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updated 2:54 PM CDT, Jul 28, 2018

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Elson Floyd name on new WSU medical school would ensure support for future

Just as it was WSU President Elson Floyd's personal presence in the legislative halls that overrode doubt and opposition to bring about creation of a new medical school for his university, naming the medical school after him would ensure that his spirit and memory provide the support for the school to weather challenges ahead.

Elson Floyd

As the awareness spread in the days following his death from cancer last week that Floyd was waging an eventually losing battle with the disease while he waged the legislative struggle to fulfill his vision of a new medical school for WSU, the idea of putting his name on the school has logically surfaced.  

There are apparently a number of bills making the rounds in the Legislature to name the medical school after Floyd, who died last week in Pullman at the age of 59 after the colon cancer he had been battling for months suddenly worsened and claimed his life.

And a move on social media emerged yesterday urging that the medical school be named for Floyd, since his personal immersion in the struggle to convince the Legislature that the state needed more than one approach to training doctors and that WSU could make the difference won the day with lawmakers.

Floyd had spent hours in Olympia early this year testifying before committees, meeting one on one with legislators and building WSU's case for why a second medical school made sense, even while UW lobbyists were saying it didn't. In the end the legislation that will allow WSU to create a second medical school in this state passed by an overwhelming margin. It was signed into law by Gov. Jay Inslee the first week of April.

"A lot of legislators knew of his battle with cancer," said John Gardner, vice president for development and CEO of the WSU Foundation. "But he handled his personal health like he handled every other issue he confronted in life, never using the challenges to advance a cause."

"His privacy was something Elson was consistent about, never wanting his burden to become someone else's burden," said Gardner, whom Floyd brought with him to Pullman from the University of Missouri when Floyd took the WSU job in 2007 and was one of Floyd's closest friends.  

While it's logical that the lawmakers who came to know and respect Floyd, and were saddened by his death would seek to put the final mark of his name on his medical school, the Legislature may not be the right forum for that decision.

The established university processes may deserve to be served in Floyd's case in particular, and the forum for a decision on naming the WSU medical school after him should remain the province of the WSU Board of Regents.

And since it seems more than likely that the school will eventually carry his name, that will virtually ensure that future legislative battles over funding to produce doctors from both UW and WSU will unfold with lawmakers sensitive to whose name is on the WSU medical school.  

Just as there was legitimate and understandable opposition to a WSU medical school from supporters and fans of the UW medical school that is one of the finest in the nation, that opposition will surface in coming legislative sessions over the appropriations necessary to provide sufficient funding for now two medical schools.

Elson's name on the school is the most certain way for WSU to weather those certain legislative funding storms, first for the focus on the initial class of 40 medical doctorate candidates who are to be welcomed in the fall of 2017, then for the funding challenges that await through 2024 when the first graduates will complete their residencies.

If that naming decision comes from the lawmakers themselves, it would likely assure that each issue is weighed on the basis of a legislative reaction that "we named this place for Elson."

But the reality is that the decision belongs in the hands of the regents of the university where he left many imprints, one of which was his vision for a WSU medical school.

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Exploring issues of WSU medical school should proceed despite McDermott urging quick end

Washington State's senior congressman has stirred reactions of surprise, disappointment and a bit of irritation for inserting himself, with an op-ed piece in the Seattle Times, into the discussion over a possible new medical school at Washington State University by urging the Legislature to reject the idea.

The University of Washington sits squarely in Rep. Jim McDermott's 7th Congressional District and he has always done an excellent job over his 24 years in Congress of putting the needs of his constituents first. So it's not surprising he would step up to help that important constituent when asked.

But it's unfortunate that McDermott would visibly support UW and his friends there by taking sides on the issue of whether a new WSU medical school should be created, likely to serve large parts of the state whose interests are not McDermott's concern.

There were some in the legislature, including from his own party, who were surprised, and a little miffed, that he would advise them in a high-profile manner on how they should decide an issue that is strictly up to the legislature.  

One staunch UW supporter in the Seattle business community told me "it was inappropriate for McDermott or any member of the state's congressional delegation to turn this into a political issue when it's a state and local issue." He added: "We have an incredible medical school at UW and it will continue to be the mothership, so to speak, whatever develops. A WSU med school won't endanger that and it might make a regional healthcare program stronger."

Really the only question before the 2015 Legislature is whether the lawmakers will set aside a nearly century old law that prevents any state university other than UW from providing a medical education. There is a bill asking the lawmakers to provide some initial funding for WSU's effort, but the major issue to decide is whether or not they clear away the legal impediment that dates to 1917.

In an era when it's become increasingly clear that competition drives innovation and new ways of doing business, it would be difficult to imagine a reason, other than successful lobbying, why the legislature would decline to remove that arcane constraint. That way the discussion about whether or not there should be a second medical school in the state can continue on.

Would competition be damaging to the University of Washington? It's not likely that its status as the 12th best medical school in the nation in U.S. News & World Report's 2013 rankings would be jeopardized with a new WSU medical school in Spokane.

And its ranking as number 8 medical school in the country for receiving grants from the National Institutes of Health at $302 million last year would not likely be seriously impacted. WSU would be going after different grants.

Might UW need to be more attuned to the needs of rural parts of the state for medical care and more doctors? Perhaps, even maybe deciding to turn out more than the 120 graduates a year that has been the limit for a decade.

And as a side note on the issue of competition being potentially damaging, it's worth noting that Stanford University Medical School ranks 4th on that U.S. News list while University of California Medical School in San Francisco a few miles up the freeway is 5th. Now obviously they don't compete for state dollars, since Stanford is private, but they compete strongly for federal dollars and grants.

WSU has been attuned from the outset to seeking to explain how it might address the need throughout Eastern and Central Washington communities for more physicians and has looked for models for community based medical education, and thinks it has found a model in Michigan.

Interestingly, although Michigan's population is nearly 10 million compared to Washington's nearly 7 million, it has five medical schools and enrolled a total of 2,941 medical students to 592 students at UW School of Medicine. That's a difference of 29 students per 100,000 to Nine per 100,000.

And again with respect to the point of competition, it's worth noting that the University of Michigan Medical School was one ahead of UW in the U.S. News ranking, despite, or perhaps because of, its in-state competition.  

And it's competition that stirred the Michigan State University medical school to focus on community-based medical education and become a national leader in that focus. And competitive innovation led MSU to offer degrees in both conventional medicine and osteopathic medicine, making it one of only two medical schools in the nation with that distinction.

McDermott spent much of his op-ed legitimately extolling the virtues of the highly regarded program in which, in the early 1970s, the University of Washington took the bold challenge to train and prepare physicians to care for patients and communities throughout the states of Washington, Alaska, Montana and Idaho (Wyoming joined in 1996). This regional medical education program known as WWAMI (an acronym representing the states it serves) has been the most innovative of what were a number of similar regional medical education and training programs in the country. It's now the last because the centralized model is not what the future holds.

And there have been discussions in Idaho, now shelved for the time being, and currently in Alaska about creating medical schools in those two WWAMI-partner states.  

And as one proponent of the WSU proposal put it to me, "More of WWAMI, even if it were to continue, would give us more of what we've gotten: concentration of health care resources and talent. How does that help our current problem of access and quality of care away from the population hubs?"

An issue that should attract more attention than it has in this discussion is that virtually all of the emerging biotech startups at UW have come out of the medical school, meaning the medical school is a key to what some hope will be a renaissance of the state's biotech industry.  

It's logical to assume the same would be true of WSU, which already has one of the best regarded of the nation's 26 veterinary schools, which is producing some biotech commercialization and would likely seek some innovative medical school partnerships toward commercialization.

Ultimately the challenge the legislature faces is the looming serious healthcare-workforce shortfall, since it's estimated that Washington will need an additional 1,695 primary care physicians in 15 years.

Currently less than 15 percent of this state's applicants to the UW School of Medicine were admitted in 2012-13 to fill the 120 seats allotted for residents of Washington, which ranked 42nd of the 45 states with medical schools in allowing eligible in-state applicants to attend those in-state programs.

And beginning to address that challenge is the forefront issue before the lawmakers. Thus the underlying factor in any decision regarding a WSU medical school is would it help or hinder dealing with the looming physician availability crisis.

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