  Mackinaw Member Username: Mackinaw Post Number: 2140 Registered: 02-2005 |
Mike Duggan is a stand up guy. He makes clear in a letter just sent out to DMC employees (I am not one but know one) that his goal is to make the DMC so great that people will come from around the region TO Detroit for healthcare, rather than regionalizing the medical itself. Good for him. He also speaks in detail about bargaining with Wayne State Medical School, which is about to completely sell out on the city, and on an awesome long-standing partnership providing real-world research and practice for medical students. Shame on Wayne State. Below are excerpts from this letter to DMC employees: Dear DMC Employees With the recent newspaper articles, I’m getting questions daily from DMC employees about the Wayne State contract. Let me try to tell you directly what’s going on and what’s at stake. The financial situation at the DMC has stabilized. 2006 will be the third straight year in the black, something DMC hasn’t accomplished since the 1980’s. Things are going to be tight for us until the Michigan economy improves, but we’ve come a long way in a short period of time. The DMC Board leadership and I have tried hard with three different Deans in the last two years to get an agreement with WSU. WSU tries to cover with innocent sounding terms like “diversifying” and “suburban strategy”, but the cold truth is WSU has already abandoned its historic DMC partnership. WSU is aggressively building a fleet of lifeboats, establishing numerous suburban hospital contracts so their doctors can one day jump ship and float off into a sea of better payer mix, taking their insured patients with them. Most WSU doctors seem to find this plan distasteful, but it is being pushed with full force by the WSU administration. At the end of the day, DMC’s decision comes down to this choice: Do we side with the WSU administration demanding huge payments from DMC while they build new programs at other hospitals who want to take our patients? Or, do we side with all those doctors, nurses, aides, techs, transport workers, administrators, and other staff who are 100% loyal to the DMC and whose jobs could be lost if the WSU doctors took DMC market share away to their new partners at Oakwood and Providence? To me, it’s not a difficult choice. I have never in my life been treated with the warmth and kindness that I have received from DMC employees the last few years. I couldn’t be more pleased that the DMC Board just extended my contract three more years through 2009, because the work here is far from done. My proudest accomplishment is the fact DMC stopped the annual cycle of layoffs and instead has actually hired 3,000 new employees in the last three years. We can’t afford a WSU contract that jeopardizes those jobs. When I came to the DMC, I didn’t come as an experienced hospital administrator, but as a lifelong Detroiter who understood two principles about our region that would determine whether DMC would survive: 1) If people have a choice between the same service either downtown or near their home, they will choose to stay near home; and 2) If the service provided downtown is truly unique, people will pour in by the thousands from 50 miles or more. My first e-mail to employees in 2004 shocked some when I told you I wanted to scrap my predecessor's plan to close Detroit hospitals. I truly believed we could save our own great institutions by building unique programs to bring patients back to Detroit. The DMC employees supported this vision with tremendous energy as we cleaned up the appearance of our campus, improved hospital services, and recruited key doctors. Those who were here in late 2004 will remember how patients responded, pouring back onto our central campus in such numbers that our parking structures were overwhelmed and we had cars backed up into the streets and parked on sidewalks. It was a remarkable turnaround and showed that you don’t need to build new hospitals in Novi to attract patients. But you do have to offer a level of care patients can’t get in Novi. Many employees don’t understand the DMC/WSU contractual relationship, but in principle, it’s pretty simple. The original partnership between DMC and WSU was formed in 1980 by visionaries who truly understood how to get patients to come Downtown. The partnership involved 4 major commitments DMC made to WSU doctors: 1) WSU received one of the largest financial payments of any medical school in America 2) Exclusive right to positions of medical leadership in all downtown hospitals 3) Exclusive right to provide many hospital services at all DMC hospitals (ER, Radiology, Anesthesiology, etc.) 4) A partnership that allowed WSU to run 69 residency training programs at DMC. It was a lot to give up, but what DMC got in exchange was a commitment of loyalty that WSU would build a great and unique academic medical center at DMC. While the relationship had many contentious issues, those fundamental principles survived essentially intact for 25 years, until WSU embarked on its recent suburban strategy. What does that contract mean to WSU today? The 700 WSU physicians and their practice groups and employees now earn in excess of $200 million a year from DMC: $80 million paid directly by DMC and another $120 million in physician fees earned at DMC hospitals. It remains one of the largest, if not the largest, financial packages received by any medical school practice group from any hospital system in America. And DMC has offered to increase that amount in each of the next three years. WSU keeps claiming DMC is exaggerating the risk from WSU’s competing programs, so judge for yourself. WSU’s suburban strategy is only in its infancy, yet here are proposals WSU either already has proposed or actually concluded: 1) A joint surgery center with Oakwood just 3 miles from DMC’s MIOSH hospital; 2) New teaching and clinical partnerships with Crittenton and Providence 3) The purchase of a massive office building in Troy—the former Saturn World Headquarters—to be the center of the WSU Medical practice. The Saturn Building is larger than all the space occupied by WSU doctors at DMC today. 4) A comprehensive affiliation with Oakwood to provide a range of specialty services. Oakwood is already promoting itself in the suburbs as the place to get Wayne State specialty services without having to go downtown. 5) The Dean’s office promised Oakwood that pediatricians from Children’s would run Oakwood’s pediatrics unit. Children’s today is the dominant hospital in the Dearborn market, getting more than 50% of the pediatric hospital admissions. Children’s would stand to lose significant patient volume if Oakwood is able to tell Dearborn parents they have the same doctors as Children’s. Are we exaggerating in being concerned? Could DMC jobs or hospitals be at risk if WSU kept making these kinds of deals with our competitors for the next three years? Now, here’s the really astonishing part. In its last written proposal 2 weeks ago, WSU demanded a new 3 year contract with all the same services and preferential contracts at DMC hospitals they have today. Then, WSU wanted an $8 million annual increase in contract payments from DMC. And then WSU demanded the total freedom to keep making all these partnerships with the other hospitals. They are demanding that DMC finance its own demise and they pretend to the rest of the world like they can’t understand why the DMC Board and I won’t just sign it. Here’s the good news: the DMC management team is about the most talented group of people I’ve ever been around. They’re working 18 hour days developing contingency plans and we’re gaining confidence that DMC is going to come out of this stronger than we are today. We know this isn’t nearly as difficult a crisis as we faced in 2004. Our plans are being developed based on the same principles that got us out of bankruptcy in 2004. If a group’s proposal builds a unique medical program at DMC, we will strongly back it. If a group’s proposal is designed to take DMC’s money while they build programs at our competitors, we will reject it and we’ll work to replace them with a group that will build uniquely at DMC. Interestingly, the process is having the unexpected benefit of naturally sorting out the gripers and malcontents who are choosing to leave on their own. There will be a lot of pain and anxiety during the transition and DMC will probably look quite a bit different than it does today. At the end of the day, I really believe we will be stronger because we’re going to have a medical staff that truly wants to be here. And that really would be priceless. Mike | ||
Crew Member Username: Crew Post Number: 1051 Registered: 02-2004 |
Mackinaw, Before you say shame on WSU, why not hear the university's side? As you know, there are always two sides to every story. Shame on Mr. Duggan for using a public forum as a negotiation tool. The university and DMC need to get back to the bargaining table and stop the public finger pointing. | ||
Mackinaw Member Username: Mackinaw Post Number: 2141 Registered: 02-2005 |
WSU gets some shame just for thinking about breaking up one of the most well-designed, sensible agreements in the world of medicine. For a university which consistently feeds us rhetoric about its lofty "urban committments," what the hell is all this about? I'm not saying Duggan is 100 percent in the right, but his email, I think, is commendable because he is clearing up rumors and telling the people who he is representing where he stands. | ||
Stecks77 Member Username: Stecks77 Post Number: 110 Registered: 08-2006 |
I read his letter just like political advertisements. A little bit of information which could be true depending on how you interpret it, manipulated and spun against the opposition for political gain This is pure politics. | ||
Zephyrprocess Member Username: Zephyrprocess Post Number: 62 Registered: 08-2006 |
Is DMC giving away $80 million, or is DMC paying $80 million for a specific set of services? What is the fair market value for those services: is it higher or lower than $80 million? If the fair market value is higher than $80 million, but WSU School of Medicine faculty are willing to accept only $80 million--effectively subsidizing the DMC--where will the faculty come up with the difference? How many outstanding millions of dollars does the DMC still owe WSU faculty from existing contracts? The departments that DMC had excluded from the teaching contract extension post June 30: where did DMC expect those physicians to practice? Since a group of physicians cannot solely sponsor a residency program, but must partner with a healthcare facility (a healthcare facility can solely sponsor a program), where would these members of the School of Medicine faculty teach medicine? And when someone reports supposed conversations for which they were not present, what part of "clearing up rumors" does that represent? | ||
Bobj Member Username: Bobj Post Number: 1182 Registered: 11-2003 |
Isn't it nice to see 2 Detroit institutions fighting it out in the news over decisions that probably aren't in the best interest of the City, maybe the suburbs. How will we ever move forward?? | ||
Detroitnerd Member Username: Detroitnerd Post Number: 684 Registered: 07-2004 |
I think it's refreshing to see any debate put before the public that isn't some simplistic push-button wedge issue like gay marriage or gun control. | ||
Ddmoore54 Member Username: Ddmoore54 Post Number: 316 Registered: 07-2004 |
It's too late, the DMC is a dying institution. The only true world class health care provider in the city of Detroit is Henry Ford Health System. I would not send any family members to the DMC with the exception of Children's Hospital. The facilities and ancillary staff are just sub-par. | ||
Innercitydoc Member Username: Innercitydoc Post Number: 4 Registered: 09-2006 |
DDmoore, have you ever been to Hutzel or Karamanos cancer center(Not a part of the DMC anymore but it was). Even Harper's not THAT bad. DRH is shitty but what do you expect, the patients have no insurance. | ||
Detroitnerd Member Username: Detroitnerd Post Number: 685 Registered: 07-2004 |
I was impressed the last time I went to Receiving. I used to deliver pizza there back in the early 90s, and it was a depressing destination. Last time I went there I was seen within 10 minutes, was offered (and took) a free five-minute HIV test, and was sent on my way as quickly as at Beaumont. A friend's wife went there last week and said it was great. It has come a long way. And that's coming from somebody who doesn't really like the idea of a massive medical center, with all the superblocks, parking structures, etc. | ||
Stecks77 Member Username: Stecks77 Post Number: 114 Registered: 08-2006 |
A friend of mine suffered a bad burn last year. She lives in Lake Orion and went to the local ER. They told her to go to the DMC. She was extremely happy with the doctors, service, and care. | ||
Mackinaw Member Username: Mackinaw Post Number: 2142 Registered: 02-2005 |
Innercitydoc is correct. Not only is the DMC now financially afloat, it is of better quality. It provides one hospital that is a universal reciever, and plenty of speciality hospitals, targeted-treatment facilities, and research institutions, all in one inner city location intertwined with a major university. Children's Hospital is ranked among the top pediatric institutions in the country, and is set to expand much the same as Mott at UM. The cost of foregoing this relationship on Wayne's part, and the cost to the city, would be immense. It would result in a lot of less-prepared doctors, and the effect on the amount of students actually living near the medical school will probably be negative. | ||
Kenp Member Username: Kenp Post Number: 113 Registered: 03-2006 |
I have heard on 2 seperate occasions in the last year that Detroit Receiving is much improved. One even saying they would rather go to DRH then Beaumont. I am not sure I agree but its good to hear that. | ||
Southwestmap Member Username: Southwestmap Post Number: 603 Registered: 01-2005 |
Mackinaw does not understand the issue: the national accrediting body for the residents in all the specialties has declared the DMC a "toxic Environment" - the lowest rating they have. Soon there may be no more residents to provide the workhorse medical staffing. The funding that supports the residents will be cut off. Yes, Duggan says that he will hire other doctors - but the money will be gone. Duggan is playing the race card here while the real issue is that the educational environment is "toxic" for the residents. Detroit residents will suffer - but because of the decisions that Duggan is making. | ||
Mike Member Username: Mike Post Number: 771 Registered: 11-2003 |
Detroit recieving is probably the best trama center here. | ||
Itsjeff Member Username: Itsjeff Post Number: 7010 Registered: 10-2003 |
I had to spend quite a bit of time at DMC's neurology department earlier this year, including a CT scan and other tests. I found everyone I've dealt with, from the guys who park my car, to the receiptionists & nurses to the neurologists to be courteous and professional. I was especially impressed with the technology. A few days after my brain scan, my doctor was able to punch up the scan on his PC. He took me "line by line" though the images, showing me what he was looking for. When he referred me to another specialist, she was able to bring it up, too. Maybe that's par for medicine these days, but I was impressed. | ||
Ddmoore54 Member Username: Ddmoore54 Post Number: 317 Registered: 07-2004 |
Yes, I've been to all the DMC hospitals. You are correct that Karmanos is nice, but like you said, not part of the DMC anymore. Hutzel is also nicer now that it has moved. I have to disagree about Harper, while it's not on the nasty level of DRH, it's not exactly nice. You know it's bad when you have patients demanding to switch hospitals because of problems with bugs. I've spent a lot of time in DMC hospitals and they don't seem all that bad until you go to Beaumont, or HF or Oakwood to a lesser extent. It's only after you see the light, that you realize how outdated much of the DMC facilities are. Now I understand that infrastructure is difficult to improve when you are operating in the Red, but what comes first the chicken or the egg. I want to be in as nice of an environment as possible as both a provider and recipient of health care. Which doesn't even address the issue of ancillary staff, I think things take at least twice as long to be done at the downtown DMC hospitals than at HF, Beaumont, Oakwood, etc. Why? Not quite sure. While the ER at DRH underwent an improvement, the rest is still outdated. Itsjeff, that may have seemed impressive, but that's pretty much standard now. Any large hospital system should have some sort of ePACS, or computerized system for viewing films. All I'm saying is that if someone told me I needed to go to the hospital, the DMC would definitely not be at the top of my list. Specifically within the city, I would choose HFHS hands down. The reason I bring this up is because I think Duggan is experiencing some delusions of grandeur about how world class his institution is and will become in the near future. That whole idea about putting more emphasis on cardiac care seems about as futile as can be when Beaumont is only a 15 min drive away and is one of the best heart hospitals in the country. The best thing going for the DMC is the WSU docs, if they leave I can see no reason for anyone to go there over the other hospitals in the area, with the exception of Childrens. | ||
Hardhat Member Username: Hardhat Post Number: 181 Registered: 10-2003 |
Jeff, You revealed that much... Inquiring minds want to know, is your brain OK? | ||
Burnsie Member Username: Burnsie Post Number: 678 Registered: 11-2003 |
WSU will operate where its students and faculty get the best deal. Regardless of what PR spin it gives, it is a university first, and "committed to Detroit" second. And that's the way things should be. | ||
Mackinaw Member Username: Mackinaw Post Number: 2143 Registered: 02-2005 |
Burnsie, if that is so, then I would prefer that WSU cuts the crap when it comes to their rhetoric. I'm not a med student and don't plan to be one, but one would think that working in a busy urban hospital where you see the whole gamet of issues would be much more educational than a suburban hospital where perhaps you'll have a better parking spot or a "less toxic environment" boo-hoo. These residents will one day make 250k a year, so what's the big deal with them having to do bitch work or work in an uncomfortable environment when they're being broken in--I'm sure the DMC is much like most major urban hospitals. | ||
Ray Member Username: Ray Post Number: 804 Registered: 06-2004 |
If you're life is at stake, get your butt to Ann Arbor. | ||
Ddmoore54 Member Username: Ddmoore54 Post Number: 318 Registered: 07-2004 |
Mackinaw, trust those of us in the hospitals when we say that although there are some benefits to an urban environment in medical education, there are also a lot of negatives also. For example, sometimes you have the opportunity to see some amazing pathology you wouldn't see elsewhere just because people will wait a long time before seeking medical help. You'll see the guy with a tumor the size of a basketball that he just never got around to removing, just like in a third world country. At the same time, spending the majority of your time dealing with alcoholics, drug addicts, can demand a lot of time and offer very little in terms of medical education. I don't think you appreciate how much of medicine in an urban environment is really just babysitting while trying to find placement for people, which really offers no educational benefit. Until you go to school for 8 years to work in a hospital 80-110 hours a week, getting shit on figuratively and literally, while making $40k a year, (or paying $25k a yr if you're a med student), while your $150k loans accumulate interest, for 5-7 years, please refrain from passing judgement. Is there merit to working in a toxic or "uncomfortable" environment just for the sake of doing so, when you can work elsewhere in better conditions? | ||
Bvos Member Username: Bvos Post Number: 2034 Registered: 10-2003 |
I have a friend who's an RN with the DMC and has worked in several hospitals over the years: Hutzel, Childrens, DRH, etc. She's also worked at Oakwood. She's thinks Oakwood is a very good hospital, but she'll quickly tell you that the DMC hospitals are far better than Oakwood on nearly all levels. I've taken my kids to Oakwood and Childrens. I've been far more impressed with Childrens and the level of expertise and service there than at Oakwood. | ||
Mackinaw Member Username: Mackinaw Post Number: 2144 Registered: 02-2005 |
Okay, Ddmoore, just how bad is it though? Knowing several people who have passed through there as residents and teachers there, I have never heard about these impossible work conditions that are threatening the accreditation of the DMC. | ||
Zephyrprocess Member Username: Zephyrprocess Post Number: 64 Registered: 08-2006 |
Mackinaw--"cut the crap?" I'm curious to know whether you have any response to the questions I raised at the top. Or is Duggan's narrative of woeful abandonment simply Gospel for you? | ||
Southwestmap Member Username: Southwestmap Post Number: 604 Registered: 01-2005 |
Again, mackinaw, you are mixing things up. Work conditions and the urban clientele are not the issues for the national accrediting body for the resident programs. They are concerned, and called the situation "toxic," because Duggan summarily cancelled the orthopedics residency earlier this year which is professionally unheard of and very negatively affected the third and fourth year residents. He said that he would use the federal funds that the DMC receives to hire new doctors to cover orthopedics (which plan was not successful) and he did not clearly understand that the federal monies are for the support of the residents programs. The accrediting body is concerned about letting any residents work in the DMC because who knows what Duggan will do or drop next? He is framing this as a city versus suburb issue so as to increase his stature locally despite his fumbling dismantling of a once-respected medical center. The race card usually works in Detroit and often is used to cloud the real issue or in this case, his ego. Also, please believe moore54 - the clientele of the DMC is not so professionally challenging as to make or break any deal. HFHS has a pretty substantal trauma use, for example, so anyone (so few) specializing in trauma can rotate there and train just as well. I imagine that st. John's has substantial urban use as well. | ||
Mackinaw Member Username: Mackinaw Post Number: 2145 Registered: 02-2005 |
Well, I don't think Duggan made up those five points about Wayne's plan: "1) A joint surgery center with Oakwood just 3 miles from DMC’s MIOSH hospital; 2) New teaching and clinical partnerships with Crittenton and Providence 3) The purchase of a massive office building in Troy—the former Saturn World Headquarters—to be the center of the WSU Medical practice. The Saturn Building is larger than all the space occupied by WSU doctors at DMC today. 4) A comprehensive affiliation with Oakwood to provide a range of specialty services. Oakwood is already promoting itself in the suburbs as the place to get Wayne State specialty services without having to go downtown. 5) The Dean’s office promised Oakwood that pediatricians from Children’s would run Oakwood’s pediatrics unit. Children’s today is the dominant hospital in the Dearborn market, getting more than 50% of the pediatric hospital admissions. Children’s would stand to lose significant patient volume if Oakwood is able to tell Dearborn parents they have the same doctors as Children’s." It does boil down to a f***ing city-suburb and that is basically the beginning and end of my concerns. When you have what most consider a major medical school possibly bolting to Troy, you have an issue. In my reactionary spirit, I come off as a universal supporter of Duggan. This is not the case, I really didn't have any feelings about him until this debacle. In the end he should be worried about the viability of the medical center, so he should worry about outsourcing to the suburbs. I do understand the orthopedics issue, and yes Henry Ford and St. John, once thought of as possible candidates for a new affiliation, are great major urban hospitals...but Wayne's proposals don't even seem to include them anymore. | ||
Zephyrprocess Member Username: Zephyrprocess Post Number: 65 Registered: 08-2006 |
Why would the plans for a surgery center in Troy be evidence that WSU faculty are "abandoning the city," but the existence of MIOSH "just 3 miles" away not suggest the same about the DMC? Maybe having a presence in both the suburbs and the city is ethically viable after all. Since the building in Troy is going to contain a surgery center and diagnostic services, but "the space occupied by WSU doctors at DMC today" does not count the analogous space, then the greater size of the Troy building doesn't really imply that the downtown practices are all moving out there. | ||
Mackinaw Member Username: Mackinaw Post Number: 2146 Registered: 02-2005 |
Let's hope not. The economics of healthcare are tricky business, I just want to know more about to motivations of Wayne especially when it comes to this big facility in Troy. I still don't get the rationale w/ the Oakwood alliance either. | ||
Zephyrprocess Member Username: Zephyrprocess Post Number: 67 Registered: 08-2006 |
Why is it that some people never get the point of a rhetorical question? Posted on Monday, October 09, 2006 - 2:09 pm: Troy: "If the fair market value [for the teaching and administration services] is higher than $80 million, but WSU School of Medicine faculty are willing to accept only $80 million--effectively subsidizing the DMC--where will the faculty come up with the difference?" Oakwood: "Since a group of physicians cannot solely sponsor a residency program, but must partner with a healthcare facility (a healthcare facility can solely sponsor a program), where would these members of the School of Medicine faculty teach medicine?" | ||
Ddmoore54 Member Username: Ddmoore54 Post Number: 319 Registered: 07-2004 |
Soutwest, Of course HFHS and St. John have an urban patient population. But I find they have a more varied patient population, as more people are willing to commute from the suburbs. In any good medical education you need that mix. Regardless, at least at HF, they stand behind their residents from what I have seen. Like you mentioned, its not the patient population that breaks the deal at the DMC but the support of the administration. It seems like they have lost their commitment to education and are devoted to preserving a profit. Now of course it's necessary to make money, but as a resident that is not your concern. My comments were regarding Mackinaw telling us the merits of an urban education and how we can suck it up, without having any firsthand experience. As for all the people who have passed through there, I know a great many also, and most of them would not advocate doing your residency there given the current debacle going on. | ||
313_doc Member Username: 313_doc Post Number: 4 Registered: 09-2006 |
I feel that there are some very misinformed people in this debate, with the number 1 being Mike Duggan. He is now taking this public and playing the poor card which is going to carry this so far in Detroit. Again he fails to realize that the $80 million dollars is CMS funding that is tied to the resident education. All the residencies there are dual sponsored by both the DMC and WSU and cannot be separated. The analogy that was used so often when the othopedics dept went down was that if the two parents (WSU and DMC) got divorced then the kids (residents) would go to foster care (other programs). In other words, Duggan cannot simply take the residents and the money and pay other people to come in and work. First off, attending physicians are not going to come downtown to take care of the DMC patients without residents. Second, the money is not going to be there because the residents are not going to be there. Third, the residents signed up for/ranked the program based on certain attendings that were/are faculty, and not some community docs that Duggan would hire to come in and work. There is a big difference between the local general orthopedic doc and the subspecialist downtown that gets all of the complex issues that the community guys sends him… The term “toxic” has been discussed here, and like someone said above, it is meant to describe the educational environment. Such that if the educational environment is unstable and not effective then the ACGME will shut down the program and place the residents elsewhere. Residents rank programs coming out of medical school based on strengths and names of faculty and programs and if those qualities are no longer there then the residents are not getting what they signed up for. The term toxic is not to describe the type of patients, the area of the hospital or how clean the place is. This has to do with the quality of education, or lack thereof. I will be waiting for Duggan’s “ideas” about the residency issues… | ||
313_doc Member Username: 313_doc Post Number: 5 Registered: 09-2006 |
Sorry, but I’m an equal opportunity person…It should be said that WSU is so far out of its league that they aren’t going to know what hit them until it’s too late. During that last year they instituted what was largely a gag order on all those involved with the collapse of the orthopedics program. They said that they had it covered and that there was a PR team that would take care of matters when it was time…Well you know what, it’s time now and they are not going to be able to compete with Duggan, the DMC and the SE political machine to which these two are connected. Drs. Frank and Mentzer are in way over their heads and there is not much leadership to speak of at WSU to guide this ship during this time. My prediction is that Duggan is going to steamroll WSU in the press and with the Detroit populace. WSU is going to come out looking like the rich doctors who don’t care about the poor simply because they won’t be able to compete with the spin doctors from the DMC corporate HQ. Even though Duggan is flat out wrong, he will likely come out ahead simply because of his background and the fact that he’s a politician. | ||
Zephyrprocess Member Username: Zephyrprocess Post Number: 68 Registered: 08-2006 |
from Dean Robert Mentzer's response to the WSU community: As I have affirmed on many occasions, the School’s commitment to the city of Detroit and its partnership with the DMC are central to our mission, and will remain so. Although the School of Medicine relies upon longstanding and essential partnerships with numerous healthcare institutions to train one of the nation’s largest medical school classes, our education, research, and clinical care programs are inextricably linked to the city of Detroit and its unique demographics. WSU’s more than 700 faculty physicians are responsible for approximately 65 percent of DMC’s revenues, and deliver about 80 percent of all care delivered to the DMC’s uninsured and underinsured patients. About 30 percent of all practicing physicians in Michigan received all or part of their medical training at WSU/DMC. Of the city of Detroit’s 690 primary care physicians, 350, or 40 percent, are WSU/DMC resident physicians-in-training. Detroit is the School of Medicine’s home: WSU has committed to capital investment of $200 million over the next five years in two new facilities on its downtown campus — the Richard J. Mazurek, M.D. Medical Education Commons and a new state-of-the-science multidisciplinary research building that will house the University’s evolving Center for Clinical and Translational Science. In fact, these facilities will be catalysts for centering regional education; and clinical translational research activities at our downtown site. As you may know, the School’s student body is the most diverse in the nation; we graduate more African-American and Arab-American physicians than any of our 125 peer United States medical schools, and rank among the top five for training African-American physicians who go on to become university faculty. Our interdisciplinary research programs are targeted to the diverse metropolitan population that we serve and are recognized as national models of excellence. These programs include cancer, maternal and child health, and healthcare disparities, and are the foundation of the Barbara Ann Karmanos Cancer Institute and the WSU Center for African-American Urban Health. The School and the DMC collaborate on these and many other programs. In summary, I assure you that Wayne State University and its School of Medicine are steadfastly committed to each of the following: * Continuing our valued relationship with the DMC; * Expanding our presence in the city of Detroit; * Upholding our mission of delivering the highest quality patient care supported by education and research; * Educating our students and training our residents and fellows in the best possible teaching environments; * Recruiting and retaining leading physicians to teach our students and serve our community; * Providing care to the region’s uninsured and underinsured | ||
Innercitydoc Member Username: Innercitydoc Post Number: 6 Registered: 09-2006 |
https://www.atdetroit.net/forum/mes sages/5/81612.html?1160530119 | ||
Stecks77 Member Username: Stecks77 Post Number: 116 Registered: 08-2006 |
The following is a message from the President of the Wayne State School of Medicine Student Senate. It contains some interesting statistics regarding the impact of failed agreement and provides some insight into the dilemma faced by students if an agreement is not made. Also, there is going to be a protest this Friday. October 10, 2006 Dear WSU medical students and colleagues, In the past weeks there has been a growing rumble among students regarding the unresolved issues surrounding the WSU/DMC contract negotiations. As President of your Student Senate, I attempt to update you all at our current juncture and future events as they unfold. Unfortunately, it appears that events have taken a dismal turn after Mr. Duggan released a letter to all DMC employees with alarmingly negative connotation. It is included below if you have not had an opportunity to read the correspondence. While the DMC and WSU complied with the Accreditation Council of Graduate Medical Education (ACGME) requirement to submit a joint statement October 1, 2006 stating that negotiations will be continued in good faith to reach a new contractual agreement, this new letter creates concerns that such an agreement may not be achieved. The ramifications would be disastrous to all parties in involved if both administrations fail to provide a solution, soon. The approximately 1,000 residents and fellows from some 87 specialties and subspecialties will be forced to relocate; the University looses medical student rotation sites as well as their residency programs at the DMC and the DMC looses 700 University faculty members providing 80% of their services and 65% of their revenue. Over concerns of recent activity between both groups of officials and the dissolution of the orthopaedics program last year, the ACGME has moved up a scheduled visit in April 2007 to November 2006. And with the last contract extension expiring December 2006, things will be moving quite quickly. My letter to you is not only informative, as you each have a right to be informed, but to declare that this situation is completely avoidable. What the two institutions, DMC and WSU, must realize is twofold: first, the potentially devastating impact on health care availability to Detroiters in an already underserved area and the repercussions on medical undergraduate and graduate education would take years to recover and rebuild. As medical students this issue is universal to all of us and I call on each one of you for support. While the undergraduate educations (i.e. medical students) may not lose accreditation, like the residency programs in this crossfire, losing a partner like DMC would be losing a very valuable asset and aspect of medical care important for our education. These issues are ongoing developments but as a student body we have been waiting patiently for years, yet no resolution was reached. At this point it is crucial we demonstrate a united front that our mission of medical education and providing healthcare is bigger than the DMC or Wayne State University and it is unacceptable that this glitch has progressed thus far. So I invite each one of you to join us in a joint demonstration of medical students, residents and fellows against squabbling administrations on Friday October 13, 2006 from 12-1pm in front of Scott Hall under the backdrop of our forefather of medicine, Hippocrates. As your Senate council we believe this "professional" protest will bring to light the most essential matters both sides have lost sight of and allow the voice of students and residents alike to be heard. I encourage you to approach any of your Class Senate members with questions or apply Blackboard forums for further discussion (not emails). Remember, this can not be accomplished without your support. Sincerely, Jessica Kado, MSIV President, WSU SOM Student Senate | ||
Ddmoore54 Member Username: Ddmoore54 Post Number: 320 Registered: 07-2004 |
Duggan: "Hey what are those students doing out there?" Mentzer: "Looks like they are protesting our inability to agree." Duggan: "Wow, I didn't realize they would be upset by all the prospect of the residencies and rotations being lost?" Mentzer: "True. True." Duggan: "Let's end all this silliness and sign on the dotted line today." Mentzer: "Definitely." This protest is about as likely to change the current situation as it is to change the troop situation in Iraq. ....rolling eyes.... | ||
Mackinaw Member Username: Mackinaw Post Number: 2151 Registered: 02-2005 |
"Losing a partner like DMC would be losing a very valuable asset and aspect of medical care important for our education. These issues are ongoing developments but as a student body we have been waiting patiently for years, yet no resolution was reached. At this point it is crucial we demonstrate a united front that our mission of medical education and providing healthcare is bigger than the DMC or Wayne State University and it is unacceptable that this glitch has progressed thus far." Very well put. | ||
Stecks77 Member Username: Stecks77 Post Number: 117 Registered: 08-2006 |
Ddmoore54: Should the students just sit on there hands and do nothing? I don't think they are protesting just to let Duggan and the Dean know there unhappy. Its probably to the draw the public's attention to the problem and the ramifications of a fallout because in addition to the students, they are the big losers if nothing gets resolved. The students don't have to protest, especially fourth years who are applying for residencies accross the area and country. There are quite a few students who are not applying for residencies at the DMC because of the uncertain future. This will hurt the DMC. In some departments at the DMC the outlook is so bad their having to offer incentive packages. | ||
Southwestmap Member Username: Southwestmap Post Number: 605 Registered: 01-2005 |
If the educational environment is unstable and not effective then the ACGME will shut down the program and place the residents elsewhere." "The approximately 1,000 residents and fellows from some 87 specialties and subspecialties will be forced to relocate; the University looses medical student rotation sites as well as their residency programs at the DMC and the DMC looses 700 University faculty members providing 80% of their services and 65% of their revenue." Mackinaw: these quotes from posters indicate that the residents will face some hardships - but they will go. The Med School will survive. Who will be the loser? I think that the DMC will be greatly reduced and the City of Detroit will lose a respected medical center. It will be reduced to a community hospital status from a major research center. Duggan is playing to lose. But he will still be considered a sucess with you and your friends because he is telling you a song and dance about being a champion of Detroit. | ||
Ddmoore54 Member Username: Ddmoore54 Post Number: 321 Registered: 07-2004 |
I agree that the students need to be active, I just don't think a protest is the way to go about it. The big issue in my mind is how little the administration has conveyed to the students, especially in the past. Recently Mentzer has been sending emails, but before that it seemed like they were going with the ignorance is bliss tactic in regards to informing their students. Maybe the forum Mentzer is giving would be a good place for the students to voice their concerns, because their voices may be heard. | ||
Mackinaw Member Username: Mackinaw Post Number: 2154 Registered: 02-2005 |
SWM, that is my chief concern, that regardless of who we blame in this, if at least some of Wayne's suburban strategy does go though, and the residence programs leave, the DMC indeed becomes just a community hospital. | ||
313_doc Member Username: 313_doc Post Number: 6 Registered: 09-2006 |
This gets more interesting by the day… The funny part is that last year when the orthopedics dept was going down and some people were saying that the sky was falling, there were few people that believed it. Most of the residents and attendings in the other specialties felt bad about what was happening, but mostly in the same way that one feels when one hears bad news about your neighbor’s friend …you sort of pause for a bit and then go on with your life. Now, these other specialties are realizing that they are going to be affected also. I am most amazed that the medical students have been kept so much in the dark. I think it’s unclear at this point if the LCME will change the school’s rating based on this, but something will probably come out of it if their major clinical sites are changed. I don’t know if protesting will do much. Again, this will probably play into Duggan’s hand and bring more news attention to this debate to which Duggan will jump right on and run with it like there’s no tomorrow. Remember, he’s a McNamara protégé, with ties to Granholm. I wonder if Mentzer realizes that the DMC board (replaced and mostly stocked by Duggan) just gave their CEO a new three-year contract extension. Its almost like Duggan is guiding the bus over the cliff and he’s convinced his board to steer and press the gas pedal. What’s worse is that Mentzer is going to have a press conference next week to discuss matters and answer questions. My question would be “why have you waited until now and why haven’t you told us what has been happening?” All the while the tempest will be brewing with the Detroit populace and they are going to only see the 30-second news blurbs and side with the DMC, in spite of what has been going on. This is the perfect storm and the only wild card, or controlling force, is the ACGME/RRC. This one body has the ultimate control to step in and end this problem one way or another. Keep the discussion going! Tigers in 4 | ||
313_doc Member Username: 313_doc Post Number: 7 Registered: 09-2006 |
It seems like the protest was largely ignored. It's good to see that the local news has devoted more time to the Tigers than what could be a cataclysmic event in healthcare and the community. Tigers in 4! | ||
Innercitydoc Member Username: Innercitydoc Post Number: 7 Registered: 09-2006 |
Not true. Here are comments from the president of the student senate: I wanted to thank you for your efforts in promoting Friday's rally. Without question, the WSU-SOM student body was an important presence. It was estimated that we had up to 500 people in attendance. We have data that suggests that our press release was picked up by over 10,000 media outlets nationally. I've got some great pictures which I can share with you guys. We were covered live on Channel 7 (by their helicopters) and received additional coverage on 4 and 7 in their 5 and 6:00 news slots... pretty impressive considering the Tigers were the primary news story of the day. We intend on making a very large push on Monday at the debate. First, we are asking everyone to submit the question that we have crafted to WXYT, in the hopes that it makes it on to the debate. Second, we intend to stage a second rally at the debate. Numbers similar to Friday would ensure dramatic news coverage. I have contacted channel 7 (since they are hosting the debate) to tell them that I have info of our plans that may affect their airing prior to the debate. I good turnout would certainly drive this into the public view. Anything that you could do to help get the word out to the medical students would be greatly appreciated. You guys can help by going to the following webpage and submitting this question to be asked during the debate. Both candidates pledge a commitment to health care access, education, and the financial stability of Detroit. Currently contract disputes between the Detroit Medical Center and Wayne State University threaten to remove nearly 850 resident physicians and hundreds of faculty physicians from Detroit, a community already known to be medically underserved. This past Friday, demonstrators outside the Wayne State University School of Medicine and Detroit Medical Center grounds stated that this would create an immediate and lasting health care crisis throughout the city of Detroit that would extend throughout the region. Do you agree that this would cause a health care crisis and if so, how would you respond? | ||
313_doc Member Username: 313_doc Post Number: 8 Registered: 09-2006 |
It's pretty impressive that 500 people showed up. I saw the pictures on the news from the helicopter with everyone in their white coats and picket boards. Hopefully with the NLCS going on and the Tigers on hold, that the news coverage will lean towards this and not how great the parties were in the streets. I think the thing to really take note of when it comes time for the debate is that Duggan is completely linked with Granholm. They go way back and I’m surprised that the DeVos campaign hasn’t jumped all over this…or maybe they will at the debate. Jenny put Mike in charge at the DMC along with the $50 million dollar bailout and if things continue to go south I would think that Lansing could be tied to this. Again, there were rumors back in March that Lansing contacted Irv Reid and forced his hand to agree to the 9-month extension without orthopedics – something that was against what Mentzer had wanted or planned. Another thing to consider is that back in March, there were only 40 residents affected…with things the way they stand now it’s on the order of ~1900 (900 residents and 1000 med students). I wonder if anyone is considering a class action lawsuit against the DMC and WSU for failure to keep their contract (one-year stints for the residents, but with an implied nature of the residency length 3-6 years)? That could also force them to the table, and to agree. However, one must also remember that if things are done by “force” i.e. other mechanisms, the RRC might still deem this a toxic situation and shut everything down. Tigers in 4! | ||
Dougw Member Username: Dougw Post Number: 1379 Registered: 11-2003 |
From today's Crain's: http://www.crainsdetroit.com/a pps/pbcs.dll/article?AID=/2006 1016/SUB/61013016/-1/newslette r02
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Mackinaw Member Username: Mackinaw Post Number: 2169 Registered: 02-2005 |
That's a pretty good blurb. The first paragraph highlights the significance. | ||
313_doc Member Username: 313_doc Post Number: 9 Registered: 09-2006 |
I'm sort of surprised that the WSU/DMC issue didn't even get touched...Interesting. I wonder if things are too far gone to fix right now. While I agree somewhat with Mary Kramer that research is important, I think that the bigger issue is one of an almost complete loss of healthcare for a large segment of the population as well as the fact that once a place loses residents it is incredibly hard to bring them back. I don't think people realize exactly how much power the RRC has in this situation and what the ramifications are for this issue. However, I would love to be a fly on the wall at the DMC board meetings to listen to what they are being told by Mike Duggan and Tom Malone in their version of the world. | ||
Dougw Member Username: Dougw Post Number: 1382 Registered: 11-2003 |
Are you referring to the Crain's article? If so, I don't understand your comment... I thought the entire article was about the WSU/DMC issue. She also mentions the impact that the loss of the residency program would have on the poor and uninsured in the city. | ||
Zephyrprocess Member Username: Zephyrprocess Post Number: 82 Registered: 08-2006 |
Dougw: I believe he was referring to the gubernatorial debate on Monday evening. Recall Innercitydoc had quoted the president of the School of Medicine student senate's plans:
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Dougw Member Username: Dougw Post Number: 1383 Registered: 11-2003 |
Ah, thanks for the clarification. | ||
Innercitydoc Member Username: Innercitydoc Post Number: 8 Registered: 09-2006 |
I just returned from the Dean Mentzer's forum. He stated implicitly that negotiations where ongoing at that he anticipates everything will be worked out by the Dec. 31 deadline. Two issues are impeding progess: 1) A disagreement about reimbursement for services rendered in the amount of 2 to 3 million dollars and 2)The issue of exclusivity,stating that WSU faculty must only provide certain services within the DMC network. This is being evaluated as it pay pose a threat in recruiting future quality faculty physicians. He also spoke of Duggan having a very unclear business agena and reemphasized WSUSOMs commitment to the city of Detroit. | ||
313_doc Member Username: 313_doc Post Number: 10 Registered: 09-2006 |
Sorry about the random comment...but I meant that it hadn’t gotten any attention in the debate. Anyways, I wish I could have gone to Mentzer’s talk. It’s interesting to hear about the exclusivity thing being that many of the subspecialist surgeons already operate at multiple sites and so I don’t know how Duggan is going to try and contain them at the DMC. Also, in the past the hold up has always come back to money. In March it was rumored that the two sides had gotten as close as $5 million dollars. I am hard pressed to believe that if the two sides are still apart now, that they will always be apart and that the DMC will always find a way to not agree on a number. I do agree that Mike Duggan doesn’t have a firm business plan. I don’t even think that he really has a good idea about medicine or its direction. Basically he has surrounded himself on the board with previous hospital executives and yes-men. The only MD on the board is Tom Malone, who probably drives the nicest car of any neonatologist. Malone stands as the only possible voice of “reason” as the only doctor and yet it boggles the mind that the board is still making these decisions. I would love to find out what goes on inside Tom Malone’s head. I am caught between thinking that he is simply being outvoted by the board (Mike Duggan) when he points out the idiocy of some of the DMC’s decisions or he simply forgot about where he came from and is now just a business executive only interested in the bottom line. I am thinking he’s happy driving his car… | ||
Zephyrprocess Member Username: Zephyrprocess Post Number: 85 Registered: 08-2006 |
As I heard the discussion, the two sides are only $2-3 million apart when you include incentive-based dollars in the DMC proposal; the Dean appeared skeptical that the incentive threshholds could be met (again--my reading). Tom Malone was in the back of the auditorium last night. | ||
313_doc Member Username: 313_doc Post Number: 11 Registered: 09-2006 |
Interesting to hear a different viewpoint on the town hall meeting and to see that Tom Malone was there as well…He probably had to get back and tell Mike what he heard and what the opposition’s plan was. Anyways…After being around this for way too long and maybe seeing a light at the end of the tunnel (possible a large train getting closer), I have come up with my version of the future of the DMC and WSU and care for the uninsured. Basically these two parties will reach an impasse on some areas and sort of “agree” on others. I think that the DMC has already showed its hand from its actions in the recent past. I think that Duggan and Malone are viewing just the bottom line in terms of $$$ irregardless of education or anything else, except for saving face in the political scene of Detroit and the underinsured and “coming across” as the saviors and the concerned. Likely, what I think will happen is that the sub-specialist residencies, i.e. ortho, ENT, urology etc will be dropped from the roles of the DMC and the faculty will have the option of staying on at WSU and working at other hospitals (Providence, Oakwood, etc…). The DMC will then higher “scabs,” doctors and PAs, in those fields to come in and cover the basics to still be considered a complete hospital and continue with their ACS Trauma level designation. I think the that the big specialties, Medicine, Surgery and especially Emergency Medicine will continue to be a joint residency with joint affiliation between WSU and DMC. Because of the size of those residencies and their workforces they might be able to fill the holes and keep the ship afloat. So where does that leave everyone…Basically, Mike Duggan and the DMC will say that they still have running hospitals and that they didn’t run to the suburbs like the WSU doctors because they are still treating the poor. It will be a win-win situation for the DMC because they will come across as not having changed their services to the layperson, which is what is becoming more and more important these days. As for WSU, Menzter will be left with a fragmented school. He will have residents and medical students spread even more so across SE Michigan. The medical school will come across looking like the rich doctors that Duggan is portraying them to be and they will have the air of being academicians instead of physicians. WSU might be able to spread into other health systems, i.e. HFH, WBH etc., but that is unclear. The days of complete WSU-DMC system is over. Those departments that remain with the DMC will do so largely because of their inherit political and $$$ worth to the institution. The remaining WSU departments were disjointed in March and that is why they could not come to a consensus then and that is why they will remain fragmented to their own detriment. Mentzer was unable to unite them to speak with a collective voice for his faculty and because of this the weak and little departments that are of little $$$ worth will cease to exist. I know this sounds bleak, but in the laypersons view it will look just the same. As for the residents…it is unclear what the ACGME will do. Likely they will not want to have to place 900 residents in other spots if they don’t have to. They will probably give in to the change in affiliation status if it means the continuation of education, no matter how different it was than before. There might be some programs that just won’t be able to continue either way and they will go by the wayside and those residents will have to be placed elsewhere. Financially, I don’t know how the final numbers will compute. I wonder if they will be able to pull it off. To replace a number of residents with other workforce with PAs or others could be expensive. It might work, but who knows if the whole institution will be able to survive without the little guys, i.e. the other smaller services. It will also matter if there is a change in CMS funding as the DMC is already operating close to the even line and without some of the guaranteed government money, things might be a little different. Plain and simple Duggan looks like he’s going to win. The biggest losers here will be the residents and the medical students (who were caught completely off guard). The citizens of Detroit might be able to stay out of the HFH and SJH EDs if the basic services stay intact at the DMC, which is probably just what Duggan wants. I only wish I am proven wrong. | ||
Southwestmap Member Username: Southwestmap Post Number: 608 Registered: 01-2005 |
I have friends who are "political operatives" - they believe that Duggan is being positioned to run for Governor after Granholm. So, obviously, he will win this one! | ||
Crew Member Username: Crew Post Number: 1055 Registered: 02-2004 |
well duh! | ||
Yvette248 Member Username: Yvette248 Post Number: 6 Registered: 10-2006 |
I think our sorry news media should be paying a LOT closer attention to this crisis than to the random rapes, robberies, murders that are their so easy-and-cheap fast food. WAKE UP JOURNALISTS!!! | ||
313_doc Member Username: 313_doc Post Number: 12 Registered: 09-2006 |
Agreed. The fox is watching the hen-house and there's no farmer around to speak of. | ||
Cassie1717 Member Username: Cassie1717 Post Number: 48 Registered: 04-2005 |
http://www.freep.com/apps/pbcs .dll/article?AID=2006610250320 WSU-DMC deadlock could cost 900 doctors Health care for Detroit's poor is threatened October 25, 2006 Troubled contract negotiations between the Detroit Medical Center and Wayne State University's School of Medicine are threatening the future of Michigan's largest source of doctors. The stalemate also jeopardizes Detroit's largest provider of health care for poor people and could make it more difficult for patients to see doctors at other health systems and in the suburbs. Wayne State's medical school, one of the nation's largest, and the Detroit-based hospital system jointly operate about 70 medical residency programs -- the hands-on programs for graduate medical students training in special areas of practice. But a prolonged failure by the hospital system and the university to agree on the contracts that govern those programs has drawn increased scrutiny from the national body that accredits graduate medical programs. If accreditation were withdrawn, Detroit potentially could lose 900 medical residents and a large number of the 700 faculty physicians who train them. Wayne State residents provide about 40% of the primary care in Detroit and treat a large proportion of the city's uninsured residents. Nonfaculty physicians also might leave, metro area doctors said, because the loss of accreditation would greatly diminish the reputation of both the university and the hospital system. In addition, they would face increased demands on their time without residents to help with round-the-clock coverage of essential services such as radiology and neurology. "This is a crisis," said Richard Bernstein of the WSU board of governors. "This is a drastic situation. If we continue without a contract any longer -- I'm talking days, not months -- the rest of these programs could lose their accreditation. ... I don't believe that is something we could recover from as a region." In response to the crisis, the Accreditation Council for Graduate Medical Education (ACGME) plans to visit Detroit on Nov. 14 -- it had originally planned to visit next spring -- to evaluate the relationship between Wayne State and the DMC and to determine whether to continue accreditation of their joint residency programs. In a letter dated Oct. 19, WSU Board of Governors Chair Jacquelin Washington invited the DMC board to attend "a joint informational meeting as soon as we can assemble," noting that "negotiations between Wayne State University and the Detroit Medical Center have reached a critical point." The WSU-DMC contract doesn't expire until Dec. 31. But it has been a source of tension for years, with both sides agreeing to extend it several times -- the last was in March -- when the parties couldn't agree on new language. The two sides are slated to return to the negotiating table Monday. But going into the ACGME evaluation without at least the promise of an agreement could bring sanctions including: • Having the residencies placed on probation, which could hurt the DMC's and the university's ability to recruit students and faculty. • Having all residencies canceled and residents moved to other programs around the country. "From the residents' perspective, there's a lot of anxiety about this," said Paul Bozyk, president of the WSU/DMC Resident Council and Department of Medicine chief medical resident. "Then, of course, there's the larger issue. For the city, this would be absolutely devastating." The state and region already are facing a doctor shortage. "If you don't train them here, they're not going to stay here," said Adam Jablonowski, executive director of the Wayne County Medical Society. "One of the doctors downtown said he has a four- to five-month waiting list for patients who want to see him. ... Just imagine if there were even fewer doctors." Executives from other health systems said it would crush them, causing long waits for patients and creating more financial strain as the DMC's high proportion of uninsured and underinsured patients spread out to other hospital systems. "We would certainly be swept up in it," said Dr. Mark Kelley, chief executive officer of the Henry Ford Medical Group. "I haven't seen any city hospital survive a fractured relationship with its academic partner. Wayne State and the DMC are extremely important to the region. We do not want to see the DMC fold." Both the DMC and Wayne State say they are committed to negotiating a contract but, at the same time, say the other side is holding up negotiations. DMC Chief Medical Officer Dr. Tom Malone said he believes both sides agree on what needs to happen with the teaching contract, but that they disagree over the details of how doctors are reimbursed for other duties they perform at the DMC and over whether those doctors should be allowed to participate in business ventures that might compete with the DMC's interests. DMC President and CEO Mike Duggan said in an Oct. 9 e-mail to DMC employees that the medical school has decided it wants to be "suburban-based" and transfer residencies out of the city of Detroit, referring to work it has done to establish residencies with Oakwood Hospital and moves by WSU's private-practice group to create a surgical center in Troy. Mentzer has said the school is still dedicated to the city of Detroit. WSU is trying to spread its training programs among several health systems, including the DMC, so that its students have a variety of opportunities for learning and because the school doesn't know which residency programs the DMC intends to support. The DMC ended its support for the orthopedics residency in March, forcing WSU to relocate about 40 orthopedics residents to other programs across the country. Shortly thereafter, the ACGME moved up its visit date. Bozyk said the ACGME has forced the relocation of residents in other states before. "The ACGME is not in the business of protecting urban health care," Bozyk said. "It's not in the business of trying to provide health care for the underserved or the needy. That is not the basis on which it will make its decision. It's in the business of making sure that we get training to make sure we're competent physicians. That is an important point that shouldn't be lost in all of this." Gov. Jennifer Granholm has had conversations with both Duggan and WSU President Irvin Reid urging them to resolve the issue, a spokeswoman for the governor said. It may not matter. "The real issue is the stability of the environment in which we work," Mentzer said. "Is this an environment in which residents feel comfortable and secure or is this an unhealthy environment in which they work? That's the key ingredient of the decision that's going to be made by the ACGME." | ||
Lig_res Member Username: Lig_res Post Number: 1 Registered: 10-2006 |
http://detnews.com/apps/pbcs.d ll/article?AID=/20061025/SCHOO LS/610250328&SearchID=73261084 712245 | ||
Femur Member Username: Femur Post Number: 1 Registered: 10-2006 |
I'm one of the ortho residents, now far away from Detroit and from the house that I bought and still own in Royal Oak. I remember well the last few weeks at Wayne. It was painfully obvious that Duggan and his talented management team were improvising. In the words of Tom Malone, they were trying to preserve "a semblance of a residency." They had earlier fired the orthopedics department faculty and Duggan had wanted to transfer control of ortho residents to DMC by suing the ACGME or by some other lawyer trick. The ACGME told him to go ahead and sue them, they told him to get in line. How amateurish can you get... Days before an ortho RRC accreditation deadline Duggan went to Chicago to ask (again) to take over the ortho program from WSU. A more stupid move I couldn't imagine, but the RRC gave him a chance. The RRC told him that they (the RRC) would ask for the residents' opinion. Duggan then came back and within a few hours he asked for a meeting with the residents at the Rattlesnake. Next thing that happened, Tom Malone, an ob-gyn, and Brooks Bock, an ER doc, are trying to convince a bunch of ortho residents that they would be better off without WSU. We know how that ended. In the end, WSU apparently decided that the ortho program was lost and that its loss would serve to "teach Duggan a lesson." | ||
Femur Member Username: Femur Post Number: 2 Registered: 10-2006 |
BTW, I had wanted the press to get involved but WSU discouraged us from talking to the press. I emailed the dimwits at FOX Detroit anyway, back in January, to let them know of the trouble that was brewing. They did not answer my emails. I didn't bother with Detnews/Freepress because they are too servile to Duggan. They don't realize that he's cannibalizing the relationship with the med school only to improve the bottomline in the short term (in the long term Duggan will move on to a different political assignment and his successor at DMC will deal with the fallout). | ||
Zephyrprocess Member Username: Zephyrprocess Post Number: 112 Registered: 08-2006 |
Femur--your life (and the lives of your colleagues, and your families) got torqued around in a major way in this, and that truly saddens me. I don't believe that there is anyone on the School of Medicine who viewed the demise of the Ortho residency as some form of satisfying punishment for Duggan. There is no consolation, nor did anyone anticipate that there would be. | ||
Lig_res Member Username: Lig_res Post Number: 2 Registered: 10-2006 |
folks, Any news yet on what happened about the talks today.I am really curious as my job like many of them is dependent on that. | ||
Zephyrprocess Member Username: Zephyrprocess Post Number: 113 Registered: 08-2006 |
Lig_res: aren't the talks (between DMC board and WSU board) scheduled for the end of the day? | ||
Lig_res Member Username: Lig_res Post Number: 3 Registered: 10-2006 |
Hi Zephyrprocess, I was not aware of the time and thought it would have started early. Thanks anyway. | ||
Thrice Member Username: Thrice Post Number: 97 Registered: 08-2005 |
This is the e-mail we were sent today at 5:30 Dear Colleagues, Last week Wayne State University Board of Governors Chair Jacquelin Washington invited the Detroit Medical Center Board of Trustees to attend “a joint informational meeting to re-establish collaborative support for the fundamental goals that link the two institutions.” I have attached a copy of the Board of Governors’ statement for your reference. DMC Board Chairman Charles O'Brien accepted this invitation, and our two boards will convene today at 5:00 p.m. I have attached a copy of the presentation that I will deliver this evening. I believe my message to be consistent with what each of you understands as Wayne State University’s regional responsibility, as well as our longstanding commitment to our DMC partner. Next, our negotiation teams will return to the table tomorrow, Thursday, November 2. I have attached a copy of a brief update on negotiations, as well as talking points that you may find useful as members of the Wayne State University community. As I have affirmed on many occasions, the School of Medicine is committed to: * Continuing our valued relationship with the DMC; * Expanding our presence in the city of Detroit; * Upholding our mission of delivering the highest quality patient care supported by education and research; * Educating our students and training our residents and fellows in the best possible teaching environments; * Recruiting and retaining outstanding physicians to teach our students and serve our community; * Providing care to the region’s uninsured and underinsured. I will continue to update you as new information emerges. I value your interest in our shared future, and I look forward to your continued support as we rise to the challenges before us. Robert M. Mentzer, Jr., MD Dean, School of Medicine Senior Advisor to the President for Medical Affairs Wayne State University | ||
Gistok Member Username: Gistok Post Number: 3021 Registered: 08-2004 |
Will Mike Duggan be at this meeting? | ||
Thrice Member Username: Thrice Post Number: 98 Registered: 08-2005 |
Gistok - I'd assume so. This is one of the attachments to the above letter - TALKING POINTS: COMMITMENTS OF WAYNE STATE UNIVERSITY IN THE CONTEXT OF THE DMC/WSU PARTNERSHIP • GOOD FAITH NEGOTIATIONS WITH THE DETROIT MEDICAL CENTER HAVE BEEN ACTIVE SINCE MAY 2006, AND ARE CONTINUING. • WSU IS COMMITTED TO THE CITY OF DETROIT ─ Wayne State University remains deeply committed to the City of Detroit and its School of Medicine’s valued relationship with the Detroit Medical Center. o DETROIT IS OUR HOME — WE ARE HERE TO STAY!  WSU has committed ~$200M in 5-year capital investment to our shared downtown campus will be a catalyst for economic development in the City of Detroit, as well as for the greater metropolitan region. • The Richard J. Mazurek, M.D. Medical Education Commons • A new state-of-the-science research building that will engage the broader region in community-based research • WSU IS COMMITTED TO EDUCATION ─ It is our core mission to educate our students and train our residents and fellows using the most innovative and collaborative teaching models. o Example: The Southeast Michigan Center for Medical Education, which is sited on the WSU downtown campus. • WSU IS COMMITTED TO RESEARCH THAT BENEFITS THE UNIQUE DEMOGRAPHICS AND HEALTHCARE PROBLEMS OF THE COMMUNITY WE SERVE SO PROUDLY. ─ WSU will continue to recruit and retain leading researchers to: o Develop a basic understanding of disease processes; and o Develop new treatments for disease and expedite those therapies to benefit the patients of our community. • WSU IS A UNIVERSITY ENGAGED WITH ITS COMMUNITY AND THE CITIZENS WHOM WE SERVE SO PROUDLY ─ WSU pledges to uphold its mission of delivering the highest quality patient care supported by education and research; ─ WSU pledges to continue providing patient care, regardless of potential challenges to our training programs, and regardless of our patients’ ability to pay. • WSU IS COMMITTED TO FACULTY EXCELLENCE ─ WSU will continue to recruit and retain leading physicians to teach our students and serve our community; BACKGROUND: THE DMC/WSU PARTNERSHIP WHO: ● Wayne State University (WSU) • University Physician Group (UPG), the faculty physicians of WSU • The Detroit Medical Center (DMC) WHAT: Renewal of companion contracts totaling ~$80M that together support the integrated education and clinical programs of the partners. WHY: ● To preserve training programs for nearly 1,000 residents (physicians-in-training). • To enable continued recruitment of faculty to carry out the academic mission of the School of Medicine; and the “safety net” mission for the Detroit metropolitan community. • To ensure the continued delivery of patient care to the citizens of metropolitan Detroit, particularly the uninsured and under-insured. THE ISSUES: ● Fair market value compensation for physician teaching and clinical services. • The School of Medicine’s continued ability to partner with regional healthcare institutions in addition to the DMC for education and clinical programs. • The ability of the School of Medicine’s faculty physicians to engage in clinical business initiatives to financially support the academic and downtown/urban missions. STATUS: ● Negotiations for renewal of the current contract extension have been ongoing since May 2006. • The parties submitted a joint letter to the national Accreditation Council for Graduate Medical Education (ACGME) on Oct. 1, 2006, reporting that good faith negotiations to renew the contracts are continuing. • At the invitation of the Wayne State University Board of Governors, the WSU and DMC governing boards will meet on Nov. 1, 2006 to review the issues and potential solutions. • The parties will return to the negotiating table on Nov. 2, 2006. KEY DEADLINES: ● The ACGME will site visit the jointly sponsored WSU/DMC training programs on Nov. 14, 2006, in Detroit. • The contracts expire on Dec. 31, 2006. | ||
Lig_res Member Username: Lig_res Post Number: 4 Registered: 10-2006 |
It seems the ACGME has given a deadline of Nov 14th to resolve the issue http://www.freep.com/apps/pbcs .dll/article?AID=2006611020321 DMC, WSU fight over doctors' pay Under pressure from an accreditation body to come to an agreement, the Detroit Medical Center and Wayne State University's School of Medicine will continue negotiations this afternoon on a contentious contract dispute. The two sides are fighting over how doctors are compensated for duties they perform at DMC and whether they should be allowed to participate in business ventures that might compete with DMC interests. Both sides are working against the clock as they attempt to salvage a partnership that produces the largest number of Michigan doctors and provides vital health care to some of the area's poorest patients. The boards of the DMC and WSU were expected to meet Wednesday night to reiterate their objectives. Each group says it is committed to negotiating a contract. The current contract expires Dec. 31. In a letter last week, the Accreditation Council for Graduate Medical Education, the national group that accredits medical programs, said it expects the DMC and WSU to reach an agreement by Nov. 14. If the two sides don't reach a contract agreement by then, the accreditation body could end the graduate medical program, which would cost the two organizations 900 medical residents and many of the 700 physicians who train them. The loss could be devastating for Michigan's health care system, which is facing a potentially crippling doctor shortage within the next decade. About 30% of Michigan physicians and 43% of doctors practicing in Wayne, Oakland and Macomb counties receive part or all of their training at WSU. Contact KORTNEY STRINGER at 313-223-4479 or stringer@freepress.com. | ||
Sailor_rick Member Username: Sailor_rick Post Number: 142 Registered: 02-2004 |
What's the latest scuttlebutt? Thanks. | ||
Lig_res Member Username: Lig_res Post Number: 5 Registered: 10-2006 |
I personally feel that a decision has already been made but it may not be out till after elections | ||
Ash Member Username: Ash Post Number: 1 Registered: 11-2006 |
What was the outcome of the meetings held on Nov 1 and 2? I am not sure if no news is good news. | ||
Ash Member Username: Ash Post Number: 2 Registered: 11-2006 |
Femur, I am sorry to hear how your life and that of your fellow residents at Orthopedics got affected. Now our lives are on the line. I would like to ask you how the process of placing the affected residents works. Do the residents have any say in where we might end up or is it entirely up to the ACGME to decide our future programs? Given that the contract is expiring in Dec, I am not even sure if Duggan will allow us to complete the current academic year. | ||
Lig_res Member Username: Lig_res Post Number: 6 Registered: 10-2006 |
Hi Ash, even i am afraid the news is not good and hence everything is kept so secret till after the elections.just hope for the best | ||
Zephyrprocess Member Username: Zephyrprocess Post Number: 115 Registered: 08-2006 |
To answer some specific questions, the Wednesday afternoon meeting with the WSU and DMC boards involved presentations from both Mentzer and Duggan. I believe (but am not certain) that the Thursday followup negotiating session involved the standard negotiating teams (vs. Boards), including both Mentzer and Duggan, again. If there's anything being held secret until after the elections, it would have to be some form of pressure from Lansing/the Governor's office. | ||
Cassie1717 Member Username: Cassie1717 Post Number: 49 Registered: 04-2005 |
If Duggan's after exclusivity with WSU, why are MSU med students the only students at Huron Valley-Sinai's DMC facility and not WSU students? I have not heard of a single WSU student who rotated through HVS. I understand he wants exclusivity w/the residency programs, but this seems to be two-faced. | ||
Zephyrprocess Member Username: Zephyrprocess Post Number: 118 Registered: 08-2006 |
And--as I pointed out early in the thread--there are existing WSU residencies that he no longer wants at DMC: not just Orthopaedics, but also Dermatology, Urology, Otolaryngology, and Family Medicine. | ||
Lig_res Member Username: Lig_res Post Number: 7 Registered: 10-2006 |
I belive that there is very little or no negotiations going on right now. Its really sad that they are keeping us guessing. | ||
Zephyrprocess Member Username: Zephyrprocess Post Number: 122 Registered: 08-2006 |
Lig_res: I believe that there was a negotiating session on Monday afternoon. | ||
Ash Member Username: Ash Post Number: 3 Registered: 11-2006 |
Election has come and gone, still no word from these buffoons at DMC and WSU. Is it true that Emergency and Anesthesia depts have already ditched WSU and moved onto DMC's fold? At this rate, Duggan is going to have an array of residencies and fellowships of his own at DMC, very soon. WSU is going to be left out high and dry. | ||
Lig_res Member Username: Lig_res Post Number: 8 Registered: 10-2006 |
I dont know if this is a coincidence but if you go to the WSU SOM website under departmhents and click on Emergency medicine,the link will take you directly to the DMC page saying NEW WEBSITE IS UNDER CONSTRUCTION.but not the same for others who are a part of DMC | ||
313_doc Member Username: 313_doc Post Number: 13 Registered: 09-2006 |
The thing to realize is that it is unclear if the RRC will allow for the parents to divorce and for one parent to get custody, i.e. WSU only or DMC only. I will tell you though that there are some departments that are more liked and associated than others. The EM site has been down for some time now, and the reason they would stick around is because Brooks Bock is buddies with the DMC and used to run the EM dept. There is no way that EM will separate from the DMC if there is a split. The RRC is the wild card here and who knows what they will do. I am hard pressed to believe that they want to place 900 or so residents who might or might not have CMS funding. It’s one things to place a sub-specialty resident somewhere in another hospital who would want this person who will bring money to the hospital, whereas a primary care resident will cost the system money and will be harder to place. That’s just the hard truth about this whole thing. With King-Drew going down, there is going to be an influx of displaced residents right now, however that place was shut down by the CMS and so it could be inferred that their funding will follow them…or one would think. I doubt that the RRC will want to deal with two catastrophic situations at once. Right now and in the near future, you will see what people are really made of. Those with real integrity will step forward (if there are any) while the cowards who have always been a part of the problem will continue to make selfish, often misinformed, and terrible decisions. Just my $0.02. | ||
Ash Member Username: Ash Post Number: 4 Registered: 11-2006 |
Duggan is playing the lawyer trick again. He is said to have found a way to deny ACGME the money that ACGME has given him to train the residents for the reminder of the academic year! It is not clear to me how this works, but it seems he can hold on to those dollars for the next 3 years. Without the money, I am now afraid ACGME can not sell us, the residents, to other programs. | ||
313_doc Member Username: 313_doc Post Number: 14 Registered: 09-2006 |
The actual way that the money is decided upon and dispersed is from what I’ve been told, very complex to say the least. I was told that it’s based on a 3-year average of the number of residents that are being trained at that institution. From there, it’s hard to understand. However, I wouldn’t be glum about Duggan finding a way to hold the ACGME money…because it’s actually CMS money. That’s the federal govt. and they aren’t going to be pushed around by some bushleague politician from SE Michigan, and neither is the ACGME/RRC. There are bigger fish than Mike Duggan. For those of you that might be affected, two words…Class Action. There are lawyers out there would love to take on this case. Remember though that the med school is not completely blameless in this mess as well. Also, the AMA is aware of what happened in the spring, but whether or not any legislation has been enacted remains to be seen. This is from the AMA: AMERICAN MEDICAL ASSOCIATION HOUSE OF DELEGATES Resolution: 312 (A-06) Introduced by: Michigan Delegation Subject: Support of Resident and Fellow Education Referred to: Reference Committee C (Erin E. Tracy, MD, Chair) Whereas, Resident and fellow trainees are a valuable resource to the state of Michigan and the Michigan State Medical Society; and Whereas, Recently, orthopaedic residents at the Detroit Medical Center (DMC) have faced the closure of their academic program; and Whereas, The DMC orthopaedic residents received little support from their educational program to seek positions elsewhere or professional guidance on how to salvage their training careers; and Whereas, Residency closures are not rare and could put future resident/fellows at risk; therefore be it RESOLVED, That our American Medical Association work with the Centers for Medicare and Medicaid Services, the Accreditation Council for Graduate Medical Education, and other appropriate organizations to advocate for the development and implementation of effective policies to permit graduate medical education funding to follow the displaced resident physician from a closing to a receiving residency program, in the event of temporary or permanent residency program closure. (Directive to Take Action) Fiscal Note: Staff cost estimated at less than $500 to implement. Received: 5/5/06 | ||
Ash Member Username: Ash Post Number: 5 Registered: 11-2006 |
313 - Looks like you are better informed than most of us. I did not know that Ortho residents did not get any help from WSU faculty in getting placed elsewhere. Why is that? I thought ACGME binds the programs to place the affected residents. I agree with you that WSU is partly to blame for this mess. Mentzer and company seems to have ignored Duggan's potential to cut and run. Worst of all, Mentzer is not even keeping us informed of the developments - a basic courtesy. | ||
313_doc Member Username: 313_doc Post Number: 15 Registered: 09-2006 |
Yup...Mentzer is not the one that's going to save this thing. I honestly don't know if there's anyone at WSU that has the integrity or intelligence to solve this. Sucks big time. | ||
Lig_res Member Username: Lig_res Post Number: 9 Registered: 10-2006 |
I completely agree with both of you that the process is not transperant and WSU is partly responsible.Its really sad that we are at their mercy and we dont get to know whats happening | ||
313_doc Member Username: 313_doc Post Number: 16 Registered: 09-2006 |
One could look at this as a giant game of chicken, but in actuality I don’t think that the DMC or WSU really cares how this winds up. WSU just put out their interpretation of the negotiations and kept stressing their “commitment to Detroit.” They are doing that to counter act the barbs put out by the DMC painting them as the rich doctors. As for WSU being responsible, I think that one should look at the events that played out in March. Mentzer delayed his start date into the 2nd week in March and basically came to the job and tried to put his head in the sand when he was faced with the loss of the orthopaedic residency. That department, though, was the sacrificial lamb in this whole thing. I don’t think that WSU actually wanted to continue the program solely to prove the point that they did not need the DMC, and this would be the first shot toward WSU creating partnerships with other institutions, i.e. Oakwood. The DMC simply looked at that and these relationships as a labor supply and would just find other “workers” to fill in the roles. The DMC might be able to recover more quickly than WSU as Duggan, if he finds money somewhere, can recruit other docs and support staff. However, as one can realize by looking at the past, the DMC was only recently in the red not too long ago. If Duggan keeps paying all these astronomical salaries to scab physicians and PAs/NPs and does not have the CMS funds from residents, then it would only be a matter of time before they’re in the red again. Remember, the payor mix of the average DMC patient hasn’t changed. By that time, I can only project that Duggan will have moved on to Lansing and have left a wake of destruction in his path. The ACGME/RRC is not going to sit in on negotiations, as they have said that this is not their business. They are only concerned with the bottom line and that is a stable educational environment, and if that cannot be provided, then they will act accordingly. | ||
Lig_res Member Username: Lig_res Post Number: 10 Registered: 10-2006 |
well said 313_doc. The bottomline is that everything boils down to economics with little or no respect to human emotions. | ||
Yvette248 Member Username: Yvette248 Post Number: 100 Registered: 10-2006 |
DMC, Wayne State agree to mediation With urging from Gov. Jennifer Granholm, the Detroit Medical Center and Wayne State University will head back to the bargaining table with a mediator in an attempt to settle a contract dispute that threatens to end programs that turn out the largest number of Michigan doctors. http://freep.com/apps/pbcs.dll /article?AID=/20061110/NEWS99/ 61110012 | ||
Femur Member Username: Femur Post Number: 3 Registered: 10-2006 |
This is a response to Ash. Again, I am one of the ortho residents formerly at DMC. From my personal experience, if your specialty RRC decides that your program must close, you will be the one to initiate the process of finding another job somewhere else. Go refresh your CV right now, and make a short list of hospitals where you wouldn't mind working for the rest of your residency; find the phone numbers and email addresses of their program directors, and be ready to call or email when the time comes. Also review the rules/peculiarities of your specialty board. For instance, the American Board of Orthopedic Surgeons has a rule that says that the last 2 years of the residency must be completed in the same place. Because of this, the PGY4 (now PGY5) residents looked for and made a deal to stay at WSU/DMC for the 5th year. Don't look for a lot of help from your program because chances are your program leadership don't have much experience with program closures. But do ask them to be direct and then to make phone calls for you. Ask them when is the right time to start looking for another job. Also make a phone call to your specialty RRC. In the case of orthopedics, as somebody pointed out, it may have been a bit easier to find places for the displaced residents. The nature of the work in orthopedics makes ortho residents valuable and that's the reason why Duggan did not want to let us go. DMC did not allow the government money to follow us, but even so, there were orthopedic programs out there that were trying to expand or that were otherwise trying to gain credit with the ortho RRC. They helped us out and we were all offered spots in other programs. I wish you all the best of luck. | ||
Ash Member Username: Ash Post Number: 6 Registered: 11-2006 |
Femur, thanks. Good luck to you. | ||
313_doc Member Username: 313_doc Post Number: 17 Registered: 09-2006 |
Wow. I'm sure the mediator is not going to be biased being that he's from the Granholm cabinet. Yeah right. Good luck WSU. | ||
Lig_res Member Username: Lig_res Post Number: 11 Registered: 10-2006 |
Any news yet folks... | ||
313_doc Member Username: 313_doc Post Number: 18 Registered: 09-2006 |
I think this editorial sums it up pretty well. I feel sorry for those who can't see the writing on the wall. Thanks for playing WSU. Please turn the lights off on the way out. http://www.detnews.com/apps/pb cs.dll/article?AID=/20061113/O PINION01/611130315/1008 | ||
313_doc Member Username: 313_doc Post Number: 19 Registered: 09-2006 |
Also...One should take a step back and look at the whole picture. It has now come down to the Michigan State Governor appointing a mediator to come in an "help" these two parties reach an agreement. If you don't call this a toxic work environment then I don't know when you would call one toxic. These two parties cannot work together and now you're going to tell the RRC that after the mediator works things out, everything will be fine in the future. If you believe that, well I've got a few things to sell you. | ||
Femur Member Username: Femur Post Number: 4 Registered: 10-2006 |
I find it amusing that most press articles say that the DMC terminated the ortho residency. It's a little more complicated than that and I'll explain below what happened. I think the current residents may be interested in the details so as to prevent (or expedite) the closing of their programs. 1. There was a time when the ortho program at Wayne was a great program. 2. At some point, DMC "bought" Grace. Grace had their own ortho program that was in trouble. 3. The powers at DMC suggested to WSU that the 2 ortho programs be merged. WSU and Dr DeSilva -ortho chairman- accepted. This merger saved the ortho program at Grace but it lowered the quality of the downtown program. 4. At Grace we used to have OR availability and staff coverage problems. Things would happen where we would not get OR time to take care of an open fracture and the such. Or we had non-WSU attendings who made questionable decisions and with whom we eventually stopped working. On the other side, our WSU staff complained that they were not paid on time by Grace. 5. That was the state of affairs until fall of 2005. At that time, Grace starts talking to WSU ortho and they ask that Grace ortho be run the same way as ortho at downtown hospitals. They offer to pay. 6. WSU ortho says OK, "will do", but you have to pay "this much". 7. A deal is then made by Grace and WSU ortho. Grace is willing to pay up for an improvement in ortho services. Then the paper reaches Duggan's desk and he calls it "extorsion" or something else to that effect. 8. It went downhill from there. WSU ortho takes the position that they want nothing to do with Grace any longer. DMC says "if you don't cover Grace, you are fired". It was now October. 9. November 1st becomes the date when all of us ortho residents would go on a 2 month "research rotation", due to unavailability of attending staff (fired) during which time Duggan was supposed to get some sense. November 1st came, and WSU ortho faculty continue working at DMC because Duggan can't find anybody to replace them. 10. A couple of months pass when we stop scheduling elective cases, stop seeing new clinic patients, and so on, per attending staff's preferences. We start complaining about not doing enough cases. There are rumors that the the DMC is trying to obtain sole control of the residency. There are rumors that Duggan no longer wants to deal with Dr DeSilva (ortho chairman). 11. Individual residents start making regular phone calls to Dr Nestler of the orthopedic RRC and they tell him what's going on at Wayne. 12. March 20th: All junior ortho residents have a teleconference with Dr Nestler of the ortho RRC where they tell him that they waned to go to other programs rather than stay on in a DMC residency. DMC meets ortho residents immediately after that teleconference and try to convince them to stay on. Tom Malone says the words "we are trying to save a semblance of a residency." 13. Mike Duggan is heard saying "fuck them" when they tell him that the residents did not like the plans he had for them. 14. March 31st: Residency loses accreditation. Residents slowly find other places. WSU helps by paying $2000.00 per resident for travel expenses. DMC says they won't help. DMC starts hiring PA's. | ||
Ash Member Username: Ash Post Number: 7 Registered: 11-2006 |
Femur - This is by for the detailed ever account of what went on behind the doors at Ortho. Thanks. So what is the story behind other residencies which moved out of DMC to Oakwood - derm, FM, Urol .. etc? Was that also due to Duggan? This is 6AM on Nov 14 and no news of contract. | ||
Yvette248 Member Username: Yvette248 Post Number: 121 Registered: 10-2006 |
Even without the doc's detailed explanation, you would have to be blind, deaf, and dumb not to realize that Duggan is a major factor in the breakdown of these negotiations. The uncertainty of operations is at the DMC, not at WSU. For them to think that they can "attract suburbanites downtown" without university research capabilities is arrogant - and ignorant - beyond measure. p.s. It doesn't matter if Granholm is "biased" or not, they will still have to come up with a solution that WSU will agree to or its no dice. | ||
313_doc Member Username: 313_doc Post Number: 20 Registered: 09-2006 |
One should add this: Somewhere after point 9. The plight of the orthopaedic residents was largely ignored by the WSU/DMC Resident Council, as most people on that council, and most other residents for that matter, probably couldn't understand nor even fathom that other depts. might be affected in the future. There was a modicum of support, but this was mostly after the fact, and basically showed the lack of solidarity with the residents for the orthopaedic dept. 13.5 The inner workings of the DMC council, namely Tom Malone, echoed those sentiments by Duggan and voluntarily chose to withhold the transfer of CMS funding that pays for resident education. With this step, the number of available or possible transfer sites for the residents was dramatically reduced. This caused the dispersement of residents across the entire country, not just the local region. This was blatant retaliation by the DMC towards the orthopaedic residents for not supporting the proposed DMC residency. 13.75 Duggan's plan was also made possible by finding and paying "scab" orthopaedic attendings to cover services at the DMC hospitals. This was very troubling for the residents as they felt betrayed by these physicians, many of whom they had worked with previously, but now were enabling the DMC to continue services without the residents. For those with questions about transfers, and what ifs, the person to contact is Dr. Mark Juzych, M.D. He is the WSU/DMC DIO and he IS the person that coordinates these issues. Honestly, I would page him if you have any questions. He is the ACGME/RRC liason and this is his job to take care when residents need to go elsewhere. Call him if you have questions. In my honest opinion, this has already become a toxic situation. | ||
Ash Member Username: Ash Post Number: 8 Registered: 11-2006 |
ACGME is in the campus. No word on the contract. Anyone else knows anything? | ||
Lig_res Member Username: Lig_res Post Number: 12 Registered: 10-2006 |
This is the only source now..no deal yet.a high risk situation http://www.freep.com/apps/pbcs .dll/article?AID=200661114027 | ||
Lig_res Member Username: Lig_res Post Number: 13 Registered: 10-2006 |
What will happen to the physicians of WSU. Will they also loose their jobs if the deal doesnt get through | ||
Ash Member Username: Ash Post Number: 9 Registered: 11-2006 |
Here is some more rambling: http://www.wcmssm.org/dmn/2k6/ e-edition/dmnnovember142006EXT RA.htm | ||
Ash Member Username: Ash Post Number: 10 Registered: 11-2006 |
Why does ACGME take till December to announce their decision? Mentzer's Email today revealed nothing new, dont you think? Sigh. (Message edited by ash on November 14, 2006) | ||
Lig_res Member Username: Lig_res Post Number: 14 Registered: 10-2006 |
It seems to never ending.. | ||
Femur Member Username: Femur Post Number: 5 Registered: 10-2006 |
There is a precedent to this situation. In Huston, Baylor split from Methodist some time ago. See Google: http://www.google.com/search?q =baylor+methodist+split&start= 0&ie=utf-8&oe=utf-8&client=fir efox-a&rls=org.mozilla:en-US:o fficial The difference is that DMC is not Methodist, in terms of cash they have in the bank, patient population, and so on. Anyway, let's hope somebody will decide to fire Duggan instead. | ||
313_doc Member Username: 313_doc Post Number: 21 Registered: 09-2006 |
Interesting point made about Baylor. The only difference is that they had about a billion more dollars than WSU in the bank. Thus, WSU is up a creek in that regard. As for the attendings, it basically varies based on what specialty they are and if they already belong to a private practice group or have ties elsewhere. There are some departments that are so intertwined with the DMC that there is no way that they would separate, i.e. Emergency Medicine. These attendings would just continue to work in the ED with/without residents. Other departments, like the sub-specialists, are probably already seeing patients at other hospitals and/or have privileges elsewhere. For them they will just expand their practice towards these areas, this time likely taking on a different payor mix at the suburban hospitals. As for the rest of the departments, who knows? Many of them without a viable option will likely sign on with the DMC to keep a paycheck or look elsewhere for employment. It’s interesting to note that this also affects the attendings as well. They also had the opportunity to speak with a collective voice in solidarity for contract negotiations in March and voted against it. Now Duggan’s plan is coming to fruition and he is picking off the departments one by one after he already secured the loyalty of those key specialties needed to run an institution. I don’t know if this was the Malone/Bock plan, but it is working. Together the departments would have been unbeatable, but few had the vision to realize what would happen. This gets back to the lack of leadership on Mentzer’s part…sorry to beat that dead horse. Would the last resident to leave DRH please sign out to the oncoming PA. | ||
313_doc Member Username: 313_doc Post Number: 22 Registered: 09-2006 |
I would be sucking down the antacids right now if I was on one of the boards of Henry Ford Hospital, St. John’s or Beaumont. Imagine the flood of uninsured patients at the doorsteps of these institutions waiting for care because the once mighty DMC can no longer take care of them. | ||
Femur Member Username: Femur Post Number: 6 Registered: 10-2006 |
Ironic that in the end, this saga that started with somebody trying to bring Grace up to DRH standards will end with the entire DMC down to Grace standards. DMC will be run by full time PA's and random part time attendings. But perhaps that's good enough for the uninsured. | ||
Femur Member Username: Femur Post Number: 7 Registered: 10-2006 |
Does anybody know, where does the department of general surgery stand in all this? Are they ready to be hired by DMC? Or are they sticking with WSU? | ||
Ccbatson Member Username: Ccbatson Post Number: 1 Registered: 11-2006 |
Here is my take on it all (with some inside information). Hospitals or Universities that run residency programs are paid to do so by CMS/the government. In this case, the residencies are "worth" about 90-100 million a year total. The DMC is paying WSU between 80-90 million a year for the priviledge of affiliating with them and all of the other benefits of their relationship. As you may know, hospitals can, and do run residencies by themselves all over the place without a University affiliation. I believe Mike Duggan envisions doing just that by cutting ties with WSU and saving the 80-90 million dollars per year (or greatly decreasing the payments and maintaining a relationship of sorts). He imagines that after the difficult adjustment period, the DMC will forge ahead in this fashion. He is gravely mistaken IMO. Duggans' opinion has been known to some degree to the powers that be at WSU. In order to survive this assault, WSU must establish other relationships to recoup some of this lost revenue. Mike DUggan would have you believe that WSU is doing this just to abandon the city and move on to greener pastures which makes no sense. If WSU were secure in the future of the ongoing revenue from the DMC, why would they throw that away for the possibility of reestablishing relations with someone else? (BTW, no one entity is willing, or interested in giving WSU 90 million a year when they already have residencies and the revenue from them). Mike Duggan is a business man and a politician with aspirations for bigger things (ie Governor), so he is being pulled in many directions on this one. I think he is playing a dangerous game but he is not gambling with his own money. The DMC, WSU, the staff, and mostly, the residents are providing the capital for his game. Duggan's letter makes it clear to me that he cares little, or not at all for anyone other than himself. He wants to be the hero and save the DMC a lot of money to further his career. The ACGME is the fly in the ointment here. They stepped in and now threaten to make losers of both sides (and mostly the innocent cannon fodder mentioned above). We all hope the worst doesn't happen and a contract gets signed soon. Worst case scenario (IMO)...residencies shut down/redeploy, DMC dies a slow death following this mistake, WSU rises out of the ashes with several new hospital partners over the next 5 years as they are the only Medical School in, or near Detroit. | ||
Zephyrprocess Member Username: Zephyrprocess Post Number: 124 Registered: 08-2006 |
Femur--General Surgery continues to straddle the fence. | ||
Ash Member Username: Ash Post Number: 11 Registered: 11-2006 |
------------------------------ --------------------------- I believe Mike Duggan envisions doing just that by cutting ties with WSU and saving the 80-90 million dollars per year (or greatly decreasing the payments and maintaining a relationship of sorts). He imagines that after the difficult adjustment period, the DMC will forge ahead in this fashion. He is gravely mistaken IMO. ------------------------------ ------------------------- Why do you think Duggan wont be able to start his own residencies and fellowships? He seems to be holding on to the CMS funding for that very reason. Without this funding, placing the displaced residents is going to be very difficult. | ||
Crew Member Username: Crew Post Number: 1063 Registered: 02-2004 |
He'll only be able to keep the CMS money for three years. After that, the DMC will bleed red ink all over midtown. | ||
Crew Member Username: Crew Post Number: 1064 Registered: 02-2004 |
http://www.freep.com/apps/pbcs .dll/article?AID=2006611150427 | ||
Corktownmark Member Username: Corktownmark Post Number: 223 Registered: 12-2004 |
http://www.crainsdetroit.com/a pps/pbcs.dll/article?AID=/2006 1115/REG/61115001/1013 Accreditation council still examining WSU-DMC dispute By Andrew Dietderich 10:59 am, November 15, 2006 Advertisement The investigation by the Accreditation Council for Graduate Medical Education continues into a dispute between Wayne State University’s medical school and The Detroit Medical Center. Bridget Hurd, corporate director of public relations at DMC, said Wednesday morning that the investigation continues. The sides are at odds over physician reimbursement and exclusivity agreements, to such a point that the council stepped in to investigate the situation. The council could move to shut down the two sides’ 69 joint residency programs if it determines that a contract is not forthcoming as first reported in Crain’s Sept. 4. That could spur the loss of about 1,000 resident and graduate medical students who treat patients in DMC hospitals and more than 250 faculty physicians. Gov. Jennifer Granholm on Monday stepped in and appointed a mediator to help alleviate the situation. According to a Granholm press release, she contacted the principals of both groups earlier this week to extend an offer of mediation assistance. | ||
Yvette248 Member Username: Yvette248 Post Number: 134 Registered: 10-2006 |
Well since the deadline was today, it looks like its too late to save this goose from cooking.... | ||
Ccbatson Member Username: Ccbatson Post Number: 2 Registered: 11-2006 |
in response to the question, I don't think that Duggan can't technically establish independent residencies for the DMC, rather I think the obstacles are too overwhelming for several reasons: 1. If the ACGME shuts the whole operation down, both the DMC and WSU will have to start over from scratch (0 residents, 0 certification, 0 credibility) and apply to do so to the organization that just shut them down...good luck. 2. If the ACGME does not shut them down, and DMC parts ways with WSU, the DMC will be competing with WSU (a major university) in endeavoring to establish new urban, non university programs at an organization with the worst possible reputation from a candidates perspective......Lets' see, I am a graduating medical student looking for a competitive program and one choice is a program that put all of its' residents on the street, cut off their funding, tried to kill their medical school, has a huge uninsured population, in urban Detroit, with census that is less than 1/3rd what it was 12 years ago, in old facilities, a lower than junk bond rating, and with recently hired teaching staff willing to see past all of this to put their careers in these hands....Where do I sign??? | ||
Ccbatson Member Username: Ccbatson Post Number: 3 Registered: 11-2006 |
As to the Domino effect if the DMC goes down further. Yes, it is, and will be, a major problem for neighboring systems. However, the exodus is already well underway. The DMC under Arthur Porter privatized most of their employed clinicians in the late 90s. Patients largely followed their doctors leaving the DMC a relative ghost town. In 1992, when I was a medical student, the average census at Harper which was a singular entity at that time (now it contains Hutzel, Karmanos, Harper, and a lot of empty beds) carried an average census of 600. Today, they are lucky to see 200-250 combined. The DMC is recently in the black, but largely artificially by cooking the books, selling off assets, and cutting costs (read as firing people). Their logic seems to have been that they were caring for a high volume of poorly insured patients and losing a lot of money. So, the solution was to cut the losses and care for less patients, and to some extent, this strategy worked. Unfortunately, it is a house of cards that will ultimately fall. When? I would not be surprised if it happens within 6 months of Duggans' departure (within the next 5 years), if Duggan has planned this well. If he hasn't, it will fall sooner, on his watch, leaving him with no choice but to leave sooner than he had planned pointing fingers at others (WSU mostly) for the disaster in order to salvage what he can of his career post DMC. | ||
Crew Member Username: Crew Post Number: 1065 Registered: 02-2004 |
Ccbatson, Good obdervations. You hit the nail on the head. Untimately, this will be spun as the rich (mostly white) WSU Doctors leaving the city and causing the DMC to fail. | ||
Yvette248 Member Username: Yvette248 Post Number: 139 Registered: 10-2006 |
Ummmm, excuse me, for interrupting the race bashing here, but many of the doctors I see down at the DMC are from some type of Asian country (India, Bangladesh, China, etc. etc.) (Message edited by yvette248 on November 16, 2006) | ||
Crew Member Username: Crew Post Number: 1066 Registered: 02-2004 |
that may be true but it will be spun as the rich suburban doctors vs the DMC |
