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Harvard suspends funds to primary care division: the division is deemed as largely symbolic; 'there weren't significant resources going to it.'.

Harvard Medical School's decision to suspend funding to its primary care division has drawn sharp criticism from many in the health care community.

Based on an ongoing review of Harvard's department of ambulatory care and prevention, "funding for the division of primary care has been suspended until the review is complete, at which point we expect to have a much clearer vision of the most meaningful structure for the programs within the division and how they can be most effectively leveraged for primary care education and clinical training."

David Cameron, spokesman for the medical school, said that the suspended funding--about $200,000--mainly paid for "lectures and symposia." There is no timeline for completion of the review, he added.

Members of the Harvard community protested the suspension via a petition urging the school to support primary care.

"We request that the administration renew its commitment to primary care and present a detailed action plan for expanding institutional support despite this budget cut," the petition reads. "As a leader in medicine, you have an opportunity to help solve [the] crisis in primary care and we look forward to working with you on this important task."

The petition, which had garnered nearly 1,200 signatures at press time, asked Harvard to reaffirm that "leadership in primary care research and education is central to Harvard's mission as the nation's premier academic medical institution," that "Harvard must continue to expand loan forgiveness initiatives that encourage students to pursue primary care specialties," and that "Harvard should support initiatives to train future leaders and innovators in primary care." It also asked the administration to "solicit and implement proposals from the [medical school] community that support the above goals."

Dr. David Himmelstein, an internist and faculty member who signed the petition, said that the primary care division "has been a joke for years," and as a result the suspension of funding "is a largely symbolic act."

When Harvard initially set up the department of ambulatory care and prevention, "primary care was going to be part of that ... and they were going to do more preventive and primary care," he said. "But the department changed leadership and there was no money to pursue research and initiatives in primary care, so they followed the money and focused on epidemiologic research ... and the primary care division became really a minor afterthought."

The move to de-fund the division raised hackles because it represented the last straw, said Dr. Himmelstein. "There weren't significant resources going to it, but at least there was the symbolism of being part of Harvard Medical School, and they didn't see fit to continue that."

Dr. Ted Epperly, president of the American Academy of Family Physicians, said he found Harvard's action ironic in light of Massachusetts' recent move to provide health care for all its residents.

"I find it incomprehensible that at a time when [the state needs primary care physicians] that Harvard is turning its back on the people that produce them," he said. "Medical schools are very good at training a workforce good for medical schools and teaching centers, but very bad at producing a workforce good for the community and people in the state."

He noted that Harvard's is one of 10 U.S. medical schools that does not have a family medicine department. "They have never invested the resources in training the doctors to shore up the primary care base," he added.

Mr. Cameron said that the decision to suspend funding "in no way reflects on Harvard Medical School's commitment to primary care training. Rather, it is an administrative matter."

He pointed out that the medical school currently has 31 centers, divisions, and institutes, "and not all receive funding from us."

One program that does receive significant funding from the medical school, Mr. Cameron said, is the primary care clerkship program, in which students are assigned to a general internist, general pediatrician, or family physician with whom they see patients three or four afternoons a month for 8 months beginning in September of their third year. The school's investment in the clerkship is increasing by roughly 20% this year, Mr. Cameron said.
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Title Annotation:PRACTICE TRENDS
Author:Frieden, Joyce
Publication:Family Practice News
Geographic Code:1USA
Date:Sep 15, 2009
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