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Archive for Thursday, March 8, 2007

Shifting justifications

Supporters of a Kansas University-St. Luke’s hospital affiliation keep changing their minds about why such an agreement is so vital.

March 8, 2007

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It is interesting to note how often those fighting to give away the Kansas University medical school brand to Kansas City's St. Luke's Hospital and possibly weaken the expanding and growing KU Hospital change their stories on why the new affiliation is so important.

The process was started a year or so ago when the leadership of the Kansas City Community Foundation commissioned a study to determine what is needed to make Kansas City a true regional leader. The first report, called "Time To Get It Right," was followed a year later by the "Time To Get Things Done" report. Both called for a strong unified collaboration among health-related facilities in Kansas City to maximize their research efforts. Those included in the recommendation were the KU Medical Center, St. Luke's, Children's Mercy Hospital, Truman Medical Center, Midwest Research Institute, Stowers Institute and the KU Hospital.

The focus of this report was affiliations for research, not education, and the authors said the effort should simultaneously include all of the hospitals and research facilities.

There is reason to wonder what came first. Did some in the planning body want to figure out a way to get help for St. Luke's and strengthen its position in the Kansas City market or were they surprised by the findings of the "Time to Get Things Right" report and then decided to use the study to strengthen St. Luke's?

Whatever the case, research was put on a sidetrack - and Children's Mercy, Truman Medical Center and UMKC were dropped from the plan. With the help of KU Executive Vice Chancellor Barbara Atkinson and Chancellor Robert Hemenway, even more emphasis was placed on developing an agreement for KU to supply St. Luke's with up to 100 medical residents a year, with St. Luke's paying KU $100,000 for each resident over a 10-year period. Nothing like this was suggested in the "Time To Get Things Right" report, but Atkinson and Hemenway have been relentless in trying to jam this down the throats of many at the medical school, KU Hospital and other Kansas medical associations. To counter the St. Luke's offer, KU Hospital offered the KU medical school $400 million, but Atkinson rejected the offer.

In the process, KU Hospital was excluded from the original discussions, and Irene Cumming, president and CEO of the hospital, has not hesitated to express her opposition to the plan. She says it could have serious, negative consequences to the hospital, as well as to the medical school.

Those trying to sell the idea then said the merger was needed for the KU medical school to have a sufficient number of cancer patients to qualify for a national cancer center designation.

However, St. Luke's has only about 10 percent of the cancer business in Kansas City. Kansas City Cancer Center, also referred to as U.S. Oncology, has 60 percent to 70 percent of the Kansas City cancer business, but KU officials have not talked with them about using their patients. Likewise, many Kansas City area hospitals could supply more cancer patients than St. Luke's could, without KU having to give away its brand, but, again, those hospitals were not asked or invited to affiliate with KU.

Next, it was argued that the affiliation was necessary because the state needs more doctors and St. Luke's could help produce up to 100 more doctors a year.

KU medical staffers opposed to the plan say KU, at its two medical school campuses in Kansas City and Wichita, could increase the number of doctors it trains by 100 a year without affiliating with St. Luke's. It's another example of phony, weak arguments by Atkinson and Hemenway.

Each time Atkinson, Hemenway and the handful of Kansas City power brokers, such as Bill Hall and Irv Hockaday, come up with a new reason the KU-St. Luke's plan is critical, there is some simple and easy-to-understand answer as to why the arguments are hollow. The result is to cast suspicion on the real reasons some are working and lobbying so hard to force the agreement.

Hearings are under way in Topeka this week, and an increasing number of legislators are beginning to ask questions. Unfortunately, members of the Kansas Board of Regents have displayed an apparent lack of oversight over what KU is trying to do. Hemenway reportedly has made a number of promises to St. Luke's even before any affiliation agreement is finalized. Many in the state have been kept in the dark about the hospital negotiations. Kansas taxpayers have poured hundreds of millions of dollars into the medical center and yet several KU leaders are willing to shortchange their own school. What does it say about their interest - or lack of interest - in the medical school in Wichita?

Cumming is not willing to give away or sacrifice the excellence, reputation and success of the KU Hospital. One of the big sticking points at this time is that Atkinson wants the cancer center to be designated as the KU Cancer Center at St. Luke's and to call St. Luke's a major academic teaching and research hospital of KU.

Legislators and the Board of Regents (if the latter has the backbone) should disregard the March 31 deadline set by Atkinson, Hemenway and the Kansas City/St. Luke's people and get some answers. Kansas taxpayers need to know what some people are trying to finesse at the state's expense. Kansas, the medical school and KU Hospital need to be protected, and the Legislature must have a continued oversight role. There must be an outclause for KU and Kansas.

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