Beth Israel Money Woes Worry Students

Budget cuts at the struggling Beth Israel Deaconess Medical Center (BIDMC) have caused widespread student concern about the future of the hopsital’s residency program.

In the wake of a report that recommended the hospital cut almost one-fifth of its resident slots over the next four years to save money, administrators at BIDMC and Harvard Medical School (HMS) have begun attempts to reassure prospective residents that the hospital remains firmly committed to teaching.

The controversy began last month when the Hunter Group, an independent monitor, released a report saying the hospital should cut its number of residents by 18 percent, or approximately 100 slots. BIDMC has long been considered one of the nation’s top choices for medical residents.

“Teaching programs are acknowledged to increase the cost of operating a medical center,” the report reads.

Hospital officials, including new BIDMC President Paul F. Levy, have publicly contested the report’s conclusions and the accompanying recommendation for program cuts.

“The Hunter recommendations were based upon data, the implications of which are questionable,” said Richard Schwartzstein, director of graduate medical education. “They found an association between number of residents and cost of per-patient care. But an association doesn’t necessarily mean a cause and effect relationship.”

“It’s our belief that that assumption is not one that can be substantiated,” Schwartzstein added.

In his overview for the hospital’s recovery plans, Levy maintained his commitment to keeping BIDMC academically-oriented, calling other options “short-sighted.”

Instead, he argued that the opportunity to work with top-notch graduates and residents attracted physicians who want to “maintain their professional edge,” and thus provide a higher-level of care to patients.

Integral as the hospital’s teaching mission is, Levy acknowleged it remains on shaky ground.

“Unless the [hospital] is able to maintain its clinical progress in a manner consistent with fiscal responsibility, it will not be able to generate sufficient support to remain as an academic medical center,” Levy said.

The unease about BIDMC’s budget and its commitment to teaching has concerned many medical students.

“There’s a lot of sadness and frustration that [BIDMC’s] finances are so bad,” said second-year HMS student Suzie Miller. “Third- and fourth-year students are starting to rotate [into residency positions], but there’s talk of some departments being eliminated. You can’t rotate through a department that doesn’t exist.”

Indeed, attention to the Hunter report has raised fears among the national medical school community.

Advisors at some schools have warned their advisees about applying to BIDMC after reading articles about its financial foundering.

To head off any public relations trouble, HMS Associate Dean of Student Affairs Nancy Priol circulated a memo to colleagues at other medical schools on Jan. 22.

“BIDMC will continue to provide your graduating medical students with the opportunities for the best possible postgraduate training,” the memo said.

“I thought media coverage might have had people worried,” Priol said. “A local article can make things sound very different than they are. I wanted to set the record straight.”

The efforts of HMS and BIDMC administrators seem to have paid off. As the deadline for applying to resident programs approaches on Feb. 22, BIDMC has not yet seen a decrease in number of resident applicants.

The long-term effects, however, are still unknown. For now, students said they see BID’s troubles as a symptom of the times.

“We thought that we were insulated from [the recession],’’ said Miller. “The bottom line is, you do have to face this. The general student sentiment here is, ‘isn’t this a mess?’”