MUSC: Balancing budgets to continue benefiting lives

Even if you don't get your health care at the Medical University of South Carolina, there is a pretty good chance that your caregiver completed some or all of his or her training there. If your caregiver trained there, they learned from some of the best clinicians in the country. Just this year, MUSC was recognized by U.S. News and World Report in its annual survey of the nation's leading health care organizations in four separate specialty areas. The American Heart Association also recognized the Medical University as one of the 25 leading centers in heart and stroke care in the country.

The Medical University is experiencing one of the most successful periods of growth in its nearly 185-year history. This past year, we set a record for research funding at more than $200 million. Our funding from the federal National Institutes of Health, the most prestigious biomedical research sponsor, has grown 17 percent during the past two years despite the fact that the NIH budget has been flat.

We are attracting faculty from the best institutions in the world — in the past year alone, faculty have come here from such leading centers as Duke, Emory, Georgetown, and Oxford Universities, as well as M.D. Anderson. Support from the private sector to MUSC remains strong, as reflected in record charitable giving last year at $67 million. We were particularly gratified to be recognized by the Charleston Chamber of Commerce this year with their first 1773 Award for leadership in the local business community. That's right — a government entity was recognized for excellence by the business community.

The economic benefit to the community from MUSC is huge. We are the largest non-federal employer in the region with more than 11,000 employees and an estimated economic impact of $2.5 billion per year. In its strategic plan, the Charleston Regional Development Alliance identified biotechnology as one of its principal targets for growth, with the Medical University as the linchpin for success.

Amidst all of these successes, the recent economic downturn has presented us with some new challenges. State funding to all higher education institutions was cut three times this year, for a cumulative reduction of 17.5 percent. Our funding from the state was already low when compared with similar institutions in other states. According to the South Carolina Commission on Higher Education, last year MUSC received about half of the money that institutions with similar missions receive in other states.

With the current cuts in appropriations, MUSC now receives the same amount of money from the state of South Carolina that it received about 15 years ago. This is not adjusted for inflation or the growth of the organization, both of which have been considerable in the interim.

In spite of declining support from the state, MUSC has thrived through the hard work of our dedicated faculty and staff. Most people do not realize that only about $1 of every $17 at the Medical University is provided by state appropriations. The rest of the money is generated principally through fees for patient care and through research grants. Most of these other sources of funding have limitations in the purposes for which they can be used, so they cannot be diverted to help fill in the gap of lost state support.

Our faculty and staff, through their proven track record of raising funds, will do their best to compensate for the loss of state support. There is every reason to believe that, working together, these talented people will rise to the challenge. We will reduce spending wherever possible, increase productivity, and continue to look for new sources of funding. In the meantime, we will do everything we can to limit the economic hardships to any employees.

These efforts should not obscure a basic reality: Declining state support for health care training today will have a direct negative effect on the quality and availability of health care for South Carolinians in the future. We are already experiencing a shortage of nurses, which is predicted to get worse in the future. Moreover, as Baby Boomers begin to reach Medicare eligibility soon, the demand for health care services will rise while the numbers of primary care doctors and specialists decline with a wave of retirements. Now is not the time to be cutting back on the training of health care providers. We will need more caregivers, not fewer, and the falling state investment in MUSC is surely pushing us in the wrong direction.

In the meantime, we are doing everything that we can with the resources available. Virtually every day, I receive letters of thanks from patients and their family members, most of whom do not know me personally. These letters tell amazing stories of people facing desperate situations, who were treated at MUSC with kindness and compassion. Many of these people would not be alive today if it were not for the Medical University. As we work through the current fiscal challenges, we will keep these people in mind — it is not about balancing budgets, it is about lives that are in the balance.

Dr. Raymond Greenberg, M.D., Ph.D, is president of the Medical University of South Carolina.