Letters to the Editor

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.

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.

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.”

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.”

Note: this essay was published in the November 25, 2020 edition of the Toledo Blade.

As a member of the local medical community for 30 years I was surprised to learn that many of my colleagues, and in fact even the physicians who have cared for me, were not among the “best and brightest,” apparently only landing in Toledo because they already had ties locally (“Area Health Partnerships Work,” The Blade, Nov. 18).

It wasn’t until Drs. Stephen Stanek and Tahir Jamil, in conjunction with ProMedica, decided to grace us with their talent that medicine in Toledo was able to undergo a badly needed renaissance.

Their self-serving op-ed is not only myopic, it is factually inaccurate. They suggest their view of the local medical landscape is “unique” because they came here for medical school and stayed for residency training. It isn’t.

There have been UTMC graduates doing local residencies and then joining the local medical community for over 50 years.

In fact, the renaissance in local medicine began with the advent of the Medical College of Ohio in 1964, well before ProMedica came on the scene.

The authors view through green-colored glasses needs to be taken with a large grain of salt. Apparently their definition of a “great doctor” is either one who is part of ProMedica or perhaps any physician who refers to them.

My view is a bit broader, having worked in every health system in town; unlike the authors whose experience is limited to one health system.

As a neurosurgeon who came here 30 years ago I was honored to work alongside other neurosurgeons, some of whom were my competitors, from world renowned training programs to include: Yale, Barrow Neurological Institute, University of Indiana, Vanderbilt, State University of New York, and my own training program at Walter Reed Army Medical Center.

I feel safe in saying that most of us had no local ties and none of us came to town because of ProMedica.

Believe it or not, some of us were able to recognize for ourselves that Toledo; with its world-class museum, top-notch symphony, and nationally recognized zoo was indeed a well-kept secret.

Toledo was not a “diamond in the rough” but was able to shine on its own merits then just as it does now. Having lived in Washington, Honolulu, and several cities in Europe, I chose Toledo because it offered state-of-the-art medical care then just as it does now.

Dr. Stanek and Dr. Jamil go on to state that the academic affiliation is good for ProMedica and The College of Medicine and Life Sciences, which is the former Medical College of Ohio.

While the statement is probably true, they conveniently leave out the fact that ProMedica’s scorched-Earth policy when it comes to competitors has decimated The UTMC hospital.

The physicians mention attracting the best and brightest physicians to town but leave out the fact ProMedica eliminated two family practice-training programs locally.

Perhaps the author’s definition of best and brightest doesn’t include primary care physicians.

The medical care here was top notch well before ProMedica came on the scene and continues to shine in every system locally. To suggest otherwise is simply wrong on every level.

I understand that friction sometimes exists between “town-and-gown” physicians, but to denigrate the highly competent physicians in every specialty who trained locally in the days before ProMedica is insulting and arrogant.

Lawrence Spetka is a neurosurgeon in Toledo.

Note: this letter to the editor was published in the November 17, 2020 edition of the Toledo Blade.

Recently The Blade reported that ProMedica Healthcare Systems is once again headed to court due to alleged anti-competitive behavior.

Prioritizing profits over people is a pattern of behavior for the health care giant. I stand with McLaren St. Luke’s in their fight, because I know what it feels like to have my own community hospital in ProMedica’s sights. I have witnessed the havoc ProMedica has caused to the University of Toledo Medical Center through the 2015 Academic Affiliation Agreement with ProMedica Healthcare System.

As the old saying goes, “Where there is a will there is a way,” and ProMedica seems hell bent on taking over the Toledo health care market by any and all means.

Because of the COVID-19 crisis, people are already scared to get the routine care they need. My neighbors and family deserve to have multiple options for medical care across the northwest Ohio region, rather than having to settle for the only provider available. A major public health crisis is not the time to make patients find a new doctor.

Having a variety of options helps foster competition and keep prices down for consumers. The courts stopped ProMedica from creating a monopoly once, and they can do it again. However, they must act quickly before thousands of families in the Toledo area loose access to the medical provider they prefer.

TERESA FEDOR
State Senator, District 11

Note: this letter to the editor was published in the November 14, 2020 edition of the Toledo Blade.

In last Sunday’s Toledo Blade the Save UTMC Coalition placed an ad calling ProMedica arrogant and selfish.

Thursday’s Blade had a story with the headline, “McLaren St. Luke’s files lawsuit against ProMedica,” which said the legal complaint accuses ProMedica of attempting to eliminate competition from the University of Toledo Medical Center, the former Medical College of Ohio Hospital, by engaging in an affiliation agreement that has shifted large numbers of faculty from UTMC to ProMedica.

Both St. Luke’s and UTMC have lost markets share since 2015, and ProMedica has monopoly power in the market, according to the lawsuit.

Over the past few months, Mercy St. Vincent Medical Center, McLaren St. Luke’s Hospital and the coalition have each lashed out at the blatant efforts of ProMedica to eliminate competition. If ProMedica succeeds, medical and hospital bills in the Toledo area would soar.

The coalition will stand with University of Toledo President, Dr. Gregory Postel, as he places programs and professional administrators in key positions at UTMC, each committed to bringing fresh energy, talent, and leadership skills to UTMC and the medical campus.

Our coalition is grateful to U.S. Reps. Marcy Kaptur and Bob Latta, state Sen. Teresa Fedor, and the northwest Ohio delegation for their ongoing support. To St. Luke’s, thank you for your leadership. Thanks to the Toledo Clinic for your teamwork.

Toledo area residents, please speak out loudly against the arrogant efforts of ProMedica to eliminate health-care competition. Citizens, please stand solidly behind our united effort to sustain each of Toledo-Lucas County’s present hospital systems.

The critical effort to defeat the pandemic requires all of our hospital systems working together on a daily basis. Together, we can and will defeat our opponent.

CARTY FINKBEINER
Former Toledo mayor and coordinator, Save UTMC

Note: this editorial was published in the August 1, 2020 edition of the Toledo Blade.

Toledo is composed of many magnificent neighborhoods and assets: the Maumee River; our Downtown Waterfront; the Central Business District and Warehouse District; the Toledo Museum of Art and the Old West End; Metroparks Toledo; Franklin Park; Old Orchard, and the University of Toledo; the Toledo Zoo, and the University of Toledo Medical Center.

I believe it fair to say that most Toledoans would not include MCO-UTMC on their list of valuable Toledo assets, yet it it certainly does belong there. For example, the South Toledo medical campus compares in worth to the University of Toledo’s main campus on West Bancroft Street. The main campus includes the Glass Bowl Savage Arena, all the academic buildings, the library and recreation center, fraternities, sororities, and dorms — all of these properties are equal in real value to the South Toledo medical campus.

Just 41 years ago, the Medical College of Ohio Hospital was officially dedicated. As Jim Winkler recently wrote in this very column: “At its dedication in 1979, then MCO President Richard Ruppert called the teaching hospital a ‘258-bed classroom.’” Mr. Winkler concluded, “It is a treasure for the region, the state, and its citizens.”

In 2020, former President Sharon Gaber and former UT Board Chairman Mary Ellen Pisanelli decided to sell or seek new management of the hospital.

But, citizens of South Toledo and throughout our region recognized the medical campus as critical infrastructure, and understood the tremendous benefits its teaching, healing, and research imparts upon the entire Toledo region. They rose up and worked together to persuade Interim President Gregory Postel and the Board of Trustees to take the for-sale sign down.

We came together as Save UTMC — neighbors, elected officials, caring UTMC staff, and AFSCME union members. And we published a 13-point agenda to breathe fresh energy, talent, and fiscal resources into our medical campus, so valuable not only to our region, but to the entire state of Ohio.

This critical resource, including the medical school, research labs, and healing hospital, is one of only two such state-owned campuses in Ohio, the other being on the Ohio State University campus.

Very special recognition goes to U.S. Rep. Marcy Kaptur, state Sen. Teresa Fedor, Dr. James Willey of UTMC, Mike D’Eramo, CEO of the Toledo Clinic, and Randy Desposito, president of ASFCME Local #2415. Their leadership throughout our journey was invaluable. Gracious thanks go to Keith Burris, editor and vice president of The Blade and editorial director of Block Newspapers, and The Blade staff, who informed and educated northwest Ohio residents on the value of our South Toledo medical campus and challenged the UT Board of Trustees and officials to recognize the value. Finally, to Dr. Postel, interim president: we are especially grateful to you for leading the way to a brighter future for our University and our medical campus.

Now, let’s move forward together inspiring, teaching, researching, and healing, at our valuable medical campus in South Toledo, truly one of the most precious assets in Toledo and northwest Ohio.