Medical School Ball Is In GR's Court

November 8, 2004
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GRAND RAPIDS — In embracing a third-party analysis that offers a different, less costly scenario, health-care and business leaders see a far better outline to use in deliberating the potential creation of a medical school campus in Grand Rapids.

While Deloitte Consulting is careful to refrain from terming its report a counterproposal to Michigan State University's initial concept from last spring, the firm does put forward a clear alternative that emphasizes medical research to build the foundation for the eventual relocation of much of Michigan State University's College of Human Medicine to Grand Rapids.

Business and community leaders now plan to get to work this week on the complex task of formulating a plan for establishing a medical school campus in Grand Rapids.

"We really are at the beginning of the process. We're re-setting the clock and we've said we really want to do this and now we have to figure out how to do this," said David Van Andel, chairman of the Van Andel Institute in Grand Rapids, which is eager to link with a major medical school as a way to strengthen its research capabilities.

The Deloitte Consulting report, Van Andel said, validates beliefs that a medical school can match up well with Grand Rapids.

"They believe it's not only a worthy cause but a necessary cause," he said.

The Van Andel Institute and other key players in the medical school discussions with MSU like the framework that Deloitte offered because its offers a more focused approach than the costly conceptual proposal MSU trustees adopted in May that called for developing a full medical school campus in Grand Rapids over a 10-year period, including the relocation of some 125 first- and second-year medical students by 2006.

Deloitte Consulting's report plays more into the region's medical strengths and needs, as well as addresses lingering concerns over the massive cost to develop a full medical school campus in Grand Rapids and relocation of clinical faculty.

"It's a more pragmatic framework. The timing of it is better, as opposed to bringing everything in a very short timeframe," Spectrum Health CEO Rick Breon said. "All of the attributes of a medical school may be a little easier to transition than if you do everything at once."

The report, commissioned by a group of local business and community leaders, refocuses discussions with MSU on the immediate buildup of a research base in Grand Rapids as the College of Human Medicine improves its financial performance, followed by the later relocation of students and the clinical aspects of a medical school. Such a scenario, consultants say, would cost far less than the proposal MSU put forward last spring, as well as avoid associated cost implications for the local health-care system.

"These alternatives, at least conceptually, appear to better fit the needs and capital capacity of West Michigan," the Deloitte report stated. "From a West Michigan perspective, the initial MSU proposal was impractical, expensive and did not fully meet the region's needs."

Even though he holds a favorable view of the Deloitte report, Spectrum Health's Breon publicly remains cautious about whether a Grand Rapids medical school campus can ultimately become a reality. An issue of such complexity requires far more detailed discussions and planning before he can conclude whether the venture is even possible, Breon said.

"We certainly don't know enough to lay a claim that this is a doable project," Breon said. "Conceptually, this has merit. The practicality is still the question out there that has to be identified. There are so many details left to look at."

Still, he said, "We are, as an organization, committed to this project and we will continue to do so."

MSU and local health-care providers have talked for years about expanding the College of Human Medicine's presence in Grand Rapids, where more than 70 third- and fourth-year medical students now receive their clinical training annually at Spectrum Health and Saint Mary's Health Care.

Those discussions accelerated during 2003 and led to a conceptual proposal that MSU trustees adopted last spring to move much of the College of Human Medicine from East Lansing to Grand Rapids over a 10-year period and start classes as early as the fall of 2005.

While the MSU overture was generally viewed as a great opportunity, the accompanying $309 million price tag generated considerable pause for many in Grand Rapids. Community and business leaders decided to pursue an independent review of the proposal by Deloitte, which concluded that MSU's cost estimate was actually too low.

Consultants peg the cost of moving the medical school at $450 million to $500 million and question whether the original MSU proposal is even practical or feasible to implement.

To ease the massive capital costs, and to better fit into what Grand Rapids has to offer, Deloitte recommends that MSU and Grand Rapids focus on transitioning the College of Human Medicine into the area with the slower movement of students and placing "considerable emphasis" on creating research enterprises during the early years of the medical school's transition.

Funding derived through research activities and associated ventures would flow back to MSU and supplement the medical school's finances, easing the need for continual financial support from the Grand Rapids community, consultants said. Under the original MSU plan, the College of Human Medicine would have had to rely on an ongoing subsidy from the area through fund raising.

"Under this plan, we leverage the unique assets of our region in a manner where we provide distinct benefits to MSU's College of Human Medicine. We are confident this approach will result in a positive transformation," said John Canepa, co-chair of the Grand Action Committee, a coalition of local business leaders that paid for the Deloitte study.

The firm also suggested that MSU keep most of its current medical school faculty in East Lansing, which would avoid the movement of additional physicians into Grand Rapids, potentially increasing the cost of health care in the region. It also would alleviate concerns in the medical community that medical school faculty establishing clinical practices in Grand Rapids would represent subsidized competition for existing physicians.

MSU President Peter McPherson called the Deloitte report informative and enlightening and promised to work with the new process Deloitte Consulting outlined.

The consultants urged the formation of a work group led by the Van Andel Institute and involving Spectrum Health, Saint Mary's Health Care, Grand Valley State University and the economic development agency The Right Place Inc. and Grand Action Committee. The work group, already in the formative stages, should continue and intensify discussions and focus on transitioning the College of Human Medicine into West Michigan, Deloitte consultants say. The work group also should develop criteria and specifications that would form the basis for further discussions and, ultimately, a final agreement with MSU.

Focusing initially on having the medical school build a research base in Grand Rapids would cost about $100 million, plus another $50 million to $150 million for the required facilities. The move would generate a cumulative economic impact of $1.57 billion in the first 10 years and the creation of more than 2,800 related jobs, Deloitte concluded.

Saint Mary's Health Care CEO Phil McCorkle also embraced the Deloitte report, saying it plays into the strengths of the Grand Rapids area's clinical and research capabilities.

Noting the large presence of MSU medical residents already training in Grand Rapids, McCorkle backs the notion of building the research base before moving the clinical operations and medical students as a far more practical approach.

"It's not like we haven't had a role with MSU. That's something we've done very, very well," he said. "We don't have to re-create that. It's already here and already established, so let's go forward on the research."

After Saint Mary's Health Care was largely left out of earlier discussions with MSU, McCorkle is pleased that the health system now has a seat at the table in what will become a more focused process that also engages the business and educational communities.

"It's not just a health-care-owned agenda," McCorkle said. "We're off to a fresh start with a white sheet of paper and we're going to do what's best for our community."

Voicing optimism for the ultimate outcome of the deliberations over the medical school's possible move, McCorkle said, "I think it's doable."

The presence of so many key players in the process improves the potential for the project to become reality, participants say.

As with other major projects in Grand Rapids over the years, if all of the core participants in the process maintain their focus on the vision and the end result, "I've always found we can usually accomplish great things," Van Andel said.    

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