Guest Editorial Week of 3/02/20

Save UTMC group turns to governor for assistance

Dear Gov. DeWine,

We represent citizens of Toledo who are deeply concerned regarding the status of the University of Toledo Medical Center in South Toledo. When these concerns were delivered about 10 weeks ago to Dr. Christopher Cooper, Dean of the University of Toledo College of Medicine and Life Sciences (COMLS), he advised that we seek to determine the needs of South Toledo citizens, and then report back to him.
Over the last 10 weeks, the “Save UTMC” citizens group has held multiple town hall meetings and solicited input regarding perceived need and value of UTMC and other UT Health Sciences Campus facilities to the region.
The response has been emotional and heartfelt. Over 1,500 citizens have signed a petition posted online, and also expressed their concerns. These citizens expect that our state and local elected leaders will do all they can to ensure that UTMC remain a teaching and research hospital, provide excellent medical care, and attract highly trained professionals to our area.
This initial report summarizes our understanding of how UTMC became financially unstable and provides some solutions that, we believe, will not only put UTMC and other Health Sciences Campus clinical facilities back on a path towards solvency but also restore the vibrant research infrastructure and NIH-funded research activities that have characterized this campus for so many years. We request your support for our efforts and will welcome your recommendations as we finalize our report to UT leaders.

Decline in revenue
As recently as five years ago, because UTMC made money through a combination of clinical activity and Center for Medicaid and Medicare payments for education of residents, it was able to contribute $35 million annually to UT educational and research missions. However, since the affiliation with ProMedica was initiated in 2015, UT faculty-appointed physicians were transferred, along with students and residents, to ProMedica Toledo Hospital. This adverse effect of the affiliation on UTMC is exacerbated by a governance regulation that requires physicians practicing at UTMC to be appointed to the UT COMLS clinical faculty. The combination of UT faculty-appointed clinician re-location, and regulatory barriers to replacement by community physicians (faculty appointed or not) has led to a decline in revenue from patient admissions, surgical and radiological procedures, and diagnostic tests at UTMC.

Insufficient marketing
UT leadership has denied UTMC sufficient funds to market their services, including the highly-rated Dana Cancer Center, orthopedics center, and George Isaac Minimally Invasive Surgery Center.

Impending Financial Crisis
At one time income from COMLS student tuition and clinical activities at UTMC and related HSC facilities contributed approximately 60 percent of revenue to the University of Toledo. Unfortunately, UTMC is now projected to lose at least $25 million this fiscal year. As UTMC finances have declined over the last four years, it is reasonable to expect that this will decrease the cash on hand for UT. The projected further UTMC budget deficits are likely to put UT in an increasingly precarious financial position. In addition, the UT Physicians Group has been adversely affected by the affiliation. Many physicians report large numbers of specific instances in which ProMedica is using anti-competitive methods to harm their practices and prevent them from using UT clinical facilities.

UT/ProMedica Affiliation.
Over the past five years the affiliation funds for research have been less than expected. In addition, a UT/ProMedica master research agreement that would facilitate conduct of NIH research at Toledo Hospital and other ProMedica Hospitals has not been completed. NIH-funding has decreased substantially over this time.
We request to meet with you at your earliest convenience. In the meeting we will explain in detail why we request that you communicate to the UT Administration/Board of Trustees support for the following actions:
-Open the UTMC Medical Staff membership to faculty appointed and non-faculty appointed community clinicians.
-Change UTMC bylaws to allow non-faculty appointed physicians to practice at UTMC. This change will be voted on by UTMC Medical Executive Council at February meeting. If accepted, it will need approval of the UT Board of Trustees to be implemented.
-Encourage community physicians to practice at UTMC irrespective of faculty status. Currently, there is a belief among many community physicians that they are not welcome to practice at UTMC as either faculty or non-faculty physicians. This must change.
- Encourage UT leadership to approve funds to market UTMC, the Dana Cancer Center, orthopedics center, and George Isaac Minimally Invasive Surgery Center at a level competitive with other regional hospitals.
- Appoint UT Board members with knowledge and experience regarding all facets of academic medicine central to COMLS and the Health Sciences Campus, including educational, clinical, and research missions. The goal is to appoint board members who will support and advise appropriately on graduate medical education, increased NIH-funded medical research, and financial stability of UTMC and related clinical facilities.
- Encourage UT leaders to hire appropriate staff necessary to re-establish outreach to Ohio and federal (e.g. NIH) research funding agencies relevant to faculty in COMLS.
- Review the UT governance structure with the goal to identify appropriate steps to eliminate possible conflicts of interests as UT leadership makes key decisions relevant to the affiliation agreement between UT COMLS and ProMedica.
Sincerely,
Carty Finkbeiner, former Toledo mayor; Kevin Dalton, president of Toledo Federation of Teachers; Teresa Fedor, Ohio State senator; Shaun Enright, president of Greater NWO AFL-CIO; Rob Ludeman, Toledo City Council member; James Willey, MD, Professor University of Toledo; Matt Cherry, president, Toledo City Council; John McSweeny, PhD, Professor University of Toledo and Randy Desposito, president AFSCME Local 2415.