Archive for Friday, March 2, 2007

Timeout needed

State and university officials should call a halt to current negotiations to merge the Kansas University Hospital and Medical Center with St. Luke’s Hospital in Kansas City, Mo.

March 2, 2007


It's time for Gov. Kathleen Sebelius, the Kansas Legislature or the Kansas Board of Regents to call for a "timeout" in the current negotiations for a merger or affiliation between the Kansas University School of Medicine, KU Hospital and St. Luke's Hospital.

Proceeding with the merger originally proposed by Barbara Atkinson, executive vice chancellor and executive dean of the medical school; Chancellor Robert Hemenway; Bill Hall, president of the Hall Family Foundation; Kansas City business leader Irv Hockaday; and several St. Luke's leaders could have significant and dangerous consequences for the KU Medical Center, KU Hospital and the state of Kansas.

The idea or plan was put together in a less-than-open (many say, secret) manner by Atkinson, Hemenway, Hall, Hockaday and St. Luke's senior administrators.

The Greater Kansas City Community Foundation commissioned a study by a "blue ribbon" committee headed by former Yale University president Benno Schmidt to look at the Kansas City scene and come up with a suggestion of what was needed to help make the greater Kansas City area a true regional leader in medical research.

The answer was that the hospitals and research centers of Kansas City - KU Medical Center, KU Hospital, St. Luke's, Children's Mercy Hospital, Truman Medical Center, Midwest Research Institute and the Stowers Institute - should combine efforts. It was a research initiative; little if anything was said about integrating the academic programs of these hospitals and schools.

Nevertheless, the report was used as a way to suggest a KU-St. Luke's merger and, along with that, to argue that KU needed to have cancer patients from St. Luke's to have a sufficient number of cases to build their own case for being designated a National Cancer Center.

Since last summer, as more and more of the secret planning has come to light, many questions have surfaced. The main one is whether this is good for Kansas. Is it good for the KU Medical Center? Is it good for KU Hospital? The only thing that stands out is that KU is strengthening St. Luke's, its competitor in the health care business.

Consider the following:

¢ KU and St. Luke's claim they need more cancer patients for cancer trials. St. Luke's actually has a small percentage of the cancer cases in Kansas City while the Kansas City Cancer Center handles about 70 percent of the Kansas City cases, 5,000 to 6,000 a year. They have not been contacted by KU or St. Luke's officials about participating in the merger effort. Doesn't that raise some questions? KU's Dr. Roy Jensen is putting together an alliance of Kansas hospitals that could supply far more than enough cancer patients. The argument that KU needs to get patients from St. Luke's is phony.

¢ In the proposed agreement, there is no "out clause" - at least the doctors at the hospital and others who would be involved have not been told of any such clause. It is a 10-year agreement so those at the medical center are having an "albatross" placed around their necks.

¢ Kansas House Speaker Melvin Neufeld told the president of the Board of Regents that he wanted them to get to the bottom of the situation. As of earlier this week, Reggie Robinson, the regents president, had not interviewed Irene Cumming, president and CEO of the hospital, regarding her many questions about the plan nor had he interviewed KU doctors or clinicians or leaders of the Kansas Medical Society who are opposed to the plan.

Robinson has relied on Hemenway and Atkinson for his information. Now, however, he has scheduled a meeting with Cumming.

¢ The doctors are so frustrated in their inability to get the attention of Atkinson or Hemenway that they have hired their own lobbyist to help tell their story to Kansas legislators.

¢ Neufeld has said he intends to find out what is going on and whether the proposed merger is good for Kansas and for the medical school. He is not going to stand for any whitewashing of the matter or having something jammed down the throats of the KU medical school and hospital that isn't in the best interests of the hospital and the people of Kansas. If he doesn't think the regents have sufficient information, he intends to call a hearing on the matter.

¢ Earlier this week, Dr. Susan Pingleton announced her plans to resign as chairwoman of the department of internal medicine, the largest department at the KU medical school. She is highly regarded, with an excellent record of achievement at the school. She enjoys great support from her fellow doctors and yet, because she questions the direction of Atkinson and the plans with St. Luke's, the environment is such she thinks it is best to leave.

If the plan is executed as originally planned, other doctors also are likely to leave.

¢ The record of St. Luke's affiliations in Kansas City with other hospitals is not good. One report points out that over the past 15 or 20 years, St. Luke's efforts to affiliate with facilities such as St. Joseph Medical Center, Shawnee Mission Medical Center, Health Midwest and St. Luke's/Shawnee Mission combined have gone belly up.

This is why the "out clause" is so important to KU. The 10-year agreement could be disastrous for the medical center.

¢ It's understood some Democratic members of the Wyandotte County legislative delegation are concerned about what might happen to KU Hospital if the St. Luke's deal goes through and are considering asking Sebelius to back off her support of the plan. State Sen. Chris Steineger, D-Kansas City, has suggested the hospital be sold to help pay for repairs at state universities and boosting the state's pension system.

¢ There are some who say the long-range goal of some is to have St. Luke's end up owning KU Hospital.

These are just a few of the issues and questions circulating about the plan being pushed so hard by Hemenway, Atkinson, Hall and Hockaday. Cumming is due to appear in Topeka next week for at least two hearings about the situation. In addition to Neufeld, Rep. Jim Morrison of Colby and Sen. Jim Barnett, an Emporia physician, also are eager to learn more.

The best thing that could happen at this stage, before damage is done and more superior KU doctors resign is to put all negotiations on hold. Forget the artificial March 31 deadline set by St. Luke's proponents and don't worry about the St. Luke's threat to seek an affiliation with Washington University in St. Louis.

It is important for all the facts to be made public and to start over. It makes great sense to have an excellent collaborative environment for research efforts by all Kansas City players. But this does not need to include the educational facet that St. Luke's boosters are trying to inject. Those favoring the education bit are more interested in doing what they can to prop up the quality of medicine at St. Luke's than in seeking overall excellence for greater Kansas City.

Again, the governor, legislators and the regents need to show some leadership and courage by calling a halt to current talks - not an abandonment of the research collaboration but an intention to start over, be open and transparent and do what is in the best interests of Kansas and KU. That should be the first priority.

Few, if any, of the KU medical center people opposing or questioning the plan are opposed to a greater research effort. They are enthusiastic about the idea! Likewise, others in the Legislature, or elsewhere, are not opposed to greater cooperative efforts in research and are not proponents of a "stand still" position, as some suggest.

They do, however, place KU and Kansas first. They find it difficult to understand why KU leaders do not appear sufficiently concerned about protecting KU's interests.

It is not a healthy situation, and it would be wrong to proceed with a plan so clouded by confusion, suspicion and self-interest and self-promotion.


ed 11 years, 3 months ago

This article makes it sound like a conspiracy theory is in the works. There is no "confusion, suspicion, self-interest, and self-promotion" in the plan for affiliation as you suspect. The logic is very simple:

-The goal of this administration is to make KUMC one of the best medical centers in the country. This will benefit Kansans.

-Affiliation will help make KUMC a better instititution. Colaboration of two great hospitals will lead to improvement of healthcare for Kansas residents.

-Arguing against affiliation, colaboration, and this overall effort to improve the healthcare system will hurt Kansans.

-A timeout, as defined in is: a brief suspension of activity; intermission or break. Time is money. An unnecessary timeout will cost Kansans money.

-Everybody says that KU Hospital will lose its competitive advantage to St. Luke's. But this is a two way street. St. Luke's will lose the same competitive advantage to KU Hospital. In the end, collaboration will mean that both organizations will come out superior, to the benefit of Kansas residents.

-In your article, you say "the argument that KU needs to get patients from St. Luke's is phony." The NIH looks at the number of patients and clinicians that a researcher has to work with when awarding research grants. Is it a cooincidence that Washington University is connected to one of the 10 largest hospitals in the country AND it has one of the 10 largest $'s of NIH funding? More patients = more NIH funding. More NIH funding will lead to a superior healthcare system in Kansas.

-There are good issues you raised, but these are not reasons to slow down or put a "timeout" on affiliation. These issues should be ironed out in a timely manner so that affiliation can move forward for the benefit of Kansans.

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