Steven Dubovsky, chair of the Department of Psychiatry and a member of the UBMD Management Council, discusses the state budget crisis and its impact on the clinical practice plans.

Q: How is the state economic crisis affecting UBMD, and what steps are being taken to deal with it?

A: The good thing about having a viable practice plan is that its separate source of income buffers you against some of these budget crises. Since the goal of a practice plan is to generate additional income to support the university’s academic mission, as well as to improve the overall quality and organization of clinical care, a growing plan provides flexibility at times of constraints in other sources of funding.

If people are making less and spending less, then yes, they may not be able to afford to see their doctor. But by and large the practice plan is in better shape and more flexible than the state system. Many state medical schools are heavily leveraged, meaning that the percentage of their operation funding coming from the state is usually fairly low while the percentage from practice plans, grants and contracts is higher. UB’s medical school has done well in terms of the amount of state funding it has, which means it is more dependent on that state aid. By expanding our practice plan, we can continue to have potential funding to recruit and retain new faculty until the hiring freeze abates.

The state crisis is a signal to us to move more quickly with the unified practice plan, or at least having more integrated functions. Our joint efforts—contracting, efficiencies of scale and working together on operations—allow us to save on the expense side and generate more income to fund the medical school’s academic mission.

What we are doing now is continuing to merge selected aspects of our practices, like billing, our common practice management system, and other administrative functions, and to find ways to save on such large-scale purchases as insurance and supplies.

To expand its oversight function and reduce redundancies, the Faculty Practice Management Plan Governing Board is delegating many operational functions to the UBMD Management Council. The council’s contract committee is beginning its work on common approaches to payers and hospitals, which promises to improve income.

We are making tremendous progress to work as a single plan. It’s no longer the 18 plans going their own way to cope with the crisis. Now there’s much more of a group effort to help the medical school get through this, and that’s very encouraging.