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Note: this editorial was published in the June 7, 2020 edition of the Toledo Blade.

It looked like a good deal. At least it looked good on paper five years ago.

The University of Toledo College of Medicine would get money and expanded research opportunities it needed. And ProMedica would get a partner in creating an academic medical center that included its hospitals.

But the reality of the partnership didn’t live up to the terms of that deal, at least not for UTMC.

Five years later, UT officials say UTMC, the former Medical College of Ohio Hospital, lost about $14.8 million through February of the fiscal year. And now the public hospital is up for sale, its continued existence in doubt.

When the UTMC-ProMedica deal was struck in 2015, then-Ohio Attorney General Mike DeWine’s office reviewed the proposal and found no antitrust concerns.

But five years later antitrust issues are apparent to the naked eye. ProMedica has systematically removed the money-making enterprises based at UTMC, transferring them to its flagship Toledo Hospital. What remains in South Toledo is a shell of its former self, destined for the auction block.

As state Sen. Theresa Fedor said in calling on state regulators to conduct a forensic audit and put the brakes on the sale of UTMC, which is a public institution, “ProMedica got the gold mine, the public got the shaft.”

Gov. Mike DeWine must intervene in this mess. State regulators must revisit the affiliation agreement and consider not just what it aimed to do, but what it has actually done to UTMC, to the medical school, to South Toledo, and to a public hospital about to be sold to the highest bidder.

As attorney general, Mr. DeWine left open the possibility that the regulators could reconsider the agreement if the deal led to anti-competitiveness in purpose or effect. The situation has clearly reached a point where this is necessary.

It’s possible that with sharper oversight — any oversight — from University of Toledo trustees who should have been looking out for UTMC’s interests in the last five years, the affiliation agreement could have been a fair bargain for both sides.

In reality, however, it’s been the healthcare industry equivalent of a car-heist ring — scooping up a vulnerable mark and stripping it for parts before shipping the skeletal remains to a junk yard.

UTMC’s medical college — one of Toledo’s crown jewels — cannot prosper, and possibly cannot survive, without its hospital. So what has been taken must be returned, with interest. Only the governor can begin that process.

That is a rotten deal and it is anticompetitive by definition. It cannot be allowed to happen.

by Carty Finkbeiner, former Mayor of Toledo

Note: this essay was published in the May 10, 2020 edition of the Toledo Blade.

The University of Toledo Medical Center, critical to health care, research, and learning, is facing financial stress. Ironically, many causes of this problem are self-inflicted. Fortunately, solutions are developing. But the University of Toledo Board of Trustees and our South Toledo community must work together closely and decisively to implement sound and visionary solutions for our academic medical campus and hospital.

Blame for the fiscal straits in which UTMC finds itself is being liberally passed around by UT leadership: trends are changing in hospital treatments, they say; the physical hospital is too small, they claim; Toledo has too many hospital beds, they state.

The real number one problem at UTMC is that doctors, their patients, the revenue generated by both, and important UTMC programs have been moved to ProMedica Toledo Hospital.

Why? Because an Academic Affiliation Agreement between the UT College of Medicine and Life Sciences (COMLS) and ProMedica was authored, signed, and entered into in 2015 by one individual, Dr. Christopher Cooper, who served three leadership roles simultaneously in his employment with the University of Toledo. At the time of the agreement, Dr. Cooper was Executive VP of Clinical Affairs at UT, CEO of the University of Toledo Physicians Group, and was dean of the University of Toledo College of Medicine and Life Sciences.

If anyone had a vested interest in maintaining the market strength and fiscal integrity of UTMC, it should have been Dr. Cooper. Instead, it was Dr. Cooper who began pushing doctors, patients, programs, and their associated revenue to ProMedica Toledo Hospital, creating disastrous voids on the medical campus he is paid to serve. That is a real conflict of interest that has served UTMC quite badly. Some might say this is akin to a leveraged buyout or a hostile takeover of a public asset by private interests.

We can only imagine what UT and ProMedica were thinking. It should have been obvious to anyone, especially University of Toledo leadership, that the outcome of the Academic Affiliation Agreement with ProMedica would cause the ultimate demise of UTMC and the Health Science Campus.

Because Dr. Cooper wrote the Affiliation Agreement, he must accept major responsibility for the financial shortfall, as well as the physician exodus UTMC is experiencing. By his actions, UTMC benefits little; indeed, ProMedica is being built up at the expense of UTMC.

There is a provision for arbitration in the Academic Affiliation Agreement between the University of Toledo College of Medicine and ProMedica should either party have concerns regarding the direction it was taking. The agreement must be placed on hold now and renegotiated to prevent further residents and physicians from being transferred, until a stable solution for UTMC is identified.

A second powerful solution to the drain of physicians from UTMC is now in place. Following pressure from the Save UTMC Coalition, a bylaw blocking nonfaculty physicians from practicing at UTMC is no more.

I have hope for a new partnership with The Toledo Clinic. This potential partnership, however, does not address the loss of the clinical programs at UTMC. We have an excellent teaching campus in South Toledo. Why is it being transferred to ProMedica?

UT officials, and Randy Oostra, CEO of ProMedica, must recognize that the five-year-old Affiliation Agreement between the two organizations is building up Toledo Hospital, while tearing down the historic former Medical College of Ohio. The Save UTMC Coalition certainly recognizes this power and money grab for what it is.S. Amjad HussainUT has few choices over fate of UTMC

The leaders mentioned above need to search their civic hearts. Mr. Oostra, a recognized community leader, must remember the important achievement that early MCO-UTMC leadership accomplished as a team by bringing the Medical College of Ohio to Toledo.

These civic leaders formed a campus for teaching bright young men and women from all over the world who yearned to be doctors or nurses. Many of these young men and women are now permanent residents of northwest Ohio. Presidents, board members, and doctors and nurses not only taught and researched and healed on the MCO campus by day, but by evening they attended various community meetings and participated in the problem-solving Toledo needed to move forward.

Mike DeWine, our governor, will certainly want to be involved in planning our future as our South Toledo campus and hospital have very large chunks of State of Ohio money invested. U.S. Rep. Marcy Kaptur has made it clear that the hospital should not be on the market until a forensic audit, going back a decade, has been conducted. Congressman Kaptur has been joined in this request of the governor by State Sen. Teresa Fedor, State Reps. Paula Hicks-Hudson and Mike Sheehy, Mayor Wade Kapszukiewicz, Toledo City Council, and the Save UTMC Coalition. Thousands of Toledoans have signed a petition asking for the same.

Serious consideration must be given to putting in place a Board of Directors or Advisory Board of men and women with medical, research, and teaching experience. The absence of individuals on the present UT Board of Trustees with experience related to the work being done on the UTMC Campus is testimony to the disappointing decision-making that has led to the fragile fiscal condition of UTMC today.

Fresh money is needed!

What is needed even more: strong leadership standing firmly against the ProMedica commandeering of our Medical Campus — a campus that has contributed as much to Toledoans’ health and wellness as ProMedica ever has.

Carty Finkbeiner is a former mayor of Toledo.