Letters

Blade Editorial: Transformation reversed

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Note: this editorial was published in the September 25, 2022 edition of the Toledo Blade.

It’s never pretty when dreams are shattered. It’s nothing short of a calamity when two vital institutions are confronting the nightmare.

The partnership between the University of Toledo College of Medicine and Life Sciences. the former Medical College of Ohio Hospital, and ProMedica health system is a classic example. In 2015 when university and hospital leaders signed a partnership agreement under the gaze of city leadership, then-UT President Sharon Gaber said, “this is a transformational day for the University of Toledo, for ProMedica, and for the Toledo community.”

That dream of institutional-strengthening synergy between UT and ProMedica has turned into an ugly situation for both institutions at about the worst possible time. ProMedica’s coronavirus related fiscal troubles have caused a downgrade of the system’s debt to junk status. UT’s enrollment decline is so significant a $200 million housing upgrade had to be canceled.

The deal between UT and ProMedica was supposed to make each party stronger and thus be great for Toledo. The university’s medical students and residents would work with ProMedica as the exclusive clinical education partner. In return, ProMedica would pay UT around $50 million a year for 50 years.

Theoretically the ProMedica affiliation makes UT’s medical school more attractive to potential students and ProMedica benefits from access to a steady stream of physicians with ties to Toledo. But reality struck this week when ProMedica’s missed monthly payments brought Ohio Attorney General Dave Yost to town, threatening to sue the health system if it doesn’t make a payment by Sept. 28.

The A.G. is legal counsel for all of Ohio’s state universities. Mr. Yost accused ProMedica of using its financial weight to starve UT into submission in a dispute over expenses UT owes ProMedica. Mr. Yost called ProMedica’s contention that the contractual obligation was balanced out by expenses owed to them, “hogwash.”

Mr. Yost says the contract shows “miniscule” expenses compared to the monthly payment owed to the university by the hospital. He says it’s possible for the 2015 pact to be renegotiated but only if the parties operate in “good faith.”

This is much more than a blemish to the reputation of both ProMedica and UT. It hurts both institutions to have this bubble up in public and reinforce the perception of serious financial decline as the cause of a deal coming apart.

Just as both ProMedica and the University of Toledo were aided by a successful deal, each is weakened terribly by this display of distress. And of course the transformation that was good for Toledo in 2015 is terrible for us all as it unravels acrimoniously in 2022.

Winkler: Past is prologue with ProMedica & UT

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Note: this letter to the editor was published in the September 25, 2022 edition of the Toledo Blade.

A kerfuffle between ProMedica Health System and University of Toledo College of Medicine and Life Sciences, the former Medical College of Ohio Hospital, involving their 2015 clinical affiliation agreement and money?

Who could have possibly seen this coming?

With apologies to Claude Rains’ Capt. Louis Renault in Casablanca, I could pretend to be shocked — shocked — that these two institutions aren’t getting along.

But guess what?

We’ve seen this movie many, many, many times before — the old tempestuous, mercurial MCO-ProMedica relationship that now has been inherited by University of Toledo and with new actors and new plots.

Who can forget, for example, that classic film noir, World-Class Medical Center, a story about the messy, doomed three-year merger discussions starting in 1993 with MCO selling its teaching hospital to ProMedica as part of an effort to create what the MCO president at the time called “a world-class medical center?”

Who remembers that 1999 gem, Fighting’ Hospitals, a tale of ProMedica unilaterally severing its academic affiliation with MCO in retaliation after MCO Hospital closed its inpatient pediatric unit to join then St. Vincent Medical Center to create a children’s hospital?

Toledo Hospital already had a children’s facility in its building.

Sure, it’s all ancient history, but provides some meaningful context for the latest imbroglio.

For the sake of medical education in northwest Ohio, let’s hope the parties can work things out.

But it is probably too much to ask for “the start of a beautiful friendship” like that of Humphrey Bogart’s Rick Blaine and Claude Rains’ Captain Renault.

Toledo is not Hollywood.

JIM WINKLER

Gainesville, Fla.

Editors note: The writer worked in several communication positions at MCO and UT for more than 30 years and is one of four editors of the book, A Community of Scholars: Recollections of the Early Years of the Medical College of Ohio.

Hussain: UTMC a success story in our own backyard

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Note: this editorial was published in the May 11, 2022 edition of the Toledo Blade.

Today I wish to report on a success story. In an era of doom and gloom, preoccupation with the ongoing scourge of the coronavirus and the drumbeat of spurious slogans to make America great again, there is positive news about something in our own backyard. It is about the University of Toledo Medical Center, the former Medical College of Ohio Hospital.

Three years ago, the hospital was in dire straits. As a small free–standing academic hospital, it was feeling market pressure. It was assumed that unless it found a partner it would not survive. Efforts to find a suitor were made as early as 2012 but nothing materialized. In 2015 the University of Toledo entered into an academic affiliation agreement with ProMedica, the large local health-care system, to train students and resident physicians.

A bit of background:

The Medical College of Ohio Hospital was built in 1964. At the time it was thought that a small, 300-bed hospital would be sufficient to meet the needs of the medical college. And it did by providing excellent patient care, teaching, and robust research in the clinical and basic sciences. The founders had not realized, they could not have, the changing health-care scene in the United States. Soon it became evident that the days of a small free-standing teaching hospital were fast disappearing.

By 2010 it was becoming clear that UTMC, as a stand-alone facility, could not survive for long. Some visionaries had realized early on that in a highly competitive atmosphere, mergers were the only way to cut costs and continue the mission. Such mergers and acquisitions happened all across the United States.

The dilemma for UTMC was that there were no viable options to join a bigger hospital. ProMedica was gun shy after its attempted acquisition of St. Luke’s Hospital in 2010. That deal was challenged, and the Federal Trade Commission ruled that the merger was ‘illegal and anti- competitive’. ProMedica had to divest itself of St. Luke’s.

In 2015 the University of Toledo signed an academic affiliation with ProMedica in which ProMedica committed a large sum of money for the affiliation. It offered hundreds of millions of dollars up front and then $50 million yearly for 50 years. According to the agreement, the Toledo Hospital would become the main academic hospital for the UT College of Medicine.

Left out of the negotiation was the fate of the UTMC. Some people at ProMedica did not shy away from saying that UTMC should be closed. And it came precariously close to being shuttered up.

Here one must acknowledge the community effort led by the former Toledo mayor Carty Finkbeiner and the local unions that started a campaign to save the hospital.

Enter Dr. Gregory Postel, the new president of the University of Toledo. Soon after his arrival as the interim president of the University of Toledo he put an end to the process of selling or leasing the hospital. He brought with him the experience of two academic affiliations that he presided over in Louisville.

A neuro-radiologist by training, Dr. Postel is a visionary and possesses a decisive mind. And he can read the proverbial tea leaves with uncanny insight and accuracy. Within a year, thanks to his efforts, the hospital became solvent.

Instead of considering UTMC a liability for the university, Dr. Postel called it an asset.

The operating rooms, providing a bulk of revenue for the hospital, are busy providing surgical care that was once the hallmark of UTMC. Though functioning at a lower-bed capacity, the hospital is busy in all areas providing excellent university-standard care and in certain areas specialized care that is not available elsewhere in Toledo. Cardiac-surgery services that some pundits on North Cove Boulevard wanted to shut down has resurged and is leading the way in innovative heart surgeries.

Most recently the hospital received level 2 designation for trauma.

And there is something else that I observed during my recent hospitalization at UTMC. It was a sense of pride exhibited by physicians and health-care workers in their work. They take care of patients beyond the call of duty. I remember this spirit so well during my long association with the medical college and the teaching hospital.

It is much easier to demolish and dismantle than build something from scratch. My argument to retain UTMC as a teaching hospital is based on ground realities, a continuum of excellence, and the continued need for such a facility in South Toledo. It is not based on nostalgic longing for a past that has long passed.

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 aghaji3@icloud.com.

Blade Editorial: UTMC’s rocky road gives way to right path

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Note: this editorial was published in the May 10, 2022 edition of the Toledo Blade.

The University of Toledo Medical Center faced a rocky road of ups and downs for several years. Most of those roads seemed to be going downhill.

University and community leaders, dedicated physicians, health-care providers, and staff turned things around. The latest example of the good news for UTMC, the former Medical College of Ohio Hospital, is its designation as a level 2 trauma center. It’s a significant step forward in a short period of time from difficult times.

Facing financial troubles, in 2019 UTMC downgraded their trauma center from a level 1, the highest designation, to a level 3.

In 2020, the plan was to put the medical center up for sale. Things were that bad.

It didn’t happen. A plan, the support of the community, and the incredible, dedicated efforts of UT President Dr. Gregory Postel turned things around.

One sign of that change in attitude was a plan to upgrade the trauma center designation.

The move forward from the loss of status and capabilities took place with remarkable speed. The new status means an increased ability to care for patients with a wide variety of trauma. Level 2 trauma centers must be able to call on certain staff 24/​7; that isn’t required of level 3 centers. It means specialists in orthopedic surgery, neurosurgery, anesthesiology, emergency medicine, and other staff can respond to get patients the care they need.

That’s what a hospital, and a trauma center are all about.

UTMC’s future looks bright, and each step forward should be celebrated. It’s more than a feel good story.

Having multiple high-level hospitals and trauma centers helps our community. It’s also key to attracting new residents and new businesses because high-quality medical care is high on the list of considerations for most corporations and the employees who work for them.

Blade Editorial: More good news for UTMC

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Note: this editorial was published in the February 5, 2022 edition of the Toledo Blade.

The reversal of fortune at the University of Toledo Medical Center continues with a recently announced increase in the Medicare reimbursement rate.

That change will net another $25 million for UTMC, the former Medical College of Ohio Hospital. The increase was approved by the federal Centers for Medicare and Medicaid Services. That could become an annual number. The money was granted as part of the CMS Supplemental Payment program to offset the hospital’s uncompensated care costs for Medicaid services, according to Blade reporter Jeff Schmucker.

That’s good news for Medicaid patients as well as the medical center. About 20 percent of UTMC’s patients use Medicaid, Dr. Gregory Postel said. And Medicaid doesn’t reimburse at the same rate as private insurances.

The added funds will free up UTMC to treat more patients in need and increase quality care while not draining resources. The money will help upgrade equipment, among other positives.

U.S. Rep. Marcy Kaptur (D., Toledo) helped procure some of the funding, along with Ohio Department of Medicaid Director Maureen Corcoran and Gov. Mike DeWine.

“Today will go down in history as the day we helped secure the future of The University of Toledo Medical Center,” Ms. Kaptur said. “UTMC is a foundational pillar of our region. Every day, countless hospital staff, doctors, nurses, professors, and students mask up and show up to deliver the life-sustaining and lifesaving care our community needs, particularly those who are most underserved.”

It’s all part of the revival underway at UTMC for the past two years. Things looked bleak ,but a coalition of local folks and university leaders came together to turn things around.

It goes to show what a determined group of folks can achieve even when things seem impossible. UTMC can prosper and will prosper — with continued focus on a grand coalition between faculty, staff, and the public.

It was a long struggle and it’s not quite time to declare victory, but UTMC is getting there.

Continued vigilance and dedication can continue and assure progress.

Blade Editorial: Activism helped brighten UTMC’s future

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Note: this editorial was published in the December 18, 2021 edition of the Toledo Blade.

The University of Toledo Medical Center is back after a rough few years. Nothing makes that more clear than plans to return the hospital to a Level 2 Trauma Center.

The shift to a Level 3 center happened in 2019, so the recovery is remarkably quick and a tribute to the new leadership at the university. The center recently obtained provisional approval for a move back up the ladder. In 2019 the center held Level 1 status.

The move will require an increase in staffing. That likely won’t happen until the middle of next year. And then of course, who knows what the omicron variant might bring?

The good news is, more and more local programs prepare students for roles in the field of medicine and medical care. Local training for local jobs creates a winning situation for patients and providers.

Too many people thought the university and the former Medical College of Ohio hospital were dying a slow death. Instead, the school sat dormant until committed citizens, doctors, professors, staff, and university leaders pushed to turn things around. The key person among those leaders was UT President Gregory Postel.

And turn around they have — from financial disaster to a future for the medical school and the hospital.

Those citizens included notables like Carty Finkbeiner and U.S. Rep. Marcy Kaptur (D., Toledo), and many nonprofessional public advocates who cared about the hospital and the medical school.

Many had experienced either in person or through family members the wonderful care at UTMC.

Challenges remain, including staffing shortages and the transfer of some cases to other hospitals, largely because of the shortage.

The long-term goal, said Dr. Michael Ellis, the chief medical officer, is to return UTMC to a Level 1 trauma center. That may take some time. Then again, many folks thought time was up for UTMC just a year ago.

The future for UTMC, though, is just beginning.

Winkler: UTMC founders would be proud of turnaround

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Note: this letter to the editor was published in the October 11, 2021 edition of the Toledo Blade.

An important part of the impressive financial turnaround of the University of Toledo Medical Center, the former Medical College of Ohio Hospital, is University of Toledo President Dr. Greg Postel’s decision not to sell or lease the facility.

Instead, he and other senior administrators confidently placed a big bet that the hospital could make money with new investments in staff, technology and marketing, and with the outpouring of community support, notably the Save UTMC Coalition.

And so far his wager is paying off with the recent announcement the hospital finished the fiscal year with a $4 million surplus.

Credit the quick boost in revenues and in performance to frontline employees who worked to improve billing processes to make sure the hospital was getting paid for all the care it was providing, to find operating room and outpatient clinic efficiencies, to renegotiate contracts with medical insurers, and to improve patient volumes necessary for educational opportunities for medical students and resident physicians.

Universities like UT that operate health-professions colleges and teaching hospitals have a major responsibility for advancing community health and wellness, an obligation best fulfilled when there is a high degree of medical school-hospital connectedness and tight organizational integration.

That synergy would have been fractured had a sale or lease of the facility occurred.

UTMC has had its ups and downs, and it will have to remain nimble and not get complacent for its achievement to stand the test of time.

But it’s now clear that what the founders of MCO like Paul Block, Jr., and Dr. Frank Rawling dreamed of early 1960s—an academic health science center with a vibrant teaching hospital — northwest Ohioans now rely on as a necessity for their health and longevity.

And for now, that portends a bright future for the hospital.

JIM WINKLER

Gainesville, Fla.

Editor’s note: The writer worked in several communication positions at MCO and UT for more than 30 years and is one of four editors of the book, “A Community of Scholars: Recollections of the Early Years of the Medical College of Ohio.”

Blade Editorial: Saving UTMC

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Note: this editorial was published in the September 28, 2021 edition of the Toledo Blade.

Just a little more than a year ago, the fate of University of Toledo Medical Center was uncertain at best. Facing steep financial losses and large budget deficit forecasts, University of Toledo officials announced in April, 2020, that they planned to request bids from parties interested in buying, leasing, or managing the medical center.

Flash forward to September, 2021, and the same University of Toledo trustees are now reporting that instead of the predicted $14 million deficit, UTMC ended its fiscal year roughly $4 million ahead.

UTMC’s financial officer called the turnaround “profound.” It certainly is that. Also, it is a testament to the power of community activism.

University trustees reviewing the good financial news pointed to UTMC’s recent partnership with the Toledo Clinic, along with marketing and operating improvements, improved results and additional revenue for the turnaround.

All of those factors added up to a successful strategy for UTMC, but another essential element was the work of a community group determined to keep a community hospital in South Toledo.

From the moment UT announced it would consider proposals to potentially sell the hospital, neighbors sprung into action and persistently pressured University of Toledo leaders and elected leaders to not only save UTMC, but restore it.

The only certain bidder interested in taking over UTMC operations was ProMedica, which the neighborhood supporters blamed substantially for the financial troubles at the hospital. The health-care system’s 5-year-old affiliation agreement with the medical college had siphoned off students, residents, medical staff, and patients, all of which drained UTMC.

The Save UTMC Coalition pressured UT to amend its bylaws and allow non-faculty physicians to bring some services back to the South Toledo hospital. It also pushed back against the school’s affiliation with ProMedica, and asked state legislators to halt a potential sale of UTMC.

By July, the university announced it was no longer considering proposals to purchase, lease, or manage the UTMC. Instead, university officials said they would instead focus on stabilizing the former Medical College of Ohio hospital’s finances.

And while financial challenges remain — many of them exacerbated by the coronavirus pandemic — UTMC’s circumstances are dramatically improved. The hospital and university officials who worked to right the financial ship deserve much credit.

The neighbors who banded together and refused to give up a vital community asset deserve credit too. Their committed activism has made Toledo a better place.

Winkler: Postel a fighter for UT

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Note: this letter to the editor was published in the March 13, 2021 edition of the Toledo Blade.

The University of Toledo board of trustees’ decision to name interim president Dr. Gregory Postel to the post permanently is welcome news.

For the last nine months, Dr. Postel has clearly proved to be much more than a caretaker president.

With his medical training and extensive experience in academic medicine, he has navigated the university though the coronavirus pandemic, put the University of Toledo Medical Center, the former Medical College of Ohio Hospital, on the path to fiscal health, and oversees preparations for a comprehensive review of the university’s programs later this year by the Chicago-based Higher Learning Commission, an organization that accredits colleges and universities in Ohio and 18 other states. It is one of seven accrediting agencies in the country.

Particularly heartening was his decision not to sell or lease UTMC following strong support for the facility from area residents.

UTMC has demonstrated its vital role to the region during the coronavirus pandemic. Front-line physicians, nurses, and other health-care workers have treated coronavirus patients, putting themselves and their families at risk. The hospital’s rapid coronavirus testing capacities have been invaluable. Researchers such as Dr. Michael Ellis are directing NIH-sponsored clinical trials to better understand and treat medical issues created by the virus.

With new investments in staff, technology, and marketing and the partnership with the Toledo Clinic, UTMC seems to be getting its financial footing. Challenges lie ahead for the university post-pandemic, but for now there are plenty of reasons for optimism with Dr. Postel and Alfred Baker, chairman of the UT Board of Trustees, at the helm.

The mascot for the athletic teams at the College of Wooster, Dr. Postel’s undergraduate alma mater, is the “Fighting Scots,” a nod to the college’s Presbyterian heritage.

Dr. Postel might quibble with the characterization, but to my mind, he has been just that — a fighter for UT.

JIM WINKLER

Gainesville, Fla.

Editor’s note: The writer worked in several communication positions at MCO and UT for more than 30 years and is one of four editors of the book, “A Community of Scholars: Recollections of the Early Years of the Medical College of Ohio.”

Blade Editorial: UTMC contributes

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Note: this editorial was published in the January 12, 2021 edition of the Toledo Blade.

The University of Toledo Medical Center is one of 40 hospitals joining the federal government’s Big Effect study to determine which treatments work best to treat the coronavirus. It’s just the latest evidence of the former Medical College of Ohio Hospital’s value, not only for patients in Toledo, but for the broader community.

Since the virus emerged early last year, scientists and health-care professionals have developed treatments and shared their discoveries with each other. Now, the National Institutes of Health is launching a national study to identify which coronavirus treatments are most effective and deserve more attention in clinical trials.

The study will look to weed out ineffective treatments and expedite therapeutics that show significant benefits to patients struggling with the virus by testing hospitalized adults who need oxygen or mechanical ventilation and consent to participation.

UTMC will seek to have at least 30 patients participate in total, and has 10 enrolled already. Those who enroll in the trial will be treated with two drugs — remdesivir, a proven benefit to treating coronavirus infections, and either risankizumab or lenzilumab, two monoclonal antibodies being investigated as potential treatments for the virus.

After the initial portion of the trial, UTMC will begin a second phase using a placebo-controlled trial that looks to examine the safety and efficacy of using each of the two monoclonal antibodies paired with remdesivir, versus remdesivir alone.

Joining the study is just UTMC’s way of doing its part for the worldwide fight against coronavirus, according to Dr. Michael Ellis, an infectious disease expert, who is the chief medical officer at UTMC.

Not only is participating in the Big Effect research a way for a regional hospital to contribute to the greater good during a crisis, it shows that UTMC is a vital institution to our community.

Faced with possible sale or even closure a little less than a year ago, UTMC is showing signs of new life. University of Toledo officials announced in December the hospital had surpassed revenue expectations for the second half of 2020 and a new partnership with the Toledo Clinic offers signs of hope.

That UTMC has a place in a national study of coronavirus treatments is one more piece of evidence that Toledo still needs UTMC and in return UTMC needs Toledo’s support.