Members of Dartmouth-Hitchcock Medical Center gathered in the Williamson Building auditorium yesterday evening to listen to College President Phil Hanlon, Provost Carolyn Dever and interim dean of the Geisel School of Medicine Duane Compton discuss further details regarding the restructuring of the Geisel-DHMC framework.
The plan, which was originally announced on Monday at Geisel, will create three divisions as opposed to the current model of having many departments. The new divisions — basic science, translational science and health care delivery — are intended to reduce Geisel’s operating costs by $15 million, decreasing the school’s currently annual deficit of roughly $27 million.
Leadership for these divisions will be decided after hearing comments in the upcoming meetings with faculty, Compton said.
After receiving and implementing feedback from faculty, staff and students over the month of October, the plan will be presented to the Board of Trustees in November.
Halfway through the town hall meeting, the administrators responded to community members’ inquiries during a question-and-answer period.
When asked about how the removal of funding would affect the departments, Compton said that Geisel’s senior leadership group is currently working on two documents to help clarify the academic missions of DHMC and Geisel.
One of the documents will describe department chairs’ responsibilities after the transition, and the other will describe how Geisel and DHMC can fill their academic missions. Compton said that the program will be successful if it occasions a decrease in the annual operating deficit, allows for improved training for medical students and supports faculty with more resources.
While there remains ample national support for medical research, Hanlon said, the federal budget remains weak. As a result, funding opportunities, like research grants, have diminished. Overall, Geisel’s budget dropped from $275 million in the 2013 fiscal year to $250 million in the 2014 year.
Director of the Program on Medical Outcomes at Stanford University Jay Bhattacharya said in an interview that funding for medical schools and research centers has remained flat over the past few years.
Bhattacharya said that more funding will be required for clinical physicians to provide care to an aging population.
The government already covers some swaths of hospitals’ and medical schools’ budgets. Medicare, for example, gives payments for training medical residents, he said.
Bhattacharya said that, as funding for research decreases, people may start to leave the scientific and research labor force to work in private industry.
When future funding is in question, researchers may start to leave or get laid off, Bhattacharya said.
In an interview Monday, Hanlon could not guarantee that the plan would not result in layoffs from DHMC or Geisel.
There are some mechanisms to keep researchers in place for a short period, Bhattacharya said, noting that a school or hospital could move a strong research fellow from an area where funding has run out into another lab with funding.
In a study published on Science Translational Medicine last May, a number of financial administrators and deans at medical schools across the country — including dean at the Yale University School of Medicine Robert Alpern — argued against cuts to funding for biomedical research. Without steady streams of resources, they wrote, researchers often do not have sufficient time to pursue the objects of study, and scientists hesitate to embark on cutting-edge work. As a result, some researchers may leave the United States, they wrote.
Psychiatry professor at Geisel Hani Khouzam said after the question-and-answer period that he thought the plans were necessary for Geisel to remain a strong medical institution.
Chair of the Geisel anesthesiology department Tom Dodds said that the administrators were acting as transparently as possible about the process, particularly considering their short time frame. Still, he said, he was surprised how “relaxed” some people remained regarding the coming changes.
Compton said in an interview Monday that the plan is not directly part of the same framework as the Geisel 2020 Strategic Plan for Excellence, announced in 2011, which aimed to place Geisel in the top 20 medical schools by 2020. But, he said, he still hopes to make Geisel the best medical school possible.
This year, Geisel ranked 37th for research in the U.S. News 2016 best medical schools list, and it placed 29th in primary care. Last year, Geisel landed at 34th in research and 18th in primary care.
While the ranking for research has remained stable for the past 5 years, the ranking for primary care has ranged from 39 in 2011 to 67 in 2012.
Four Geisel professors declined request for comment, saying that they did not have enough information on the subject.
Twelve people at Tuesday’s town hall declined to comment.
