An administrative shake-up — one expected to increase patient care hours and decrease teaching and research time among clinical faculty — is coming to the University of New Mexico Health Sciences Center.
The university health system is implementing a plan to standardize what it calls the “distribution of effort” among its teaching doctors, attempting to adjust the average ratio of clinical care to academic time from about 61%-to-39% to 70%-to-30%.
The initiative is “designed to better balance the institution’s core missions: providing compassionate clinical care to New Mexicans, training the state’s future healthcare workforce and, advancing discovery through research,” UNM Health Sciences Center spokesperson Chris Ramirez wrote in an email to The New Mexican.
However, the change — which comes as the UNM Health Sciences Center endeavors to double its medical school enrollment with a $636 million expansion and as New Mexicans lament a statewide doctor shortage — has drawn concerns from a group of clinical faculty members known as We Practice What We Teach. The group argues the change will reduce support for medical students and residents, and contribute to workplace attrition when the university should be doing the opposite.
The group outlined these concerns in a March 28 email to the executive vice president of the UNM Health Sciences Center, Dr. Michael Richards, and UNM School of Medicine Dean Dr. Patricia Finn.
“Faculty are not only invested in UNM’s mission — we are the individuals who operationalize it every day,” the group wrote in the email, which was obtained by The New Mexican. “We are committed to working toward solutions. However, solutions cannot be imposed; they must be developed through collaboration.”
Ramirez said university officials heard the faculty members’ worries on the subject. After a series of town halls, information sessions and opportunities for feedback, he added, “we don’t believe this is a predominant concern.”
Rather than creating barriers to expansion, Ramirez argued the “distribution of effort” initiative will be an “important step” in allowing the Health Sciences Center to “appropriately scale for growth.”
“As the SOM hires more faculty to support this growth, all faculty members will continue contributing to patient care, teaching, and research,” he wrote. “That’s a win-win-win for our patients, students, residents, and for contributions to health science research.”
‘Greater health equity’
The roots of the “distribution of effort” initiative can be traced back to late 2025 and early 2026, according to internal documents The New Mexican obtained through a public records request.
A presentation — dated March 4 and included in the cache of documents — indicates UNM Health Sciences Center faculty were spending about 61% of their time in a clinical setting, according to an audit conducted in November. The remaining 39% of their time was devoted to academic and administrative responsibilities, including undergraduate and graduate medical education.
In addition to being marked “Confidential,” the presentation includes the brand and trademarked motto of ECG Management Consultants, a firm that specializes in advising health systems, including several attached to public universities.
Representatives from ECG Management Consultants did not respond to requests for comment.
The presentation proposes shifting to a so-called “One Minus” model, in which the university “subtracts specifically defined and agreed-upon non-clinical time” from a faculty member’s regular hours. The faculty member would then be expected to apply all clinical time — on average, about 70% of their work hours — to patient care.
How much time each faculty member is expected to spend seeing patients versus performing educational, research and administrative tasks depends on their current job responsibilities, Ramirez said. Not every teaching clinician will be required to implement an exact 70%-to-30% ratio, and some would spend up to 90% of their work hours in clinical settings, according to a document distributed to faculty.
An overall average of 70%-to-30%, Ramirez added, will bring the university more in line with similar institutions nationwide and help the UNM Health Sciences Center meet the demands of New Mexico patients.
“New Mexico faces a significant shortage of healthcare providers, and the demand for increased access to physicians and other health professionals continues to grow,” Ramirez wrote in an email to The New Mexican. “In response, UNM is taking a thoughtful, data-informed look at how faculty allocate their time, particularly the time spent delivering patient care, to expand access and promote greater health equity across the state.”
The Health Sciences Center has a financial incentive to increase faculty clinical time, too. In general, more time spent on patient care equals more services billed to insurance and more revenue for the health system.
UNM Hospital reported an operating loss of $169.5 million in fiscal year 2025 as a result of high labor costs and inflationary price increases, according to its latest audited financial statement. However, the hospital’s net position as of June 30, 2025, totaled $869.4 million, after accounting for all assets and liabilities.
In addition to their clinic time, Ramirez acknowledged UNM doctors “play a vital role in education and research.”
“The [distribution of effort] initiative ensures that faculty continue to dedicate meaningful time to teaching students and training the next generation of providers, while also supporting scholarly work,” he wrote.
Faculty requests pause
Not all faculty members see it that way.
In its March email to Health Sciences Center leaders, We Practice What We Teach voiced “serious concerns that the proposed changes to effort distribution will significantly impair our ability to fulfill our clinical, educational, and research missions.”
The group conducted a faculty survey, collecting 160 responses with particular concern about the possible implementation of a 90/10 split between clinical and education time.
Nearly two-thirds of respondents said they would be “somewhat or very likely” to leave UNM if that model were implemented, according to survey results included in the email. About 44% said they would be “somewhat or very likely” to leave New Mexico entirely in that case. And nearly 90% said such a such a change would “negatively affect the quality of medical education and trainee supervision.”
Faculty in the email asked Health Sciences Center leaders to pause implementation of “distribution of effort” initiative pending the distribution of the full proposal; timely communications to faculty, residents and medical students; and an opportunity for discussion about the proposed change.
“We are ready to collaborate and work with leadership. At the same time, we are equally committed to ensuring that these [clinical, educational and research] missions are protected more broadly. … We expect to be part of the discussion and the solution, starting now,” the email said.
Ramirez said the University of New Mexico Health Sciences Center has assuaged some of these concerns through a series of town halls and information sessions, though the institution will “continue to closely monitor” faculty recruitment and retention.
The school of medicine, he wrote, “has long relied on its mission to attract and retain faculty, and this will continue to be a core strength of the institution.”
