know about it, it is run through a process called the Liaison Committee on
Medical Education. LCME is a joint organization, and leadership shifts each
year between the AMA and the Association of American Medical Colleges. But
they jointly appoint members on the Liaison Committee on Medical Education,
and they do the accreditation.
It’s a little bit different model from what I had known. I actually had chaired
the committee of the American Bar Association that accredits American law
schools, so I had a little bit of background in accreditation when I became president.
I think some of that background actually helped me, because I understood
how you start out a law school and how you put a law school through its paces
up to provisional accreditation and then to full accreditation. That’s a process
that is in place for virtually every accrediting authority that you could find in the
world – except the Liaison Committee on Medical Education at this period of
time. It had no provisions, no rules for provisional accreditation. They did not
contemplate there would ever again be a [new] medical school in the United
States…. [T]heir website said:
There’s no need for any additional physicians in the United States, no
need; There should be no new medical schools; Three, you should not
allow people who have gone to foreign medical schools a path to getting
a medical license in the United States.
Now, if you’re an antitrust lawyer, and you want to describe an anti-competitive
position, you now have the classic case. And they’ve got it on their website!
I found myself wondering: Who the hell are their lawyers? What are they doing
broadcasting the fact that they’re so anti-competitive?
Actually, it’s even worse than I’ve described it so far. If you looked at the reasoning
behind this, you’d see some language that says that to have more physicians
would really harm the position of existing physicians…. It was just a classic
statement of anti-competitive intentions….
[The accreditation process] was delayed because they did not want to come
and even visit us until we had selected the dean – Myra was our acting dean, but
we knew from the beginning that probably it was going to be necessary to have
an M.D. as dean… Once the new dean was in place, they agreed to send in a
site-inspection team. The [team] comes in and looks at all your data, looks at
your facilities. I think the first time they arrived our facilities were these trailers,
but we were able to show them pretty pictures of what this building was going to
look like. Actually the pretty pictures had not been fully drawn yet, but we were
able to show them the pretty picture that was our budget; we had a rollout plan
which had been approved by the Legislature showing how much money we’d be
getting each year, and that probably was the prettiest picture we could show, and
it was one that contemplated building a medical school over a period of years.
So they ultimately brought this survey team here. Wonderful report! Just a
great report about where this medical school was. Well, think about it: We’d
been running a first year of medical school for 30 years!... It had been part of the
52 | Breaking the Mold