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UND MED SCHOOL RESTRICTS RESIDENCY PRACTICE IN MINOT DOCTORS IN TRAINING NOW AREN'T ALLOWED TO SEE PATIENTS AT ONE OF CITY'S TWO HOSPITALS

Despite efforts to remain neutral, the UND School of Medicine has been drawn even further into the long and bitter fight between two hospitals in Minot.

Last week, the school's family practice residency training program in Minot directed its resident physicians not to see patients who go to UniMed Medical Center for care. That prompted an angry response from Dr. David Blehm, a UND medical school graduate, who says a tax-supported institution such as UND should not be choosing sides in a business competition.

UND officials, however, say that while they regret the problems caused by the intense competition between UniMed and Trinity Hospital, they have been acting in the best interest of their patients.

The current problem began earlier this year, when UniMed said it could no longer afford to subsidize the residency program. In most hospitals, federal reimbursements more than cover the cost of residency training, but, through a quirk of historical circumstance, in Minot that reimbursement falls short and the hospitals have had to put their own money into supporting the training.

UniMed offered suggestions for cost savings, but UND rejected those ideas, saying they wouldn't work. Meanwhile, Trinity offered to pay the entire cost of the training, so UND agreed.

Since then, the program has been centered in Trinity, but patients who came to a UND resident doctor for care still had the choice to go into UniMed if hospitalization became necessary.

The recent directive, from Dr. C. M. Smith, director of family practice training in Minot, states that residents will not be allowed to see patients in UniMed. "If patients (go to) UniMed ... they will not be seen by our physicians. They can be given the option to go to Trinity to be seen by us or to consult another physician."

Smith referred questions to Dr. William Mann, chief of family practice at the medical school in Grand Forks.

Mann said that, as time has gone on, the Minot medical community has become more polarized, with more and more Minot doctors and specialists electing to practice in only one of the hospitals. Also, the residency program has become busier, he said, meaning that residents are being spread more thinly.

The result, Mann said, was that Smith began to fear that patients would not get the kind of attention they should get.

Gloria David, director of public relations for UniMed, said her hospital is concerned the decision limits choices for Minot patients who want to see a doctor at the UND Family Practice Center.

Blehm, who practices at the Medical Arts Clinic -- an independent clinic that is closely associated with UniMed -- said he's upset his tax dollars are being used to support a competitor that's trying to drive him out of business.

UND officials say the hospital competition in Minot creates a difficult situation for them. The city and health care in general would be better off without it, said Dr. David Wilson, UND Medical School dean.

Mann said the best solution would be for the two hospitals to resume sharing the residency program costs. But, he cautioned, UniMed would have to agree to the medical school's terms.

UND officials, however, say that while they regret the problems caused by the intense competition between UniMed and Trinity Hospital, they have been acting in the best interest of their patients.

The current problem began earlier this year, when UniMed said it could no longer afford to subsidize the residency program. In most hospitals, federal reimbursements more than cover the cost of residency training, but, through a quirk of historical circumstance, in Minot that reimbursement falls short and the hospitals have had to put their own money into supporting the training.

UniMed offered suggestions for cost savings, but UND rejected those ideas, saying they wouldn't work. Meanwhile, Trinity offered to pay the entire cost of the training, so UND agreed.

Since then, the program has been centered in Trinity, but patients who came to a UND resident doctor for care still had the choice to go into UniMed if hospitalization became necessary.

The recent directive, from Dr. C. M. Smith, director of family practice training in Minot, states that residents will not be allowed to see patients in UniMed. "If patients (go to) UniMed ... they will not be seen by our physicians. They can be given the option to go to Trinity to be seen by us or to consult another physician."

Smith referred questions to Dr. William Mann, chief of family practice at the medical school in Grand Forks.

Mann said that, as time has gone on, the Minot medical community has become more polarized, with more and more Minot doctors and specialists electing to practice in only one of the hospitals. Also, the residency program has become busier, he said, meaning that residents are being spread more thinly.

The result, Mann said, was that Smith began to fear that patients would not get the kind of attention they should get.

Gloria David, director of public relations for UniMed, said her hospital is concerned the decision limits choices for Minot patients who want to see a doctor at the UND Family Practice Center.

Blehm, who practices at the Medical Arts Clinic -- an independent clinic that is closely associated with UniMed -- said he's upset his tax dollars are being used to support a competitor that's trying to drive him out of business.

UND officials say the hospital competition in Minot creates a difficult situation for them. The city and health care in general would be better off without it, said Dr. David Wilson, UND Medical School dean.

Mann said the best solution would be for the two hospitals to resume sharing the residency program costs. But, he cautioned, UniMed would have to agree to the medical school's terms.

Grand Forks Herald, August 27, 1996