Tuesday, November 2, 2010

Harvard's Big Heart for Primary Care

Harvard Medical School sure knows how to make itself look good. This week's news is loaded with reports and accolades for Harvard's new initiative to support primary care.


But Harvard's record on funding for primary care research and education is actually pretty terrible. 


Harvard Medical School educates very few primary care doctors every year - only 10% of their 2009 class went into front line medical care, and that's the lowest rate of the region's medical schools. By contrast, the University of Massachusetts graduated 39% into primary care in 2009.

Also, Harvard's recent history of funding for primary care initiatives is dismal. Just a little over a year ago, Harvard made news for eliminating funding for its primary care division. This action caused a stir just as the nation was gearing up for a vote on health reform. We now know that health reform included several provisions that will shift massive amounts of new funding to primary care research, education and practice.

This new effort is welcome, but it is not funded by the generosity of Harvard's big heart, or even by a small dose of creativity. It's the direct result of hindsight on health reform. HMS now sees major new funding streams coming down the pike through accountable care organizations (ACOs) and through new initiatives in training of primary care doctors. 

The upshot of this? If you are a primary care center in Massachusetts and you see opportunities for growth as a result of reform, you're on the right track. Community Health Centers, for instance, stand to grow substantially. But these centers must beware of competition from the 800 pound gorilla. Harvard is positioning itself to gobble up as much as possible of the region's anticipated new primary care dollars.