Ward Rounds

In March, I penned an op-ed piece for the Chicago Tribune about the current state of research funding in the aftermath of federal budget cuts. It was entitled, “We Can’t Let Research Funding Wither.” In it I talk about a friend who recently had surgery to repair an abnormal heart valve. He was amazed by the scientific advances that made his surgery possible, what I call the “fruit of biomedical research.” Yet, the current state of research funding, the very same funding that has made so many medical discoveries possible, is in decline. NIH funding in 2012 is about $30 billion but has been flat since 2003; factoring in inflation, funding has declined every year for nearly a decade. This is a drain on the resources of all academic medical centers. If the Budget Control Act (BCA) is not amended by Congress before January 2013, a $1.2 trillion reduction in defense and non-defense programs will occur over the next nine years. This would include significant cuts to The National Institutes of Health.

Research is not the only thing that will be impacted by the proposed cuts to the federal budget. Also affected will be our ability to fund graduate medical education through our teaching hospitals, which will decrease the number of physicians we can train. If they continue to cut GME funding, it will only exacerbate the problem, increasing shortages to 90,000 doctors within the next 10 years, according to the AAMC Center for Workforce Studies.

On the clinical side, many anticipate Medicare cuts, higher operational costs, and lower insurance reimbursements. As a result, our partners and we are wisely tightening our belts. While we don’t yet know what the Supreme Court justices have decided about the constitutionality of the health care reform plan laid out by President Obama, we realize there could be further pressure on the healthcare community.

So, what are we doing about it? We’re certainly not standing by idly waiting and wondering what’s going to happen next. As part of Northwestern Medicine over the past two years, we have been collaborating to increase efficiencies, better combining and utilizing our resources, and tapping into new opportunities to reduce costs. This includes creating a Finance Working Group and a Shared Strategic Capital Pool (called the  NM Catalyst Fund) to integrate our finances and foster transparency, and the launching of the Enterprise Data Warehouse to share operations, clinical, research, quality and other data across institutions.

Believing there is opportunity in chaos, we’re also developing a plan to fund the future development of our clinical operations and education, as well as our shared vision for research. Our goal is to double the size of our research enterprise over the next 10 years to foster even more innovation. I think we’ve done exceedingly well at our current scale, but if we truly want to distinguish ourselves and create a competitive advantage, we must grow. In addition, we are looking at ways to improve the quality of our fellowship programs, helping trainees gain leadership skills and author more publications, as well as creating a fund to finance their clinical months of training.

Does this stronger spirit of collaboration mean that we will be unfazed by these health care challenges?  No, but we will be better equipped to respond from a united front because we share a vision and goals that are explicitly linked. Being nimble is part of our continued success. We thank all of our alumni, friends, and donors for their continued support as we start to emerge as a new leader in academic medicine.

With warm regards,

Eric G. Neilson, MD
Vice President for Medical Affairs and
Lewis Landsberg Dean