Reporting From Alaska

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Budget office distorts statistics on Alaska doctors, pitching false evidence for stopping medical training

The Dunleavy administration hasn’t distinguished itself with an ability to provide accurate interpretations of statistics. In some cases, this appears to be deliberate, such as with the misleading reports about the University of Alaska.

The latest evidence about misusing math comes with the plan to eliminate $3.1 million that helps young Alaskans become doctors.

The Dunleavy analysis presented to the public states that the number of doctors returning to Alaska has declined and the program is ineffective.

“From calendar year 2014 through calendar year 2018, the percent of graduates practicing in Alaska has decreased from 84 percent to 61 percent,” the state claims.

A backup document to the so-called “Honest Budget,” claims, “The WWAMI program has not proven effective at meeting the demand for new physicians, despite a significant state investment over the years.”

But the numbers in the analysis are inaccurate, according to the administrators of the WWAMI program in Seattle.

The 84 percent figure was larger because the calculation included Alaska students and students from other WWAMI states who ended up in Alaska, while the 61 percent figure included Alaska students only, according to WWAMI. This needs to be corrected to provide an honest picture.

In 10 minutes of phone calls I was able to learn that something was amiss with the percentages. It’s not clear how the mistake occurred. My guess is this was not a deliberate act, but someone under the temporary budget director should have checked with WWAMI.

A more realistic way to talk about this program is that Alaska has the fourth highest return rate of students in the country, according to the WWAMI administration in Seattle. This is important in a state with a shortage of doctors. The program has been effective and remains so.

The WWAMI letters stand for Washington, Wyoming, Alaska, Montana and Idaho—states that participate in this long-running program at the University of Washington to train more doctors in a region with a scarcity of medical schools.

Alaska, which does not have a medical school, provides a subsidy for 20 Alaskans to attend medical school each year via the University of Washington, with training that starts in Anchorage.

The Alaska students selected for medical school have a tremendous track record of success.

“In the more than 44 years of the program’s existence, only 20 students have not graduated due to various reasons including academic difficulty, personal problems or death. The major component to achieving this target is selecting Alaskans who demonstrate the academic and personal characteristics that are strong indicators of their ability to thrive in the challenging academic setting and their commitment to return and practice in Alaska,” the state said in a performance review during the Walker administration.

Alaska students who do not return to Alaska have to pay back the state to make up for half of their subsidized tuition, creating a strong incentive for doctors to practice in Alaska. There are many WWAMI-trained doctors who have spent their careers in Alaska. There are other WWAMI doctors from other states who decided to make Alaska home. We need to encourage this, not eliminate it.

“The state of Alaska views these subsidies as loans that are repayable once medical education is complete,” the University of Alaska Anchorage tells prospective students.

Alaska WWAMI students pay the equivalent of resident tuition in Washington, so this is hardly a free ride.

About $882,000 a year is returned to the state by doctors who do not return, which reduces the overall state cost by close to 25 percent, according to this 2016 document from the state hospital association.

About 70 percent of the state subsidy gets spent in Alaska. Graduates who spend three years working in rural Alaska or five years in urban Alaska may qualify for loan forgiveness and many remain in Alaska afterward.

“The partnership between the University of Washington School of Medicine and Alaska continues to be a productive and cost-effective approach for meeting the needs of the physician workforce in Alaska,” the hospital group said.

That is what the so-called Honest Budget should say.

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