The USC medical school is at a crossroads. We will either continue to grow and improve as one of the better schools or will succumb to the marketplace forces that are presently dumbing down the academic mission. The School's faculty must be the ones who make the choice; we cannot allow it to be made by those whose primary agenda is not the academic mission. For more than 100 years the partnership between the School and the County of Los Angeles has provided the fiscal engine for the teaching and research that are the School's mission and give us the opportunity to fulfill the School's covenant with the people of Los Angeles - public service. Now, for the first time in ten years, that relationship is under review and likely to change. A new contract needs to be forged and provide a basis for the new partnership.
The reasons for the change in the relationship between USC and the County are several and are driven most by the changes that have occurred in medical care over the past ten years. Fewer patients are hospitalized, but they are sicker. Sicker patients need more intensive care. More patients than ever can and should be managed as outpatients, but that care needs to be comprehensive, primary care focused on outcomes, not only on treatments or encounters. The care must be delivered effectively and efficiently and meet the fiscal and social challenges of the County's patient responsibilities. These are some of the new challenges that we and the County must face to deliver medical services to the public. But our relationship has changed over the past ten years. The new face of the School as medical entrepreneur does not ease our task of negotiating as unbiased physicians who have the public's interest at heart.
We need to restore faith that the physicians who work at LAC+USC do so because they care and are willing to meet the challenge of public service, daily. We must negotiate a contract that assures that only the physicians who deliver service to the County will be paid and paid fairly, from the public purse. The monies we earn will be spent to meet those physicians' salaries and directed to the true academic mission, not entrepreneurial activities. The services we deliver will always be of the highest caliber, as befits an academic community. We shall continue to meet the challenge of public service and are able partners with the County in the changes that must occur. The principles that have guided our success as a School over the past century have not changed. They must be renewed to meet the challenge of our next century and form the basis for our new partnership with the County and the people of Los Angeles.
Peter Heseltine, MD, FACP, Professor of Medicine
Candidate for MFA Representative to the CPSA Committee
Elected as the MFA Representative on February 4, 1997