If the news of Gottesman’s gift was received with such admiration and enthusiasm, it was in part because it seemed to drown out the noise of transactionalism that resonated around so much generosity. It has rarely been louder than in recent months, when some of Wall Street’s most successful people worked to unseat university presidents whose ideologies and management styles did not align with theirs.
“There’s a wonderful humility to the story,” observed Amir Pasic, dean of the Lilly Family School of Philanthropy at Indiana University, especially given what he described as a “change of sentiment” among donors, who see donations as an investment rather than “a community process.” This dynamic is much more prevalent now than it was 20 years ago.
Einstein’s donation is the third largest ever made to an institution of higher education. (Michael Bloomberg’s $1.8 billion for Johns Hopkins, his alma mater, tops the list.) Einstein will not displace his namesake to call it the Ruth Gottesman School of Medicine, nor does his benefactor appear to demand any other form of grand institutional deference.
Ruth Gottesman has been involved with the school for more than 55 years, first as a specialist in the diagnosis and treatment of learning disabilities and then as an administrator. Dr. Gottesman knew, as Pasic said, “how sausage was made on a very intimate level.” What he noticed in particular was the gristle: how difficult it is, especially for anyone wanting to enter the primary care field, to leave school saddled with the kind of debt that $59,000-a-year tuition can bring. Nearly half of all Einstein students end up owing $200,000 or more when they leave.
The cost of medical education is a major factor driving the physician shortage that Jesse M. Ehrenfeld, president of the American Medical Association, has called a national crisis. In an October speech at the National Press Club, he said the shortfall of doctors in the United States could rise to at least 37,000 over the next decade, and could reach 100,000. One of the greatest needs is in family medicine, where the salary is usually much lower than that of the different specialties. Last year, 217 family medicine residency positions were unfilled, the most in any category. By comparison, anesthesiology had only one opening: there were no residencies for plastic surgeons.