Ivy Docs Spurn Teaching

Physician's Money Digest, July31 2003, Volume 10, Issue 14

Boston Globe

The 1300 students at Harvard MedicalSchool expect to get a first-classmedical education, but the prestigiousmedical college is having a tough timefinding physicians who are willing toprovide that education, according to arecent report.

Facing income pressures and increasedproductivity demands, the 9000physicians at Harvard's affiliated hospitalsare balking at taking time to trainthe upcoming generation of doctors,even though they're supposedlyrequired to teach for a minimum of 50hours a year, if asked. Harvard is takinga hard look at the issue as part of a curriculumrevamping, the first at the medicalschool in 20 years.

The school administration is tryingto make it clear to the doctors that afaculty appointment carries with it aresponsibility to teach. The doctorscounter that teaching pays little, ifanything, and takes time away fromseeing patients, which is the majorsource of income for most facultymembers. In 1 example, doctors saythey're paid $450 for teaching 1 afternoona week for 30 weeks, which is afraction of what they could make ifthey spent that time seeing patients.

Unlike some other medical colleges,Harvard does not pay a salary to its faculty,who trade a commitment to teachin return for the Harvard seal on theirstationery, which can help them buildtheir private practices and win researchgrants and speaking opportunities.The doctors must make their livingfrom their private practices or aHarvard-affiliated hospital.

Falling reimbursements from third-partypayers are squeezing doctorsfinancially, forcing them to see morepatients to maintain income levels. Thisleaves them with less time and less inclinationto teach. Other medical schoolsare also finding that faculty memberswant to cut back on teaching time infavor of spending more time treatingpatients, an indication that the financialrealities of the health care sector arebeginning to make themselves felt inthe once-protected halls of academia.