Eastern Virginia Medical School - Yearbook (Norfolk, VA)

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i l t President, EVMS Foundation Chairman, EVMS Foundation Development Committee support for a private school. A delegation of eastern Virginians appeared before the Appropriations Committee and pointed out that many states were contributing much more to private schools of medicine, that Virginia was getting a third medical school with no capital investment by the State and the requested subsidy was far less than the estimated 824,000 per student per year the State was already putting into the two public medical schools in addition to other millions of tax dollars supporting the university hospitals. The Appropriations Committee inserted the subsidy in the budget, the Governor did not veto it, and that building block was in place when the legislature adjourned in March. The Spring of 1972 brought a surge of progress to the campaign, now 28 months old. In May alone, a half million dollars came in through a legacy, a corporate pledge and scattered individual gifts. More faculty was added. No small accomplishment considering that maj or career decisions were being made in joining a medical school that did not yet exist. Through a buy and leaseback arrangement the Medical Authority acquired the building that would eventually be the interim home for the School until construction grants, could be received and a new building put up. By midyear, more solid support had appeared - from citizens for the school, through a pledge of 575,000 from an areawide labor organization, from the government for a program, through a multiyear, multi million dollar staffing grant for the Mental Health Center still under construction. Then the 'pendulum swung. By late summer, there were setbacks. Two grant applications totaling more than S1 million were turned down by HEW. A S900,000 request for renovation funds for the interim school building was rejected because of lack of nonfederal support in short, not enough money had been committeed to prove' the School financially stable. A S240,000 request for startup funds was denied because the entry date for students had not been set. As the summer of '72 slipped into autumn there were some sobering second thoughts. For more than two and a half years the Campaign Committee had been meeting to re- port and exchange prospects every Thursday except Thanks- giving Day and Christmas week. They had secured more than S11 million in cash and pledges. Buildings had been acquired, faculty had been attracted Con contractj, a foundation had long been established to hold and manage funds, the City of Norfolk had agreed to increase its yearly contribution to SS00,000, the State legislature had approved the student subsidy, and hundreds of prospective students had applied for the 24 openings in the Charter Class. But, in four months, January of 1973, the Liaison Committee would review the School's request for permission to accept students, and the Campaign was still more than S3 million short of the needed money. Battleweary from hundreds of solicitation calls, veterans of major triumphs and disappointments, faced with ever smaller prospect lists as calls were made fthe big ticket potentials had long since been exhaustedj, the volunteers could look at the most successful fund raising campaign ever conducted in the Commonwealth of Virginia - and could see it still was not enough. The moment of truth was fast approaching. The big break came in October. A challenge gift of 81.5 million was made by a Richmond, Virginia philan- thropist on the condition it be matched with newly raised funds by December 31st. The campaign Committee had just 67 days to review the lists, make more calls and try to pry still more money out of the area that had already been drained financially. The decision was made to go public . To this point there had been no general, mass appeal for gifts because of the difficulty and expense of returning the smaller contributions should the campaign fail. Now in the eleventh hour, it was a make or break situation and all the stops were pulled. Full page ads were donated in area newspapers with clip-out and mail-in pledge forms. Area radio and television stations responded with public service announcements and programs on the need for broad support to match the conditioned gift. The revitalized campaign gained speed. By mid-Decem- ber more than S1 million in fresh money had been raised. The mass appeal brought 300 responses totaling over 850,000 One of the clip-and-mail pledges came in with two dollars in cash and a promise of eight dollars more within a year. At the last report meeting of 1972, Thursday, December 28th, the terms of the conditioned gift had been met and the campaign total was S15,731,856.52 in cash and pledges. On December 31st a S1 million gift from a national foundation was announced. By the time of a celebration dinner on January 3rd the total had reached 317.6 million and the School's minimum financial base had been established. However, there were still problems. When the Liaison Committee reviewed the school's progress a week later, there were reservations about its ability to be ready for a class that year. In February a survey team visited the school. Their decision was that not enough faculty had been brought

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the Medical Authority helped recharge campaigners batteries. At the Children's Hospital a Department of Pediatric Neurology was started. A Renal Dialysis Center with six artificial kidney machines was opened in another hospital with the promise that work would soon begin on a kidney transplant program. Up to this point, the nearest transplant facility for patients with serious kidney disease was more than 100 miles away at the medical school in Richmond, and the waiting time for transplants was measured in months and years. Plans for an 80 bed mental health center and psychiatric institute were announced along with the immediate opening of three mental health outreach centers to provide limited care until the institute became operational. The fund raisers kept making the calls, visiting homes and offices, and became thick-skinned about rejections. In October 1970, ten months after the formal start of the campaign to establish the EVMS, the prestigious Carnegie Commission on Higher Education issued its report on Higher Education and the Nation's Health . The Carnegie Report identified the eastern Virginia area as the second largest population center in the United States without a university health science center. In its Report the Carnegie Commission also recognizes that local initiative is desirable, and usually essential, in planning for a new university health science center. In the absence of local initiative, it may be difficult to develop centers in the nine communities we have identified. The Carnegie Report not only validated the need for the establishment of the EVMS and the benefits that would follow, it underscored the essential rightness of the approach, local response to a local need. January 1971, the first anniversary of the fund campaign, found the total at just over S7 million in cash and pledges, virtually all of it from eastern Virginia. National sources were still saying No and that part of the campaign was to be intensified. It was and the results were discouraging. April was a climactic month. The fund drive reached the local goal of 37.5 million, the first meaningful out of town money came in - S200,000 from a foundation, the medical school's Dean was appointed, a site visit was scheduled by the accrediting committee, and it appeared there might be trouble at the State Capitol on the request for a student subsidy. The Governor was preparing his budget for the 1972 - 1974 biennium and had asked for a detailed report on the financial planning for construction and operation of the school. The Medical Authority produced a comprehensive report which included the hoped for subsidy of 54,000 per student per year. A delegation of Authority Commissioners, the Campaign Chairman, State Legislators and the United States Congressmen from the area was to hand-deliver the document. The meeting with the Governor was cancelled abruptly by phone with instructions to mail the report. The signals from the State Capitol were not good. In May the Liaison Committee on Medical Education sent its survey team to eastern Virginia. The Committee is made up of members from the Association of American Medical Colleges and the Council on Medical Education of the American Medical Association. It is the formal THE HONORABLE PORTER HARDY, JR. Chairman, EVMS Campaign Committee accrediting body for United States medical schools. Bulky reports had been prepared by the Dean and the Authority staff, which now numbered eight people. After three days of concentrated study of plans and facilities and of conversa- tions with medical professionals and educators, the site visitors left to deliberate and prepare a report for the full Committee. Meanwhile, the thirty-five Co-chairman of the fund raising campaign had added more volunteers as contributions became harder to get. The small army slogged its way through the summer and fall raising money locally, but getting no significant responses from ,national sources. At the second anniversary of the fund drive, in January 1972, the total of cash and pledges was approaching S9 million and the Governor had not included the state subsidy in his budget. However, in late January the Liaison Committee officially declared the Eastern Virginia Medical School to be a school in development and recommended that it be granted provisional membership in the Association of American Medical Colleges. This is the first in the four step process of accreditation and it put the School formally into business, making it eligible for some federal assistance in development. This recognition also armed the state legislators of eastern Virginia for a battle in the Appropriations Committee. There, they would attempt to put into the budget the state subsidy funds the Governor had refused to include. From the Liaison Committee's report, state funds are absolutely necessary and must be committed before the School can enroll students. With the limitation as presently cast at S1 million, the Commonwealth of Virginia is acquiring a definite bargain in medical education. There was a sharp skirmish with the Governor who ob- jected, he said, not to the 596,000 at issue for the 24 students expected to enter in 1973, but to the concept of state

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aboard in the basic sciences, department chairman and other faculty had to be in place to bring the school to acceptable strength. They urged an intensive recruiting effort and said the status would be reviewed in March. An interim report was sent to the Liaison Committee that month and there was no official position taken on the school. The Committee would meet again in June. During April and May as recruiters continued their efforts cross country, the Medical Authority received as a gift an electron microscope laboratory from the National Aeronautics and Space Administration, the equipment had become surplus, and the Community Mental Health Center was dedicated and received its first patients. By June 5th, all needed departmental chairman had signed contracts and the Liaison Committee was immediately notified. At the Committee's meeting on June 13th, the medical school was granted permission to accept students. Registration was set for late September and acceptance notices mailed to 24 of the 1200 applicants, twenty of the students from Virginia, the Charter Class of the Eastern Virginia Medical School. As diplomas were awarded to the graduating Charter Class, 148 other students were working their way through the three year curriculum. Sixty-four entered in July and are deep in the study of basic sciences. The second and third year students are getting their clinical experience in community hospitals and physician's offices, the environment in which most will practice, instead of in the traditional university hospital which is fast becoming an expensive anachronism in medical education. By 1978, ninety-six students will be entering the Eastern Virginia Medical School each year. The increase in class size made possible by a new Basic Medical Education Building now under construction. With the Medical School in place, the Authority formed more links in the educational chain that begins with pre-medical training and runs through medical school, residency training and continuing education for practicing physicians. Organized by the Authority, a seven member consortium of colleges and universities is working to coordinate and improve pre-medical education. Area hospitals have affiliated with the Authority in a joint venture as the Eastern Virginia Graduate School of Medicine. This entity handles the recruitment and management of interns and residents on a regional basis. It coordinates the educational programs of the hospitals, and the Medical School's faculty provides a core of basic science and clinical instruction. This strengthens the academic quality of the residencies and improves the patient care provided by the hospitals. Scientific meetings, seminars and workshops are being arranged for the continuing education of physicians, soon to be a requirement for practice. More than a third of eastern Virginia's 1500 practitioners are already sharpening their skills and knowledge through voluntary, non-salaried, teaching assignments and curriculum development at the School. These links of medical education have been forged by the Authority as parent organization of the School, holding legal and management responsibilities. The Authority itself has undergone a major change. Because of the regional nature of its operations, the educational and health care programs have an inescapable impact on the communities of eastern Virginia. It was apparent these communities should have a direct voice in the govemance of the programs. On request of the Commis- sioners, the General Assembly of Virginia amended the Authority's charter to allow direct appointment of Commis- sioners by city councils of the region's municipalities. Along with the voice in governance came the implicit obligation of financial support. The name of the organization has been changed to the Eastern Virginia Medical Authority, the number of Commissioners increased from seven to ten, appointed by six cities, and the yearly financial support from these communities is expected to soon exceed S1 million. This is the first voluntary agreement and joint funding arrangement ever entered into by this group of cities. In itself a pioneering and significant step. There has been strong continuing support for the School and the Authority by the people of eastern Virginia. Since the end of the formal campaign to establish the School in 1973, the EVMS Foundation's Development Committee has continued the fund raising - to make up the lack of federal support and for special programs - to date contributions total more than S20 million. In the area of state funding, the General Assembly has increased its operational support of the Medical School to 85,333 dollars per student per year. This reflects the three year curriculum of the EVMS as opposed to the more traditional four year program. The Assembly also approved S560,000 over two years for support of the Family Practice program, recognizing its parity with similar programs being operated by the two state supported medical schools. However in the largest and in some ways most critical area, funds for the medically indigent, the Assembly has not responded. Because of the over-riding importance of these millions of dollars in general tax revenues channeled into patient care through state medical school hospitals, the Authority and area hospitals will continue efforts to have the eastern Virginia hospital consortium recognized as a surrogate for the university hospital. This would provide a means of returning to eastern Virginia those tax dollars for care of the destitute that are now being disbursed only in the Richmond and Charlottesville areas. Nationally, changes in the patterns of medical education and the providing of health care services are both overdue and inevitable. A cohesion and singleness of purpose must be brought to the fragmented mass of medical resources. The need is for a logical arrangement of contracts, mergers and joint efforts using all medical resources with maximum efficiency for both medical education and patient care. In eastern Virginia the Medical Authority is the framework on which new systems are being fleshed out. Education, persuasion and negotiation involving health professionals, government leaders and health insurers are bringing about changes. Differing views of mission are being reconciled to a single goal - better health care - with all things medical geared to that purpose. In eastern Virginia the impossible dream of thousands of people, the Medical School and the Medical Authority which created it have become the means to the beginning.