State lags in funding for OHSU.

Byline: GUEST VIEWPOINT By Joseph Robertson Jr. For The Register-Guard

Oregon is on the cusp of a health care work force crisis. The nursing shortage is compromising access to care in many areas, and in March an independently commissioned survey, `Physician Workforce in Oregon,' predicted a physician shortage within 10 to 20 years.

This shortage threatens the health of all Oregonians, especially in rural and underserved areas.

To ensure quality care in Oregon, today and for the future, we must fund health care education and support programs that attract providers to rural and underserved communities. This is not the time to cut funding for the Oregon Health & Science University; the consequences are too costly.

As baby boomers reach retirement age, from 2010 to 2020, their health-care needs traditionally increase. As this occurs, physicians will retire in significant numbers, and the ratio of patients to practicing physicians in Oregon will worsen.

To prevent a shortage of providers before 2020, we need to ensure that primary care physicians, nurse practitioners, physician assistants and other health care professionals are trained and available to all Oregonians. Cuts in funding for health care education will seriously jeopardize our ability to meet Oregon's future needs.

The proposed state budget pushes funding for OHSU near the bottom of the list of 75 publicly supported U.S. medical schools. In 2003, OHSU School of Medicine received $14.4 million in state appropriations, compared with a national average of $46.4 million. The University of Washington's medical school received $55.5 million in the same year.

This session's proposed state funding for the OHSU School of Medicine is approximately half of the 2003 appropriation. OHSU faculty now contribute more to cover the cost of medical education than the state does.

Because of the repeated cuts in state funding, the School of Medicine has to increase tuition, resulting in a debt load for most graduates of more than $150,000. The decrease in state funding is coupled with increased costs for technology and medical education.

Oregon now trains only half the number of physicians per capita per year as is the national average. We must match supply with demand.

Clearly, Oregon will need more doctors, and OHSU School of Medicine is the best source of new physicians. Many OHSU students stay in Oregon after graduation, some in underserved and rural areas. Ninety-three students from Lane County attended OHSU schools last year, and more than 770 OHSU alumni live in the Lane County area.

One OHSU program helping secure physicians for rural Oregon places third-year medical students in community-based, rural health clerkships. Florence was the site for four of these clerkships in family medicine last year.

Students value this opportunity to provide care throughout Oregon; in many areas, OHSU's rural health programs are the only care available. However, these programs are costly and in danger of receiving cuts.

Consider the impact of proposed cuts in state allocations. OHSU provides essential health care, especially for Oregonians in underserved and rural areas, people without insurance, the homeless and the critically ill. Nearly 40 percent of OHSU's inpatient admissions are low-income people, almost twice the average for health systems statewide.

OHSU provides half of Oregon's physician work force. OHSU supports more than 200 community service and outreach programs, brings health and education services to all 36 of Oregon counties, reaches 96,000 square miles of Oregon, provides 250,000 people with community services each year and volunteers more than 25,000 hours to provide care and community education.

OHSU is vital to meeting Oregon's health care needs - yet Salem is proposing budget cuts that will severely compromise OHSU's ability to meet Oregonians' health needs and to educate tomorrow's health care professionals.

As Oregon's only health and research university, OHSU touches the lives of all Oregonians. An investment in OHSU is an investment in healing, teaching and research in new treatments and means to deliver care.

To ensure the health of every Oregonian, today and in the future, we must hold off the looming health care work force shortage. We must support OHSU for the health and well-being of all Oregonians.

Joseph Robertson Jr. is dean of the Oregon Health & Science University School of Medicine.