Georgetown University Medical Center lost $38 million in the first half of this fiscal year, widening the deficits that have hobbled the prestigious teaching institution for years.

If those losses continue at the same pace through the end of the fiscal year next week, the red ink will exceed $75 million for the full year. Georgetown's medical center lost $62.4 million last year and $57 million in 1997.

Like major academic medical centers across the country, Georgetown is under enormous pressure from reduced federal medical education payments mandated by the Balanced Budget Act of 1997 as well as a continuing decline in hospital use by people with cost-conscious health plans.

It's a situation further complicated by a tumultuous and lopsided local health care system with a sea of empty hospital beds and 80,000 uninsured residents who do not have reliable access to basic medical services.

Those financial pressures already have driven the medical center on Reservoir Road NW into partnership talks with MedStar Health, which owns some Baltimore health facilities and this region's largest hospital, Washington Hospital Center.

MedStar officials said yesterday they know what they'd be getting into by making a deal with Georgetown and said school officials have been forthcoming with all the financial data--including any bad news.

"If this transaction is completed, it's because we think we can turn it around," said MedStar Vice President Lisa Wyatt. "We have smart financial management here and a history of success."

Georgetown officials expressed confidence that the deal will go through and that the university is on track in its pursuit of a financially strong partner.

"Our board is not going to panic," said Georgetown spokesman Dan Porterfield. "It's going to focus on Georgetown's strengths and making sure those strengths are preserved and enhanced. In our case, that's academic quality, and that means having a first-class school and biomedical research enterprise. Those have both had excellent years."

Across the nation, academic medical centers have suffered disastrous losses, with many reporting much larger deficits than Georgetown. Wall Street analysts who review their creditworthiness have created a new category of academic medical centers they call the $100 Million Club that includes those whose single-year losses surpass that figure, said hospital consultant Susan Hansen.

Georgetown's consolidation with MedStar is the best hope of preserving hospital services at the current site, Hansen said.

"If they didn't do anything, I think for sure there would be a loss of service to people in that part of the city," she said. "If Georgetown had to decide which was more important, the academic enterprise or the hospital, I'm pretty sure the academic would win."

Jordan Cohen, president of the Association of American Medical Colleges, said that if current trends continue, 40 percent of the nation's major teaching hospitals will be losing money within three years and the average loss at each will be $50 million.

Stanford's partnership with the University of California at San Francisco, already is reporting huge losses, as are the teaching hospitals at the University of Pennsylvania and Harvard, among many others.

"This is really serious business," Cohen said yesterday. "We're concerned that unless something is done we're going to see some irreversible damage done to the gems of American medicine. I'm sure Congress didn't intend the Balanced Budget Act to have that kind of effect. We're calling on Congress to make some mid-course corrections here."

In the District, George Washington University Medical Center's projected loss is $39 million for the current fiscal year. That does not count a slight profit posted by the hospital, which was purchased by a for-profit firm, said Skip Williams, university health affairs vice president.

The financial performance of the District's other teaching hospital at Howard University has improved slightly, according to Moody's Investors Service.