August 18, 2009
Partnership Discussions
Colleagues, there has been a lot of discussion generated regarding the documents on the Partnership I sent out last week. Please feel free to communicate with my blog and let me know if you would like to have your comments posted. I am posting my communication from early Monday morning to a faculty member on the subject of the Partnership, Unionization, and we the Faculty. Best.
I'm happy to see the discussion here. First, I believe if energies were placed in helping with improvements needed to move us to the next level as an institution rather than efforts to unionize, we would all be better off. Second, I do disagree with many of your points which are frankly (and respectfully) inaccurate and misleading. For example the Hartford Hospital status statement that they are "on probation indefinitely" is patently false, since they are off probation now. The "fait accompli" statement is completely false. While many things have been worked out, many of the issues are still being worked out or will need to be clarified either in these documents or new documents to come. For instance a faculty member operating board composed mainly of department chairs will be responsible for day to day UP operations. Their specific duties may need to be better clarified. Restrictive covenant language may need to be looked at to make sure it is not too onerous. Please understand that a number of academic centers now have restrictive covenant language. In our case it may be particularly helpful for our current faculty where a private practice physician joins UP, gains the imprimatur of being a UP physician, then chooses to leaves UP. I do agree that it would be helpful to have as much language as possible regarding UP's role in the academic mission. Could you send some appropriate language to be considered for incorporation? (I'm copying Steve Cowherd who is revising the documents).
I do disagree with you regarding your point about administrative accountability. Hartford Healthcare is guaranteeing 40 million dollars to reorganize the clinical mission, guarantees that any future losses on the practice plan will be covered by them, and guarantees a payment of 7 million dollars each year to the medical school whether UP makes money or not. That's a lot of administrative accountability.
Regarding the agreements, if one sends out agreements too early to everyone, one can be criticized that they are incomplete or need lots more clarification. On the other hand sending out agreements to late will make them appear to be too set. I think there is a balance here.
In my experience, it is easy to criticize, and tougher to truly be a part of a solution. I am wary about proponents of unionization as an answer to all challenges and controversies. Adding another layer to the discussion won't solve problems, and they certainly won't magically make them go away, but will diminish us to being a part of the worker-management/administration rhetoric too often put forth. Taking on challenges and controversies head on, one by one, together as a faculty, is really the answer.
You, we, have the power to do that right now. That's been my goal in being here-- faculty leadership empowerment, and faculty leadership responsiveness to their faculty constituents. This is a critical time when I need the faculty to stand up and help provide input as we move forward with the partnership. Each faculty member (as opposed to an elected few in a union) has the ability to provide substantive input. This input is through elected Council members, (if Council members reflect your interests, great, if not, vote for new ones) and through the faculty Chairs, peer faculty who have been selected specifically for their skills in leading academic faculty. Input is directly through me too. I'm a faculty member who sees patients, operates, runs a large lab, directs students, speaks at national meetings, etc. Personally, I'm someone that has placed a big priority in my career on mentoring, and creating environments where faculty can develop to their full potential, and be successful. As Dean, I'm here for one reason, to see the interests of the school and the faculty flourish.
Thanks.
Posted at 09:17 AM
August 06, 2009
Executive Summary and Integration Agreement
Over the past several months, with considerable input from many faculty leaders, an Integration Agreement between Hartford Healthcare Corp. and the UConn Health Center was drafted. As you know, we are now waiting for legislative action to move forward with the Integration process.
In the meantime, I encourage you to read the executive summary and the Integration Agreement and learn more about this exciting opportunity to transform the Hartford area into a major destination for academic medicine. You can send comments directly to my blog.
Also, as a follow-up to discussions about the proposed Partnership and the Integration process, I will be scheduling a series of meetings, together with President Hogan, for medical school faculty members during the next two weeks. The meetings will be arranged by Department Chairs and Center Directors. In addition, Dean MacNeil, President Hogan and I will also meet with faculty from the School of Dental Medicine in the coming weeks.
- Executive Summary (PDF)
- Integration Agreement (PDF)
Posted at 09:57 AM
February 24, 2009
A View of the Proposed Hospital Partnership
Dr. Joel Levine, professor of medicine, recently emailed me his views on the proposed partnership with Hartford Hospital. I thought I would share his thoughtful perspective titled, “A Culture of Mastery.” Thanks to Dr. Levine for sending me his comments.
Posted at 03:12 PM
January 16, 2009
Affiliation Questions
I received two interesting questions from our faculty regarding our affiliation discussions with Hartford Hospital. Here they are, along with my thoughts:
1) Perhaps you could explain how the leadership of the merged institutions would be able to maintain the mission of the Health Center (training a large portion of the state's physicians, as the only public hospital) as a top priority. The desire of clinicians at Hartford Hospital "to be more academic" appears genuine, but in practice, it requires a much more than just that desire. For an institution with a different bottom line, some of the teachers and educators here who really make the medical and dental schools what they are could be the first to be cut when the finances need to be tweaked.
This is among the more complex issues I and many others have been discussing since the negotiations got underway. Of course, what we are talking about is a blending of two very distinct cultures. We all know that academic medicine is much different than private practice and there is no quick, easy solution to bringing these two worlds together in a way that respects all interests. We are not relying on one “magic bullet” here. Instead, we expect the solution will be derived from a number of sources, including governance structure, organizational structure, compensation plans and operational policies. Importantly, we recognize the importance of maintaining academic integrity and we will not lose sight of this going forward.
2) I am concerned, like the editorialist, that the merger did allow Hartford Hospital to prevent enlargement of the JDH. The original CASE report stated that expansion was key to the JDH's survival. Yet apparently the new proposal provides for minimal expansion of the JDH, because Hartford already has some 750 beds. As I understand it, the aspect of our size that makes us unviable is the number of patient beds on site, not the total number of beds owned by an organization, regardless of whether most of them are at least a half hour away through a busy city. Why, if this is our one chance to build a new hospital, would the priority be "to be unthreatening to HH," rather than to increase the number of beds on site, so that the JDH is financially viable?
We need to look beyond the traditional view of bed counts and bed locations in the region. Instead of “us” versus “them” lets consider “we.” Working with a larger clinical partner allows us to create economies of scale and clinical and financial synergies not otherwise possible. In so many respects, bigger is indeed better in health care delivery today, especially in academic medicine. If we can successfully partner with another clinical enterprise in our region, the designations and locations of the beds within the system are reduced to a manageable operational issue.
Posted at 04:17 PM
January 15, 2009
Merger Commentary
I came away with mixed emotions after reading an opinion piece in Sunday’s Courant on the Health Center’s proposed affiliation with Hartford Hospital, http://www.courant.com/news/opinion/commentary/hc-commentaryhyde0111.artjan11,0,2757379.story.
Written by Fred Hyde, M.D., an advisor to six unions representing employees at the Health Center, the commentary is very supportive of the Health Center’s unique mission and our outstanding faculty and staff. I certainly have no objections to those points.
What troubles me, however, is the article’s premise that any affiliation between us and Hartford Hospital is not worthy of further discussion. I have said, and will continue to say, that these affiliation talks are attempting to address some very knotty issues that many observers say are unsolvable. Perhaps the naysayers are right about some of the purported roadblocks. But maybe, just maybe, they are wrong.
What we need now, more than anything else, is a collective attitude that says, “What if?”. What if we try it this way? What if we take a different approach? What if we look at the glass as being half full instead of half empty?
There will be plenty of time to critique whatever results from the affiliation discussions. But for now, we need to consider, examine and exhaust all possibilities, however challenging they may seem. And above all we must remain focused on the future quality of health care in our region.
Posted at 10:02 AM
December 22, 2008
Holiday Letter
In keeping with the spirit of the approaching holidays, I’d like to express my gratitude and appreciation to everyone here for the hard work and dedication to the Health Center that has been clearly apparent since my arrival.
The holidays provide time to take stock of the past year and to make resolutions and plans for the new. Certainly, for the Health Center there are very serious challenges that continue to be the focus of our attention. We know what these challenges are, and I’ve spoken to you about them on a number of occasions. I have also spoken about my firm belief that we will meet these challenges head-on and succeed.
In this same spirit, we should not lose sight of the successes and accomplishments we have achieved. Let me touch upon a few of them.
Our excellent School of Dental Medicine achieved commendations for its D.M.D. degree program and for its seven advanced education programs from the Committee on Dental Accreditation after their recent site visit. The accomplishment is a true testimony to the professionalism and dedication of the faculty and staff of one of the nation’s top-tier dental schools and to the quality and enthusiasm of our students.
Our very successful regenerative medicine and stem cell research program received over $15 million in grants. Research in this area places our scientists at the forefront of these fields and provides the potential for us to revolutionize medicine and health care.
We have completed our application for a clinical translational science award (CTSA) from the National Institutes of Health. I believe the application in and of itself has had and will have a tremendous positive impact on the Health Center and indeed the entire university as it builds groups to interact in collaborative ways, integrating different centers and resources for the benefit of all.
The recent gift of $3.8 million from longtime university supporters Carole and Ray Neag will allow the Health Center to upgrade its CT scanner to beyond state of the art level. We will incorporate new planning and treatments tools into an expanded integrated imaging and treatment facility that will be the first of its kind in the region.
I have always believed that great challenges lay the groundwork for great opportunities. As we continue to explore partnership opportunities with Hartford Hospital and promote greater collaboration with other area hospitals, we can continue to move toward my vision of the UConn Health Center as an essential destination on the national list of places to go for outstanding health care.
I hope the holiday season presents all of us with the opportunity not only to spend time with our families and friends but also to reflect on our work and plan for our future. I want to thank you for your contributions and welcome your commitment to our success. Please accept my very best wishes for a wonderful new year for you and your family.
Posted at 08:00 AM