Eastern Virginia Medical School - Yearbook (Norfolk, VA)

Page 10 text:

CHAIRMEN OF THE MEDICAL AUTHORITY MASON C. ANDREWS, M.D. HARRY H. MANSBACH ROBERT L. PAYNE, JR., M D T964-T970 1970-T974 1974- H Mason C. Andrews, M.D. 'Charles F. Burroughs, Jr 'Marian P. Capps, Ed.D. Roy R. Charles 'Edwin W. Chittum 'Richard F. Clark, M.D. 'Charles N. Cooper Lawrence M. Cox John Franklin, M.D. COMMISSIONERS OF THE MEDICAL AUTHORITY Asterisk indicates current appointment A. B. Gornto, Jr. Roy D. Hudson, Ph.D. 'Sidney S. Kellam 'Arthur A. Kirk, M.D. Harry H. Mansboch Walter A. Page M. Lee Payne R.l. Payne, Jr., M.D. Harry B. Price, Jr. Llewellyn S. Richardson E., Redwood Richardson Toy D. Savage, Jr. C. E. Thurston, Jr. Richard F. Welton, III Richard F. Wood William P. Woodley

Page 9 text:

The difference that a medical school makes in the quality of health care in a region is staggering, it is most easily seen in the number of available physicians. In 1960 the ratio in eastern Virginia was 86 practitioners to 100,000 population. In the area around Richmond, site of the Medical College of Virginia, it was 183 per l00,000g around Charlottesville, home of the University of Virginia School of Medicine, 281 per 100,000. The impact on the availability and quality of health care is obvious. Eastem Virginia is an area of approximately 6,000 square miles containing about 28 percent of the state's population. Its largest city is Norfolk and as a medical trade area it includes northeastern North Carolina. It did not in 1960, and does not today, have enough physicians to adequately care for its 1.3 million people, but the odds are getting better. Since the Eastern Virginia Medical School was established in 1973, there has been a considerable increase in the number of practitioners, currently 116 per 100,000. In the nine months from November 1974 to August 1975 alone, there was a net gain of 85 physicians in eastern Virginiag 35.570 of the gain for the entire state. In fact, a medical school itself is only the tip of the iceberg in the health care benefits it can bring to a region. Events of the past years have clearly shown that the heretofore separate worlds of patient care and medical education must come together. Rising costs, demands for more health services and the now recognized inter-depen- dence of these worlds make necessary their uniting in a single system. When properly seated, a medical school becomes the core element for better programs of premedical education, graduate medical education Qinternships and residencies in hospitalsl as well as for continuing education of practicing physicians. The interweaving of these programs with the ways of providing medical care to people creates entirely new mechanisms in which health education and health care strengthen and improve each other. On September 24th of this Bicentennial year the Charter Class of the Eastern Virginia Medical School graduated. When the 24 students entered in 1973, they found themselves in a ten year old, four story building that had been used as a domiciliary and teaching facility for a Licensed Practical Nurse program that had been phased out. Senior faculty offices were in hastily partitioned apartments where bathtubs were being used for book and equipment storage. Junior faculty space was anywhere room could be found for desk, chair and filing cabinet. By contrast, the students moved in relative luxury with newly built study carrels, renovated lecture halls and a lounge magnificently appointed through gifts of furniture. As formal classes began, renovation crews were still wiring and painting some laboratories and shelving was being installed in the library. What may appear to be poor planning was really the result of an incredible success story in the establishment of a private school of medicine despite seemingly insurmountable problems in raising S15 million in private contributions, obtaining state and federal support and in gaining accreditation. As a demonstration of faith justified, formal permission to accept students came only three months before classes began. In this age, when medical schools are usually established as part of a state university by legislatures spending tax dollars, the EVMS is unique in that it was created by public subscription. The only known instance in the United States, perhaps the world, where citizens donated the millions needed to bring together teachers, researchers, administra- tors and the equipment needed for a medical school. And, through that Medical School began a series of changes that greatly improved the quality of their health care. The clinical base for a medical school fthe place for bedside training of studentsl had been rapidly developing through the early 1960's. The Norfolk Public Health Department had opened a large new headquarters near the area's biggest hospital. Within a year, a 100 bed childrens hospital and a physicians office building housing 100 practitioners opened in the same area creating, for practical purposes, a medical center. Of the approximately 5,000 hospital beds in eastern Virginia, more than 1,200 were available for teaching through the cooperation of hospitals and physicians. Ultimately, a consortium of community hospitals in seven cities became the operational substitute for the traditional university hospital. Vigorous support from leaders in the business and professional communities and the endorsements of local and state medical societies became a call for a medical school as a means of improving health care services. The State Council of Higher Education studied the possibilities in eastern Virginia and reported that a medical school was not only feasible but desirable since it could be the focal point of a third major medical center for the state, attracting physicians and providing more educational opportunities for Virginia students. However, along with that solid recommendation there was an observation that since Virginia was already supporting two state medical schools with general tax revenues, it was appropriate that the proposed school be constructed and operated with private funds. In other words, It's a great idea, but you'll have to do it yourself. Members of the state legislature from eastern Virginia were quick to respond. Even before the Council's report was formally delivered to the Governor in January 1964, a bill keyed to its findings had been drafted. By the time the legislative session ended, the Assembly had passed and the Governor had signed a bill creating an Authority to create a private school of medicine. The enabling act provided no funds and, perhaps because of this, gave an immense range of powers to the newly created Norfolk Area Medical Center Authority. In six pages the bill empowered the Authority to plan, design, construct, remove, enlarge, equip, maintain and operate medical educational institutions, medical and paramedical facilities, together with related and supporting facilities and to do all things necessary and convenient to any of its purposes. That included the right of eminent domain, the right to charge and collect fees for services and facilities, accept loans, grants or assistanceg and borrow money and issue bonds. The act also empowered any municipality in eastern Virginia to cooperate with the Authority in virtually any way it wished. Health officials, educators and planners

Page 11 text:

have called the act one of the most enlightened pieces of health care legislation ever produced. And, judging by what the Authority has accomplished, it may well be. However, to the pragmatic community leaders, business and professional people, who would lead the drive to establish the. school, it was seen primarily as a hunting license - great things were possible, if you could make them happen. When the City Council of Norfolk appointed the seven non-salaried Commissioners to the Medical Authority in 1964 they choose regionally oriented people from other eastern Virginia cities as well as Norfolk. Able, dedicated men with demonstrated success in their professional and business operations, the Commissioners were also members of the establishment in the finest sense of the word. People with long careers of voluntary public service in education, community funds, hospital board memberships, planning councils and other civic groups that aided the professional social service organizations. Administrative costs of the Authority were funded by the City of Norfolk. A part-time director and a secretary were selected, total costs for the first year including equipment and office space were under S35,000. Recognizing that more health service elements had to be in place to establish the credibility of the medical school concept with federal agencies and the national accrediting body, the Authority concentrated first on enlarging the clinical base and attracting' top flight physican! teachers. Because of their own high credibility the Commissioners were able to organize committees of physicians and other interests to advise on the area's most critical health needs, and on ways that meeting those needs could be structured for future use by the medical school. Thousands of hours of planning, research and consultation were voluntarily contributed over the next five years. The Medical Authority acted as broker in arranging multiple sources of local, state and federal funds to establish and staff high-priority health care facilities. The first to flower was the Tidewater Rehabilitation Instituteg con- struction began in 1965. It was the first of four new health service programs the Authority opened in 1967. In June the Rehabilitation Institute began providing a broad range of physical and occupational therapy to the handicapped including the area's first public resource for children with learning disabilities. Five months later, in concert with area hospitals, the Authority opened a Cardiopulmonary Labora- tory and a Cardiovascular Center to provide the first capability for open heart surgery in eastern Virginia. Cancer and heart ailment investigations began later that year when the Research Institute was opened in the area's largest hospital by the Authority. By mid-1969 there were enough health care facilities in the pipe line to provide the needed clinical base. It was time to get to the financing. Health educators and consultants had estimated the long range costs for all elements of the medical school at S60 million, most of it federally financed or self amortizing. The immediate requirement was in privately contributed funds to start the ball rolling. Thirty-five of eastern Virginia's public service minded citizens were named Co-chairmen of the Campaign Committee and charged with raising S15 million in front end money to finance construction and endowment of the medical school. That bargain basement price was predicted on the use of existing hospitals for the bedside training of students, thereby avoiding the enormous expense of building and maintaining a university hospital. It also counted on the practicing physicians of the area contributing teaching time to the school, and on matching federal construction funds on a two-federal for one-local basis, the then prevalent matching pattern. The broad stroke plan was to raise S5 million for construction fproducing S15 million with the federal matchj and S10 million for endowment. Interest on the endowment funds would help meet the expected annual operating loss of S2 million. The balance of the deficit was to be made up through a yearly contribution by the City of Norfolk and a hoped for state subsidy of 34,000 per student per year. Because of the massive sums needed, the fund raisers would concentrate only on prospects capable of gifts of 530,000 or more, payable over 10 years if necessary. Less would be accepted, but the first effort was geared to the big-ticket potential. To make the soliciting of large gifts easier, and to provide protection for the contributors should the campaign fail, the Eastern Virginia Medical School Foundation was established. This non-private foundation made possible maximum IRS benefits to the donors and provided an entity for holding and managing contributed funds. The broad geographic area represented by its trustees assured a regional approach to the Foundation's mission. Privately, the Campaign Committee solicited its own members, getting commitments that approached S1 million. It was expected that half the S15 million would be raised with difficulty in eastern Virginia, the balance coming with relative ease from major national foundations and corpora- tions. This was the only major miscalculation of the Campaign Committee. The campaign began on January 15, 1970, with the expectation it would be completed within six months - it actually took three years. The national sources, with very few exceptions, were usually courteous and always firm in saying No and the people of eastern Virginia kept digging down to make up for the lack of national support. Public reaction to the fund drive was excellent. From the beginning the business and professional communities supported the school and contributed handsomely. Many clubs and civic groups contributed through self-assessment by the membership without being asked. One persuasive argument was the tremendous economic benefit the school would bring. The attraction of highly paid professionals, the increase in jobs at the medical center, millions of dollars in construction and the attendant tax revenues through the years - it all added up to additional yearly payrolls of more than S20 million and a cash turnover of about S100 million a year when the school and medical center reached maturity. However, by mid-1970 the campaign began to lag. About S4 million had been pledged locally and the first disappointments were coming in from national sources. Announcements of new health care facilities established by