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Widespread turmoil causing extremely low morale within the University of Arizona College of Medicine "could destroy the fabric of the college," says a new report on the situation.

The problems plaguing the medical college have pushed many of the UA's top senior physicians and scientists to "the verge of desperation," said UA faculty Chair Wanda Howell.

One devastating result has been a major decline in federal funds for medical research at the UA — which now ranks last among 10 "peer" university medical schools of similar size and scope in the United States.

The report, which cites "considerable unrest, demoralization and loss of focus on mission" at the UA medical college, will be presented today at a meeting of the UA Faculty Senate.

But these conclusions are "a bit overblown" and do not reflect the up-to-date situation at the medical college, said Dr. Philip Malan, the vice dean for academic affairs.

"From the people I've talked to, a lot of these concerns are moderating now over what was going on when this report was compiled," he said. "There has been a lot of modernizing and updating going on here, and we're seeing that play out and seeing the benefits of it."

At the crux of the crisis, according to the report, is the amount of time UA doctors must give to their clinical practices, in order to generate profits, at the sacrifice of academic research and teaching, the report stated.

"As a university medical college, we are supposed to pay more than lip service to research," Howell said. "But the doctors are so burdened by their clinical duties, there is absolutely no time for research.

"This has put many faculty members (teaching physicians) on the verge of desperation."

These and other troubles surfaced a year ago when several key physicians — including top trauma and transplant surgeons, as well as the chief of psychiatry — left the UA.

At the time, several cited fear that the medical college was declining to second-rate status, drained of funds and resources by two new UA medical campuses, in Phoenix and here at Kino.

In the wake of those physician exits, a UA faculty panel — known as the Committee of 11 — launched an internal study of the medical college, interviewing doctors, scientists and department heads over several months.

At the core of much of the turmoil, the study found, is the "three-headed monster," as some call it, that shares power over the medical faculty — the College of Medicine itself, University Medical Center, the teaching hospital, and University Physicians Healthcare, the UA doctors group. UPH also operates the money-losing University Physicians Healthcare Hospital at Kino.

"It is a widely held belief among clinical faculty (physicians) that the current structure makes it essentially impossible for them to engage effectively in academic medicine," the report states.

"After investing 10 hours a day in clinical duties (patient care), they did not understand how they could provide high-quality teaching and build a competitive research program."

The situation also is blamed for low salaries, confusion over tenure status and concern that doctors can be forced to leave UMC and work at Kino.

The effect of all this on the UA's research mission appears critical — blamed at least in part for a recent 14.3 percent drop in federal research funding, compared with an average 4.8 percent drop at other academic medical schools, the study found.

Finally, decisions about such crucial issues as physician hiring, salaries, research space and curriculum have been made with little or no input from the medical faculty. And those who question these decisions and policies are punished for it, resulting in "low morale and distrust," the study found.

"Several senior faculty members said . . . morale is the lowest they have seen in the last 30 years," the report concluded. "Valuable programs and individuals are in jeopardy. This situation, if not addressed, could destroy the fabric of the college."

While these findings summarize the concerns "of a large number of faculty," the report also said "some faculty felt the college was moving forward positively."

A letter of support for the dean of the medical college, Dr. Keith Joiner, signed by 22 UA physicians, scientists and department heads, states in part:

"Dean Joiner has made the necessary and often difficult changes that are moving the University of Arizona toward becoming a top-tier biomedical research institution."

Joiner was out of town and unavailable for comment through the weekend.

But Vice Dean Malan noted that tightening economic pressures are straining medical schools across the country, affecting decisions about who does research.

"So we have to target research efforts on faculty members with the best chance of success, and we've brought in some very good, highly trained recruits for research projects," he said.

Malan agreed that the tug of war among the medical college, UMC and University Physicians Healthcare is "a legitimate issue" of concern. An outside consultant has been brought in to develop a plan to get them "to function together in a strategic way and get their missions aligned," he said.

But the ultimate fix for the UA College of Medicine rests in the hands of UA President Robert Shelton, said members of the Committee of 11. Although efforts to contact Shelton last week were unsuccessful, he is expected to speak about the situation at today's Faculty Senate meeting.

"These are complex problems, but when they hit critical mass and things become disruptive, there is an urgent need for attention," said Michael Cusanovich, director of Arizona Research Laboratories, who was the former UA vice president for research.

"What we are seeing is a significant number of valued longtime faculty now voicing concerns, and if that persists, it could have very serious consequences," Cusanovich said. "The success of the College of Medicine is critical to the future of the University of Arizona."