it is not appropriate for him to introduce it. Nichols is also a professor in the department of family and community medicine.

Nichols said there is much rationale behind support for UMC.

"One arm of the state, AHCCCS, for whatever reason, legitimate or illegitimate, is depriving another arm of the state, UMC, from fulfilling it's mission," he said. "The mission of AHCCCS is to provide health service at the lowest cost. The mission of the university is to educate health providers for the state."

But Nichols said, "It is a competitive environment. The university should not receive special privileges."

If legislation is introduced, it will be done before UMC reaches its critical stage in July.

"The governor unofficially said we'll be out (of session) in 95 days," Nichols said. "I don't know what the final outcome will be."

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