Note: this letter was published in the June 14, 2020 edition of the Toledo Blade.
Thank you, Governor DeWine, for caring so deeply about the health and fate of Ohioans as you address the Covid-19 pandemic, which began to bear down here in late March. In contrast to your leadership, the University of Toledo‘s Board, a few weeks into Covid-19, made the unsettling, callous decision to publicly announce the proposed sale or transfer of our region’s only public university medical teaching hospital — the sole, anchor teaching institution for academic medical education and research in the entire northwest quarter of Ohio.
Our future doctors and medical professionals learn there. Can you imagine the shudder that ill-timed board announcement sent down the spines of thousands of medical personnel that report to work in that hospital and on that precious campus? They hold the 24/7 responsibility to meet our region’s medical needs, refusing no patient, so life can conquer death. Their work became more stressful as they reported to the front lines to combat an illness for which there is yet no known cure.
Yet, did the UToledo Board even consider the added worry its announcement engendered in these essential medical personnel? Further, did the board give any consideration as to how their ill-timed dictum would impact the morale of thousands upon thousands more worried patients who call UTMC, the former Medical College of Ohio Hospital, their medical home?
Sadly, this dense mentality of the current board of this state university toward its medical campus and hospital is highly troubling. It is antithetical to the generous, founding spirit that first inspired and created this hard-fought, precious state academic medical college as an educational resource for our medically underserved region in December, 1964 —161 years after the state of Ohio’s founding. UTMC became Ohio’s youngest public medical college, and still one of only six statewide. A priceless, caring community of medical professionals began to emerge where none had existed before. UTMC’s teaching hospital is one of only two state authorized academic medical colleges, with Ohio State being the other.
Next, to make matters worse, the current president of UT then surprisingly announced her departure, three years before her contract was up for renewal. Compensated at the highest salary of any public official across our region and afforded many other benefits like housing and family tuition, she chose to depart, as thousands of university faculty, personnel, and students were reeling because of uncertainty about Covid-19. They wondered what the future held for them as the university shut down its classes, graduation ceremonies, and activities.
Governor DeWine, our Toledo community needs a visionary University of Toledo Board. We need a new president who cares about Toledo, its people, and our region. Our health challenges are substantial. Our University needs your informed intervention, starting with enlightened appointments to its board who live in and care about our community. Our medical university requires a separate state-appointed board like that of Ohio State.
We well understand that the medical fate of millions of Ohioans rests in your hands. But you inherited a state that ranks very low in health outcomes — in the bottom 10 percent of our nation, alongside Mississippi and South Carolina. Ohioans deserve better. The future of the University of Toledo’s academic medical center, its teaching hospital, and research campus hang in the balance, intricately bound to the Toledo’s region’s future and its health.
For far too long, your predecessors did not appreciate the hard struggle this state medical school has endured — first, to exist, and then to crawl forward to become a respected teaching and research hospital with acknowledged proficiencies in orthopedics, cancer treatment, neurology, cardiac surgery, and pharmacological expertise, to name a few.
Former presidents and faculty have devoted their lives to creating this medical community that trains doctors and medical practitioners for the future and conducts our highest level of medical research. Most recently, it was seven UTMC young female scientists who created the original Covid-19 test kits supplied to doctors across our region. We applaud them! Why hasn’t the university board?
You now inherit the challenges that emanate from decisions made by your predecessors that do not serve the public interest. I believe it incumbent for the state of Ohio to delve into the series of decisions that have led to the current, unfortunate, destabilizing predicament at the University of Toledo Medical Center. Nontransparent UToledo Board actions threaten to further harm our medically underserved region. The campus is located in the heart of Toledo proximate to census tracts with high percentages of minority populations and senior citizens. Please know, the diverse patient profile of the UTMC medical center is 75 percent Medicare/Medicaid.
Meanwhile, many of the board and key decision makers driving this UTMC sell-off do not live in Toledo. They live outside Toledo, and even outside Lucas County, but leverage Toledo’s assets to enrich their interests. The University of Toledo should reflect the diverse culture of Toledo, its caring heart, and its international bent as a major port city on the Great Lakes. The upending of fine medical care at UTMC not only must stop, it must be reversed. The people of our community cannot afford to lose this medical community located in the heart of Toledo. It has been built with love by those who devoted their dear lives to creating it and building it forward for us to yield better health outcomes for all.
Certain critical facts need to be assembled to forge a sound pathway forward.
But first, a forensic audit of UTMC history is essential. The public, and you, have a right to know the net worth of decades of taxpayer public investment on the UTMC medical research campus and its teaching hospital. Painstakingly, over time, those on the medical campus have earned their way forward with real investment amounting to well over a billion dollars. Yes, progress occurred.
I believe new university partnerships can be struck to create a sterling state medical facility complex to meet the health-care needs of our region. For instance, UTMC could partner with Bowling Green State University, its Firelands campus, and the Erie County Health Department to inform medical outcomes in underserved rural counties that surround Toledo, employing telemedicine and other means. With the concurrence of our state, our region can create its own “research triangle model,” ultimately serving a vast underserved tristate region.
But all decisions forward must be informed by a real audit of UTMC’s worth, not simply revenue flows in a given year, especially an atypical year like 2020. Internal year-to-year shifts in flows of funds relative to the medical university vs. main campus, especially over the past decade, must be evaluated.
Full transparency in a state public institution is essential. Nothing should be hidden. It appears some current revenue statements mask interfund transfers within the university structure itself, especially post 2015. These transfers must be tracked over time and presented publicly. A one-year snapshot is inadequate to the challenge at hand.
The auditing process the state must undertake should respect the taxpaying public, those medical professionals earning revenues by providing medical services, private philanthropists that helped build forward this critical academic medical campus and its teaching hospital, and public officials like myself whose votes in Congress have brought millions of dollars to the medical campus.
When governors Jim Rhodes and Mike DiSalle envisioned this youngest medical campus in Ohio, they knew how medically in need this corner of Ohio was. As a child, I still remember going into the old County hospital with my father to visit our grandfather. I learned firsthand how insufficient, even dreadful, it was. UTMC, formerly the Medical College of Ohio, was a dream imagined by visionary, educated citizens like Paul Block, Jr., whose inspired leadership for a medical school and research capacity in neglected northwest Ohio is legendary.
As Ohio nationally ranks among the 10 to 20 worst-performing states in our nation in terms of health outcomes, I strongly have urged your Chancellor of Higher Education, Randy Gardner, to seriously evaluate how federal support being directed to Ohio relating to Covid-19 — including in both education and health accounts — could assist Ohio’s six public medical universities and its two teaching hospitals to improve their performance and reach. Ours, as the youngest medical university, has to stretch not retrench, nor sell its silverware. In addition, our region must be highly mindful that significant anti-trust concerns attend to any proposal regarding medical services in this region, as the Federal Trade Commission has a watchful eye on the Toledo market based on recent rulings.
In looking toward the future, please let me share with you further examples of how the University of Toledo Medical Center and hospital could embrace opportunities to augment its depth and reach.
● Veterans. There exists a federally supported veterans’ clinic at UTMC.
It took our painstaking efforts over two decades to appropriate federal funding to construct this full-service Veterans’ Clinic in Toledo. The goal was to create a “dual affiliation” for the Veterans Administration with both the University of Toledo Medical Center, as well as currently with the University of Michigan/Ann Arbor V.A. Unfortunately, and oddly, this dual affiliation has never been a priority for the University of Toledo. Far too many of our veterans must travel to Ann Arbor for treatments that would be more humanely provided here.
A dual affiliation would make it easier for UTMC to provide hospital care closer to home, as the new V.A. Mission Act encourages, as well as draw down V.A. research funds and place residents for training within the VA. Our region, based on the number of our citizens who served in the U.S. military, is more than worthy of such a dual status.
● Research linkages. With the Red Cross blood facility co-located with UTMC on Research Drive on campus, collaborative research should be pursued. With millions of federal support dollars having built this regional blood bank that serves our tristate area, literally hundreds of medical locations across our tristate area are accessed. Our medical campus could become a significant research node with the Red Cross for research on blood components, and even the development of vaccines.
This has never been developed. Why?
●Ohio National Guard. For many years, I worked with the Ohio National Guard, at the urging of Sen. John Glenn, to secure a medical trauma mission on campus because it had a renowned trauma center. The United States military needs additional medical proficiency lodged in our Guard units across the country to meet medical shortages at home and abroad, including in theater.
Ultimately, the Ohio National Guard decided to create a facility on Research Drive, but peculiarly assigned our campus an MP unit instead.
It seems such an unusual decision and did not fulfill the medical-mission objective to which UTMC is well-suited. Perhaps as you evaluate Guard medical asset placement, you might help us better meet the medical needs of our military here.
● School of Pharmacy. The University of Toledo operates the only major pharmacy school across all of northern Ohio. I believe it a perfect location to spur the “making of medicine” and have urged UT leadership for almost two decades to seek opportunities to spin off medicines and pharmacological products in Toledo to meet human need. That effort would also create new jobs and potentially offer products at more affordable prices to consumers compared to other entries in the marketplace.
One former provost, astoundingly, advised me that making insulin, for example, would be very difficult because you have to refrigerate it. I informed him we build refrigeration equipment in this region. With more than 2 million diabetics or prediabetics in Ohio, surely our state has a crying need to address this epidemic.
● Intercollege collaboration. The University of Toledo’s medical relevance can be enhanced by intercollege collaboration. For example, UT’s Engineering School is world class. As sciences blend, health-care remedies can develop from collaboration between engineering, physics, chemistry, and medicine. The Toledo region has a higher than average orthopedic injury patient base due to the nature of work across our region.
With the assets already existing on campus, including its adjacent rehab hospital, new technologies and medical assists can be invented to repair nerve and spinal cord injuries as research advances in bioengineering, neurology, energy, and bone-tissue science.
● Research with live agricultural and wildlife species collections. Many recent human-health threats, like Covid-19, have emerged from the wild kingdom. The University of Toledo Medical Center is located proximate to our state’s only federal wildlife refuges, and to the famous Toledo Zoo.
Doctors from the university already perform operations on zoo species. Nationally, there is a shortage of doctors in veterinary sciences in demand across our nation and state. UTMC should expand its platform to embrace medical education in conjunction with our agricultural and zoological communities.
Many decades ago, I worked with UTMC President Frank McCollough and farmers from our region to develop sterile hogs whose valves are now being transplanted in human beings at UTMC as well as patients across this country. That represents real medical progress. Pivoting off that experience, there are endless possibilities for UTMC to perform consequential research — linking to our surrounding agricultural community, wildlife refuges, and the science campus collections at the Toledo Zoological Society with its wild animal species, medicinal plants, and botanical conservatory.
● Innovation. In order to earn additional revenue for UTMC, I have suggested to medical professionals at the university they begin to patent and license more of their medical innovations that researchers and practitioners there conceive.
I was informed by one specialty that that was unnecessary because a major pharmaceutical firm visits the University every year, sponsors a lunch, and asks attendees for their suggestions. So the practitioners freely share their ideas with that particular company that then walks away with their intellectual property.
UTMC personnel didn’t appreciate how valuable their knowledge is. I urged them to set up a process within the university to patent, trademark, and license their ideas. UTMC must spearhead health innovations.
● Telemedicine regionally and internationally. With the construction of the SIM Center, the University developed the awesome capability to teach medicine, even beyond its borders. This could include not only a broader linkage across our region, but internationally.
UTMC doctors have brought modern medicine abroad through “medical missions” to some of the most forgotten places on Earth. I believe with the number of UTMC’s internationally capable medical students and doctors and nurses, and with our region’s language capabilities and cultural diversity, our region can teach medicine globally.
I have visited places in Lebanon, Egypt, Israel, the West Bank, Vietnam, Ukraine, and many more where UTMC could improve medical outcomes globally.
● Neighborhood health association and county health departments. Every year, federal support flows to our region for nearly two dozen neighborhood health clinics. Over time, these clinics have developed into critical intake sites for underserved populations. With the onset of Covid-19, additional federal funds have been disbursed to the Neighborhood Health Association to address the underserved. It may be the appropriate time for UTMC to begin discussions with NHA to create a campus presence for NHA activity.
Our region is in serious need of family practice physicians and registered nurse practitioners. This affiliation could be mutually beneficial. In addition, closer linkage to county health departments in northwest Ohio — even presence on campus — could inform new research related to local health outcomes.
In sum, what is needed:
● A futuristic UTMC vision for our state academic medical campus and its teaching hospital, modeled on Ohio State, including its own separate medical advisory board.
● A forensic audit with a stay on further University of Toledo Board decisions regarding the status of UTMC and its Teaching Hospital pending the audit results.
● Appointments of an experienced, community-committed president and locally knowledgeable UT board members, including several appointees with a passion for medical education and teaching, interdepartmental research collaboration, and a desire to take UTMC’s medical teaching and healing more broadly regionally and globally.
● Recruitment of local candidates who have lived and excelled in Toledo, but with experience elsewhere, to interview for the position of University of Toledo President, along with others who have no local experience.
● A research triangle perspective across our region for new partnerships and collaboration on UTMC-led medical research, innovation, and advanced academic medical education.