Note: this editorial was published in the August 5, 2020 edition of the Toledo Blade.
The fate of the University of Toledo Medical Center, the former Medical College of Ohio Hospital, has been the talk of the town. Despite the cacophony of myriad voices, no one except U.S. Rep. Marcy Kaptur (D., Toledo) has proposed a clear path for its survival. The big elephant in the room however, has not responded to the public concern.
There is much confusion in public discourse about the overall objectives: Should UTMC morph into a small community hospital or should it be resurrected as a teaching hospital that it is meant to be?
The two objectives are not the same. Teaching hospitals stand apart from community hospitals.
It has been a long-standing desire of the Toledo Hospital to become an academic medical center. During the tenure of Roger Bone as president of the Medical College of Ohio (1993-96), an agreement was forged where the Toledo Hospital and Medical College of Ohio Hospital would merge to create a “world-class medical center.” Within a short time it unraveled.
The latest effort by ProMedica to transform its flagship ProMedica Toledo Hospital into an academic medical center began in 2015 when ProMedica brought an attractive offer to designate Toledo Hospital as the main teaching hospital of University of Toledo College of Medicine and Life Sciences. It stipulated that the College of Medicine would relocate academic departments from UTMC to the campus of Toledo Hospital. ProMedica committed to pay $50 million a year to the UT for 50 years and committed to construct buildings on its Toledo Hospital campus to accommodate academic departments.
UTMC was left out from the negotiations.
So according to plan, most of the residents in training were transferred from UTMC to Toledo Hospital. Now the federal government pays a hefty sum to academic institutions to train future doctors. With the transfer of residents, that money found its way to ProMedica. In addition, by transferring most of the academic physicians to Toledo Hospital, their patients followed them to Toledo Hospital.
The irony is that most physicians at Toledo Hospital did not welcome academic staff from UTMC. Where there was dire need for certain specialties such as neurology at Toledo Hospital, those specialists were gladly accommodated.
However, the medical staff of Toledo Hospital put all sorts of roadblocks in the way of other specialists. I have learned that highly competent and internationally recognized cardiologists from UTMC could not get privileges to work at the Toledo Hospital.
There are physicians at Toledo Hospital who have worked there for decades and are deeply entrenched in the medical-staff hierarchy. Most of them are fine clinicians but are not academic physicians. However, they have the power to delay granting privileges to UTMC physicians. If these physicians were doing research, publishing in prestigious journals, and had recognition beyond the greater Toledo area, one could accept them on par with their academic counterparts.
It takes years of hard work to develop the kind of reputation that leading academic centers have. Toledo Hospital can’t compete with the likes of Cleveland Clinic, University of Michigan, or Henry Ford Hospital. It is only by morphing into a true academic center that the Toledo Hospital will be able to attract patients with complicated ailments that now seek care outside Toledo.
Back in 2010, it was estimated that Lucas County loses about a billion dollars a year to academic medical centers located elsewhere.
The Toledo Hospital, for all practical purposes, is a community hospital and an excellent one at that. It has not been an academic center in the past five years. It will happen only when ProMedica recruits nationally recognized specialists in the fields that are not available locally. One could start with advanced neurosurgery, heart-assist devices, and heart transplantation.
So, what to do with UTMC?
In a full-page open letter to the governor of Ohio published in The Blade on June 14, Congressman Kaptur outlined a way forward. Dr. Gregory Postel, interim president of the University of Toledo, should seize the opportunities outlined by the congressman.
It has also been said by supporters of UTMC, including The Blade, that the 2015 affiliation agreement between ProMedica and the University of Toledo is grossly flawed.
The university should seek help from the Ohio Attorney General to renegotiate the agreement. UT should insist that UTMC would be part of the teaching and training along with Toledo Hospital. Some of the academic departments and residents in training should be brought back to UTMC. The physicians at Toledo Hospital who are not interested in teaching should move aside and allow physicians who could bring new services and research to Toledo Hospital.
The Health Science campus of UT, with its architecturally acclaimed buildings, should not be allowed to deteriorate into another Scott Park campus of the University of Toledo.
S. Amjad Hussain is an emeritus professor of surgery and humanities at the University of Toledo. His column runs every other week in The Blade. Contact him at aghaji@bex.net.