Can medical schools like Hopkinss continue to afford tenure?
Nowhere is tenure economics under closer inspection these days than at the nation’s medical schools, which rely largely on revenue from patient care, grants, and government funding to pay faculty salaries. The problem is that this “soft money” has never been more volatile. Managed care is making sweeping changes in the healthcare marketplace. By simply signing a new contract, a health maintenance organization can shift hundreds or thousands of patients from Johns Hopkins to another health system, says Medicine’s Miller. “If Blue Cross/Blue Shield says its clients can’t use Hopkins, we lose $100 million or more,” he says. Medical schools are also waiting uneasily to see whether they will gain or lose crucial government reimbursements as Medicare and Medicaid patients are shuffled around. At Hopkins, the School of Medicine is currently on sound financial footing, according to Miller. Grant support from the NIH increased 55 percent in the past five years–10 percent over the past year alo
