this is how it works,
a web designer has absolutly nothing to do with their clients other than offering them a service, these med schools being their clients. they offer their clients 2 choices: 1- lets hire a photographer to go out and photograph your students to use for images within the web site. the college not only has to pay the web designer more money to do this, but now also has to pay for a photographer. on top of that the college now has to choose which student, get them to sign a release, coordinate the whole shoot, blah blah. thus it takes longer and costs more. or 2-the web designer will offer to use stock images within the web site instead. it's easier/faster/cheaper. 🙂
there ya have it. 😀