ACADEMIC MEDICAL CENTERS: In Dire Straits
Faced with reduced government funding and managed care pressures, the nation's 125 academic medical centers "must close or downsize to survive," hospital administrators said yesterday at a conference by the Association of Health Care Journalists. ACM and teaching hospitals train about 75% of the country's physicians, provide 44% of indigent care and conduct most of the nation's clinical research, according to the Association of American Medical Colleges. The institutions blame the 1997 Balanced Budget Act, while others, like Dr. Catherine DeAngelis, editor of the Journal of the American Medical Association, argued the current health-care environment "is forcing these institutions to operate as competitive businesses, a trend that could render them extinct."
Who's to Blame?
In response to BBA funding cuts, hospitals have turned to pharmaceutical companies to finance medical research -- and could face pressure from drug companies' to report positive results, DeAngelis said. She argued that MCOs "manipulate care 'to ensure profitable cash flow.'" Dr. Charles Cutler, chief medical officer for the American Association of Health Plans, countered, "Managed care does have a commitment to academic medicine. I think we can serve each other well" ( AP/Worcester Telegram & Gazette, 5/5).