Save UTMC

by Dr. James C. Willey

Note: this essay appeared in the January 25, 2020 edition of the Toledo Blade.

As is evident from recent news coverage, citizens of South Toledo are pooling resources, knowledge, and energy in an effort to optimize delivery of health care in our region.

A key goal of the Save UTMC Citizens Group is to ensure that the University of Toledo Medical Center, the former Medical College of Ohio hospital, remains a teaching hospital. Citizens of South Toledo value having qualified medical professors regularly engaged in teaching students and residents. There is extensive objective evidence that health care delivery is better when delivered in a teaching hospital setting.

A less well-recognized UTMC feature worth preserving in our community is its status as a research hospital. Over the last 50 years, University of Toledo faculty on the Health Sciences Campus in South Toledo have conducted research to address key needs in human health. Funding from the National Institutes of Health has been a major source of support for jobs and business activity in our region. Faculty on the main campus of UToledo also have relied on UTMC and Health Sciences Campus faculty to conduct important health studies.

UTMC and UT Health Sciences Campus research faculty and staff provide Toledo residents, especially those in South Toledo, opportunities to participate in cutting-edge research. They know that UTMC will conduct the studies in a way that minimizes risk and maximizes meaningful outcomes. A UT team conducted a multi-institution study in which 80 subjects were enrolled at UTMC, and 320 additional subjects at eight other major institutions, including the University of Michigan, Cleveland Clinic, and Ohio State University. The purpose of this study was to evaluate a genetic test for lung cancer risk that this UT team developed through funding from NIH. Due to the care and skill of UTMC staff, the study was conducted safely and there were no serious adverse events.

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Unfortunately, in today’s health-care business climate, clinical research may be considered too risky; not to patients, but to the balance sheets of a hospital. In this time of transition since the agreement between the university and ProMedica, it is important to clearly communicate the economic benefits for a region that maintains and advances research hospitals. A prominent direct economic benefit is the grants awarded by NIH to UT faculty totaling more than $300 million to our region over the last 25 years, including over $11 million in 2019 alone. Nearly all of this funding was awarded to conduct research that involves human subjects enrolled into clinical research studies at UTMC. NIH estimates that each $1 million of its funding leads to employment of 13 people and brings $2.2 million of additional economic activity to a region. Further, NIH-funded research often leads to development of new technology that is licensed to private companies in return for royalties to UT that directly benefit the region.

As an indirect economic benefit to our region, the research hospital enables UT to attract highly qualified faculty who conduct cutting-edge NIH-funded research.These individuals typically bring state-of-the-art practice of medicine and make important contributions to the teaching of both medical and doctoral students.

As an example, UT was recently able to recruit a nationally recognized investigative oncologist, Dr. John Nemunaitis, in part because of UTMC’s reputation as a research hospital. Other factors that led to this successful recruitment included the influx of funds from the UT/​ProMedica affiliation and the presence of the highly-rated Dana Cancer Center. Dr. Nemunaitis moved from Texas to Toledo two years ago and over the last two years he and his team established multiple Phase I and Phase II clinical trials of cutting-edge cancer treatments in Toledo. Many patients in our region have benefited from access to the new drugs made available through these trials.

The best option for South Toledo and the entire region is for the University of Toledo to maintain existing research activities at UTMC and the Dana Cancer Center on the UT Health Sciences Campus, while also developing other regional hospitals as centers that support clinical research. These steps will enhance the ability of the UT College of Medicine and Life Sciences to recruit faculty who can compete for NIH grants and conduct clinical trials. These clinical research activities will bring new job opportunities and advance health care in our region.

Rather than considering health-care activity to be a zero-sum game in which one community of Toledo must lose in order for another community to gain, it is important that we find and develop opportunities for cooperation that will attract new federal and state funding, jobs, energy, and ideas, and thereby expand opportunities for all citizens of Toledo.

Dr. Willey, M.D., Professor of Medicine, George Isaac Endowed Chair for Cancer Research, UTMC, is a member of Save the UTMC Citizens Group, with former Toledo Mayor Carty Finkbeiner, state Sen. Theresa Fedor, and Randy Desposito, president of AFSCME Local 2415. Dr. Willey’s views do not necessarily reflect those of the University of Toledo.

Note: this editorial appeared in the September 18, 2019 edition of the Toledo Blade.

Sometimes we end up paying for mistakes of our predecessors. The current status and future of the University of Toledo Medical Center is a case study in good intentions gone awry.

The good intention in this case was the construction of the teaching hospital on the campus of the Medical College of Ohio in the late 1970s. Since the inception of the medical college in 1964, Maumee Valley Hospital, located on Arlington and South Detroit avenues, had served as the teaching hospital along with St. Vincent and Toledo hospitals now under the aegis of Mercy Health and ProMedica, respectively.

The new hospital, a few hundred-bed state-of-the-art facility, served for many decades as the center of academic activities in Toledo. The students and residents got the bulk of their education and training at the Medical College Hospital. It was renamed UTMC after the merger of the Medical College of Ohio with the University of Toledo.

However, by 2010 it was becoming clear that UTMC, as a stand-alone facility, could not survive for long. The days of small independent academic hospitals were mostly a thing of the past, and mergers, acquisitions, and affiliations had become the buzzwords across the country. Some visionaries had realized early on that in a highly competitive atmosphere, mergers were the only way to cut cost and continue the mission.

Such mergers and acquisitions happened all across the nation.

Currently the United States only has a few free-standing small academic hospitals.

The dilemma for UTMC was that it had no viable options to join a bigger hospital. ProMedica was gunshy after its acquisition of St. Luke Hospital in 2010. That deal was challenged, and the Federal Trade Commission ruled that the merger was “illegal and anti competitive.”

However an opportunity arose when ProMedica, one of the two major health providers in our area, showed interest in having an affiliation with the University of Toledo College of Medicine. Mercy St. Vincent Medical Center was also interested but opted out during the initial negotiations.

Of interest for both ProMedica and Mercy Health was an opportunity to become academic medical centers. In the real world, academic medical centers, because of teaching, training, and research, are considered a few notches above other health-care providers irrespective of their size or reputation.

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. A stipulation was that the Toledo Hospital would become the main academic hospital for the UT College of Medicine.

It was also mentioned that the medical college might move to the campus of Toledo Hospital in a purpose-built facility.

UTMC was not mentioned in the talks and conversations about the affiliation. After mulling it over for a few years UT decided that the hospital would cease to be a teaching hospital and would become a community hospital.

That was a short-sighted decision.

In private conversations some people who are not friends of UTMC have said that the hospital should be boarded up. It raises an important question: Why should a vibrant academic center with a sterling record be allowed to whither on the vine? Why couldn’t it remain a teaching hospital supplementing the student and resident teaching at ProMedica Toledo Hospital?

There is not enough clinical material at Toledo Hospital to satisfy the needs of medical students and residents in training. As such there is always the ever-present danger of jeopardizing the accreditation of some residency-training programs.

Sometimes ironclad agreements have to be revisited for the greater good of the community and the profession. Keeping UTMC as a teaching hospital with close affiliation with ProMedica Toledo Hospital is in the best interest of people of Toledo, University of Toledo, and the young men and women who have opted to come to Toledo for medical education and training.

UTMC is fiscally solvent and not in financial straits. It provides employment to 1,900 people and has, according to a recent economic impact analysis, an annual impact of $400 million in our region. It may not be able to survive in the long run, but with a partnership with a large system, it can not only survive, it can thrive, as well as retain its unique academic mission.

It is much easier to demolish and dismantle than to build something from scratch. My argument to retain UTMC as a teaching hospital is based on grounded 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 appears every other week in The Blade. Contact him at: aghaji@bex.net