It appears KU officials, the governor and several Kansas City business and philanthropic leaders have thumbed their noses at members of the Kansas Legislature by signing or helping draft powerful letters of intent to form an alliance involving the Kansas University Hospital and Medical Center and St. Luke's Hospital.
KU Medical Center Vice Chancellor Barbara Atkinson, Chancellor Robert Hemenway, Gov. Kathleen Sebelius, several key Kansas City business and philanthropic leaders, such as Irv Hockaday and Bill Hall, along with some at St. Luke's Hospital, took the action knowing full well that a bill has been introduced in the Kansas House calling for delaying such a deal until more details of the proposed alliances can be studied. They also knew a number of Kansas medical organizations question the alliances and that many at the KU Hospital and medical school are opposed to the plan and angry that they have been kept in the dark.
Nevertheless, the officials charged ahead on the alliance, paying little, if any, attention to anyone who questioned their goals or tactics.
Critics of the alliances say the KU Medical Center brand has been given away to St. Luke's, that the medical school and hospital have been weakened, and that KU and the state of Kansas gain nothing by this action. The belief is that the entire effort was masterminded by St. Luke's supporters who want to strengthen their operation because they realize St. Luke's has been losing market share and the KU medical school and hospital have taken over as the area's premier medical research and health care facility.
For some difficult-to-understand reason, Atkinson bought into the idea even though many members of the hospital and medical center staff were strong in their opposition. She kept negotiations secret, even excluding Irene Cumming, the highly recognized president and CEO of KU Hospital. Maybe it was the pressure from the highly regarded Hockaday and Hall, president of the Hall Family Foundation, that swayed Atkinson. Maybe it was money; maybe it was politics and raw power. Hemenway is in a difficult position because he serves on the Hall Family Foundation board, and the Halls have been extremely generous in their fiscal support of KU. At the same time, he is chancellor of the university and should be motivated primarily by what is best for KU.
It is not a pretty picture, and the manner in which it has been put together allows many to question the real motives behind the action. The one question that comes up at every turn is: What does KU get out of the deal?
The historical relationship between the KU Hospital and KU Medical Center has been fractured, and there no longer will be an exclusive relationship between the two institutions. Likewise, KU will share its research facilities and name with St. Luke's. KU Hospital will not be designated as the sole medical center if and when KU gains the covered designation as a comprehensive cancer center.
Neither hospital officials nor Hemenway will release details of the KU-St. Luke's affiliation even to Kansas lawmakers. However, it is reported KU will provide St. Luke's up to, or perhaps more than, 100 medical residents and offer an almost wholesale volunteer clinical track affiliation to all St. Luke's doctors. KU gives away the brand name Kansas taxpayers have spent hundreds of millions of dollars to develop over the years. It is reported the new alliance will provide a means for St. Luke's to get out of its relationship with Truman Medical Center and the University of MIssouri-Kansas City and will be able to operate under the imprimatur of the KU Medical Center, allowing St. Luke's to strengthen its retail position in Kansas City.
What do KU and Kansas get out of the deal? They are giving away a brand name and strengthening a competitor. If the KU Medical Center is designated as a National Cancer Institute Comprehensive Cancer Center, this recognition would be shared with St. Luke's.
The addition of St. Luke's adds relatively little to the medical research efforts because KU, not St. Luke's, is THE research center. Except in the area of heart care, St. Luke's doesn't contribute much in the way of high-level research, and KU already has a top-flight group of cardiologists and heart surgeons, as good as those at St. Luke's.
KU does not need patients from St. Luke's for its research efforts. Affiliations with several other Kansas City hospitals could provide more than the needed number of patients for research without giving away the KU brand.
The deal also may allow St. Luke's to move into some research areas it does not now have, taking these efforts away from the KU Medical Center.
Observers close to the situation say Atkinson has been "relentless" in her efforts to put this deal together. One has to wonder what she hopes to gain for herself or for the medical center. If and when the deal is completed, will she be given the top medical education position in Kansas City and is there some kind of position in the works for her with the Stowers Institute?
For several reasons, Atkinson and Cumming do not get along. Cumming is one of the nation's best hospital executives. She is demanding, doesn't accept less than the best efforts by her staff and is committed to doing what she thinks is best for the hospital. She is not willing to stand by silently as she sees efforts she is convinced will weaken and handicap the hospital and its chances for further growth and greater excellence.
Cumming has serious reservations about the plan that is being jammed down her throat. One possible consequence of the new affiliation with St. Luke's is that she might decide it would be best to leave and accept an attractive and lucrative offer elsewhere. Another scenario might be that Sebelius may appoint a sufficient number of new members to the hospital board to force Cumming to resign or be fired.
This would be a huge loss, and if it were to come about, chances are, a number of current hospital staff members also would leave. If that were to happen, some say the hospital might regress to its state prior to Cumming's arrival. This idea suggests St. Luke's would come in to run the hospital. Yet another result, some say, is that Stowers executive Dick Brown, who is not a strong admirer of Cumming, would enter the picture and perhaps try to put together a group to buy the hospital.
It will be interesting to watch the reaction of Kansas legislators to the arrogant move by Atkinson and Hemenway to defy the desire of some lawmakers to have more information about the alliance with St. Luke's. It is not a popular move among many in the health care field across the state. Some have serious questions about the impact on the state's medical school operation in Wichita and why Hemenway, Atkinson and others are not as concerned about building the staff and reputation of that school as they are in building the excellence of St. Luke's across the state line. Will the Wichita school be left in the dust and continue to beg for greater financial assistance?
Whatever the answers to these and many other puzzling questions, one thing is sure: There must be dancing in the hallways of St. Luke's these days.
Atkinson, Hemenway, Hockaday, Hall and others got their job done. Now Kansans can wait to see the consequences. It is hoped they will be good for all parties, but particularly for KU and Kansas.