No abstract

We performed two surveys to uncover the status of philanthropic endowments in general internal medicine divisions. The initial survey of U.S. medical school departments of medicine found that only 14.1% of general internal medicine divisions hold endowments versus 21.9% of all other divisions, and that endowment sources for general medicine are atypical. The second survey of successfully endowed divisions found that sympathetic administrators and active pursuit of endowments were associated with endowment success. Aggressive pursuit of endowments, publicizing successes of general medicine, and consideration of endowment sources noted in this study are recommended to improve philanthropic contributions to general internal medicine. T his is a time of upheaval in the financing of academic medicine. General internal medicine may be particularly at risk of inadequate financing by not having the capacity to generate large reserves of clinical dollars. Previous publications have examined research funding, 1,2 ambulatory and graduate education funding, 3-5 and general financial support and survival, 6-9 but with little mention of endowments as a funding source. In fact, endowments receive little attention in the medical literature. A MEDLINE search for "endowment" and "endowed chair" located only 46 articles since 1975, of which 37 were from the nursing literature, and only 5 of the articles 1,3-6 addressed endowment contribution to funding academic medicine. The Association of American Medical Colleges' AAMC Data Book reports endowment funds as a percentage of medical school operating revenues, 10 and the Web page it references reports departmental, but not divisional, endowments.To further explore this issue, we sought to obtain specific information concerning the status of endowments in all divisions of internal medicine departments, particularly focusing on general internal medicine divisions. METHODSAn initial survey instrument was sent to chairs of internal medicine departments at the 123 mainland U.S. and Hawaii medical schools. Data on institutional type (public vs private), specific divisions represented in the department of medicine, and details of each major endowment (arbitrarily defined as $100,000 or more) were collected. For each endowed position, the division holding it, the amount, and the funding source were recorded. The initial survey was followed by a reminder to improve response. For consistency, in those departments without combined divisions, responses for hematology and oncology divisions were combined, and those for allergy, immunology, and rheumatology divisions were combined. For endowment amount, some institutions noted market value and some noted original book value.In order to learn more about the strategies involved in those general internal medicine divisions that were successful in obtaining endowments, a second survey was sent to general internal medicine division directors at all medical schools. This survey asked only those with endowments to respond by providing as much detail as w...

This case report illustrates that a patient over 80 can have a successful outcome with multidisciplinary medical coverage of medical, surgical, rehabilitative, social, and psychological areas. More studies need to be done of these patients.