Opinion | Duluth has a once-in-a-generation chance in academic medicine

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Duluth has always been treated like a regional outpost regarding medical education, a strong hospital town that feeds into the University of Minnesota’s training pipelines but never controls them.

The state’s doctors are mostly minted in Minneapolis, where Fairview Health Services has long bankrolled the U’s teaching hospital with a $100 million annual subsidy. About 70% of physicians across Minnesota learned their craft through the U’s medical school or residencies. The power, the money and the decisionmaking live in the metro. For decades, Duluth has played its part but stayed in the shadows.

Now, with the collapse of talks between Essentia Health, the U and Fairview (front page, Sept. 26), the script is starting to flip. For once, Duluth has a chance to seize the initiative. The U’s deal with Fairview expires in 2026, and nobody can say with certainty where that partnership goes from here. Essentia has already set aside land on its medical campus for a new building, not for another routine expansion but for something bigger. The writing is on the wall: It’s prepared to host an actual teaching and research center in Duluth if the door cracks open.

The opportunity couldn’t be clearer. Fairview’s reluctance to merge under an Essentia-led structure pushed Duluth’s system to the sidelines, but that doesn’t mean Essentia has walked away from academic medicine. Far from it.

Its public statements have made it plain — it still wants to work with the U, it still wants to shape the future of Minnesota’s health care workforce, and it still believes greater Minnesota deserves a bigger voice. This isn’t about boardroom egos or legal contracts; it’s about geography, vision and leverage. Essentia controls the land, Duluth holds the ambition and the university has the need. That’s a recipe for a shift in statewide balance if anyone can act on it.

We talk all the time about diversifying our economy — this is it. This is the shot. A teaching center on Essentia’s campus would change Duluth’s story and shape the kind of doctors Minnesota produces for decades to come. Rural kids training in a rural hub, learning how to care for patients across the Arrowhead and beyond, without having to leave their own communities behind. That’s how you build both a workforce and a future.

And here’s where Duluth can dream bigger. Because if we’re serious about bringing an academic medical hub north, then we should also be serious about solving another glaring problem at the same time: our hollowed-out downtown.

Half-empty office towers, darkened storefronts and too many “for lease” signs have left the city’s core struggling for identity. What if we treated the teaching center as a 2-for-1 project — medical education on the hill, student housing and vibrancy in downtown? Fill those vacant buildings with medical students, residents and young professionals. Build modern apartments, training labs and collaborative spaces that spill into the restaurants, coffee shops and nightlife that follow young energy wherever it goes. Suddenly, downtown Duluth is alive again, with lights on in the windows and feet on the sidewalks after dark.

That’s how you turn one bold move into two transformational wins. Build the teaching center, and at the same time activate the city center. No tourism campaign or civic branding effort could deliver the same jolt. This is the best investment Duluth could make in itself, because it ties our health, our economy and our sense of place into one unified project.

There’s another factor that plays in Duluth’s favor. Young medical students aren’t just picking training sites based on labs and clinics. They want to live in a place where they can breathe, where they can kayak on a Tuesday night, hike in September colors, ski a few minutes from home in January, or sit on the shore of the world’s largest freshwater lake and clear their heads after a long shift. Duluth and Lake Superior offer that lifestyle in spades.

The risk is just as stark. If Fairview and the U hammer out another long-term deal, Duluth’s chance fades away. Essentia’s reserved land could sit idle or end up housing just another clinical wing. The money and power stay locked in Minneapolis, the Northland applauds politely from a distance and we carry on with business as usual. We’ve seen this movie before. Duluth waits, the metro decides and nothing changes.

For Essentia’s people — the nurses pulling double shifts, the doctors chasing scarce specialists, the techs who keep the gears turning — this isn’t some abstract power play. It’s about whether the system they’ve built here gets to shape the future of Minnesota medicine, or they remain second fiddle to institutions 150 miles away.

A Duluth teaching hub means more resources, more young colleagues coming north instead of fleeing south and a shot at real influence in how health care is delivered across this state. For patients, it means shorter trips for complex care and the comfort of knowing that the doctors treating them were trained in communities like their own.

That’s why this moment matters. It’s bigger than a contract expiration date. It’s bigger than Essentia’s corporate strategy. It’s a once-in-a-generation chance for Duluth to plant a flag and say we’re not just a regional player — we’re shaping Minnesota’s future. The university says it’s open to conversations with Essentia, and that’s the opening we should drive a truck through. Because if Duluth is ever going to stand on equal footing with Minneapolis in academic medicine, it won’t be handed to us. We’ll have to fight for it.

This is the fork in the road. One path leads to another generation of status quo, with Fairview cutting checks in Minneapolis while Duluth claps from the balcony. The other leads to a bold new partnership, a building on Essentia’s campus and a city that finally seizes the mantle of statewide leadership.

Here’s hoping our leaders don’t just recognize the opportunity — they make it our No. 1 priority when the Legislature gavels in next session.