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Archive for Tuesday, January 16, 2007

KU push

Proposed affiliation plans involving the Kansas University Hospital and School of Medicine appear to be coming to a head.

January 16, 2007

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It appears the negotiations involving the Kansas University Hospital, KU School of Medicine, St. Luke's Hospital, the "Time to Get It Right" and "Time to Get Things Done" efforts, Truman Medical Center, Children's Mercy Hospital and the Greater Kansas City Community Foundation may have a greater political side than previously acknowledged.

It is understood Executive Vice Chancellor Barbara Atkinson's office has issued an edict or directive ordering KU medical school and KU Hospital officials to agree on a letter of intent that would bring about an affiliation between the two and St. Luke's Hospital.

This is to be done by Feb. 1 or 14, when Gov. Kathleen Sebelius is scheduled to meet with Missouri Gov. Matt Blunt, apparently in Kansas City, to announce the new affiliation. Just how much do the governors really understand about the issues involved? Or is this primarily a staged affair to make the governors look good and give St. Luke's supporters what they want?

St. Luke's and the Greater Kansas City Community Foundation officials are reported to have said that unless such an agreement is reached by the February deadline, they will seek an agreement with Washington University in St. Louis. Some say this might be the best solution, rather than to weaken or handicap KU.

Those at the KU Medical Center and KU Hospital who are deeply involved in the issue say those trying to force the affiliation with St. Luke's are using "heavy-handed methods" and playing "hard ball" to try to shove this agreement down the throats of the two entities.

It is not a happy situation. Some say Irene Cumming, the very successful and highly respected president and CEO of the KU Hospital is not enthusiastic about the merger and may be fired or asked to resign. If she were to leave, she would receive many offers because she he is recognized as one of the nation's outstanding hospital executives. The relationship between her and Atkinson is not as good as it should be.

As an outstanding researcher who recently left KU for another major university said, "It is unfortunate there are those at the university who find it difficult to accept success, excellence and recognition of others." This may be a large part of the problem at the medical center.

The KU medical complex/St. Luke's matter didn't have to grow into such an ugly mess.

The idea or dream of making the greater Kansas City area a center of excellence in medical research is sound. The "Time To Get It Right" study, which was commissioned by the community foundation, not KU, said it was important to merge research efforts. KU Hospital and KU medical school people are in total support of this plan. They do question, however, the effort and real reasons for forging a relationship between KU academic programs and St. Luke's.

It is interesting that for years, the KU Medical Center and hospital were not held in the highest regard by many on the Missouri side of the state line. St. Luke's was the hospital of choice. Times have changed, and St. Luke's now realizes it needs the KU school and hospital to shore up its slipping competitive position in Kansas City.

The secrecy in planning the affiliation has hurt the effort. KU Hospital officials were left out of most of the early discussions until this freeze-out was made public. This was a major mistake! Likewise, only a few in the medical school were included in the planning. As of this date, only a handful in the medical center have any idea what will be in the agreement or affiliation letter of intent that will be presented to the Kansas and Missouri governors and how this affiliation may affect their professional careers. In fact, it is interesting this agreement or commitment is to be handed over to the two governors without many at KU knowing what has been agreed to.

There are other negative factors. Some at KU question the honesty of several on the Kansas side concerning their statements and handling of this matter. Has Sebelius been fully informed on possible consequences of the agreement and has she heard from those opposing the action?

The morale of many at the Medical Center and hospital is not good. What has happened to earlier discussions of having Truman Medical Center and Children's Mercy be part of the plan at the outset? What might happen to Truman if St. Luke's drops or lessens its relationship or dependence on Truman for residents and interns, and who will be taking care of the indigent patient load in Kansas City, Mo.? Will St. Luke's take on this added responsibility and expense?

What happens if, for some reason, the $400 million pledged by the independent KU Hospital to the KU School of Medicine does not materialize because of the way this affiliation has been forced on the hospital?

It came as a surprise to many to learn that the $200 million or so pledged by Kansas City business and philanthropic leaders for this effort will not go to any KU health plan or hospital but rather to the community foundation. KU officials will have to make application to access the funds. The KU Hospital offer of $400 million was to go directly to the KU medical school.

And lastly, and terribly important, is the potential fallout for the KU Medical School and KU Hospital. Will Cumming be forced to leave, perhaps damaging the current growth and excellence of the hospital? Will other faculty members decide to move on?

Another factor that hasn't received much attention is the behind-the-scenes role of some at the highly acclaimed and internationally recognized Stowers Institute, particularly Dick Brown, co-chairman of the Stowers board of directors. It is reported he does not get along with Cumming.

There is every reason to believe Kansas City could and should become one of the nation's outstanding centers for medical research, but the way some have handled the potential affiliation is unfortunate. They have not been open about all of their motives. It would have been far more helpful and triggered more universal support if talks had been open and honest from the outset. The fact that too many people were trying to operate behind closed doors created suspicion, concern and distrust.

KU people should try to be helpful and cooperate, but their primary interest should be to protect the medical school and hospital. Over the years, Kansas taxpayers have invested hundreds of millions of dollars in the medical complex, and it is difficult to understand why some at KU seem so willing to sell out their school. Likewise, why haven't members of the Kansas Board of Regents and Kansas Legislature demanded to know far more about all aspects of the planned affiliation before it is handed over to the governor? Have the regents, lawmakers and the governor bought the plans of St. Luke's, the community foundation and Atkinson/ Chancellor Robert Hemenway hook, line and sinker?

The February gathering could prove to be a pivotal event in the history of the KU School of Medicine and KU Hospital. Time will tell whether it will be the start of something grand or the beginning of a diminished role and prestige for the KU medical entities.

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