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Published: Saturday, 2/14/2004

What about the kids?

THE ProMedica Health System is bristling from a physicians' revolt, an uprising that has taken the form of "no confidence" and "lack of confidence" votes toward its administration by medical executive committees. These represent 700 doctors at Toledo Hospital and Toledo Children's Hospital.

The doctors' newest displeasure stems from the ProMedica board's removal of a pediatric radiologist, who had been elected chief of staff by doctors at TCH, from the children's hospital board.

By-laws of that board give automatic membership to the elected medical chief of staff. Dr. Daniel Dessner's offense was to be one of 136 pediatric and family doctors in this region who have been critical of the quality of care offered children here, saying two children's hospitals dilute resources.

The doctors formed Physicians for the Effective Delivery of Care, PEDs for short, and advocate for a single hospital devoted to healing sick children. This is the right thing to do for kids, they say, though ProMedica officials especially have taken an unfortunately firm stance against this change. ProMedica says a stand-alone children's hospital would be too pricey.

But the fact remains that two children's hospitals are one too many. ProMedica's Toledo Children's Hospital and St. Vincent Mercy Medical Center's Mercy Children's Hospital need to merge. There is an array of creative arrangements to permit joint or independent governance. The wars these two hospitals wage are counterproductive and adversely affect patients and quality of life.

At stake is whether Toledo can attract and keep children's specialists in several fields, adequately serve children with a variety of ills, and promote pediatric education at the Medical College of Ohio, whose graduates often remain in northwest Ohio.

This latest conflict between physicians and a hospital system comes on the heels of ProMedica's failed attempts in 2003 and 2002 to strong-arm area specialists into deals with its health insurance subsidiary, Paramount.

The aim was to try to dominate Toledo's medical market. It wanted the specialists to be affiliates, and not simply treat patients with Paramount coverage. The doctors stood for their own independence and patient choice. The ProMedica system has suffered as a result.

If the competing giants put their minds to it, they could evolve a plan as smooth as that created to deliver health care to many who are uninsured. Both, for the service they provide, have federal tax-free designations that save substantial money. They owe the public before they serve themselves.

ProMedica President and CEO Alan Brass says Dr. Dessner had "multiple opportunities to fix the conflict." But where is the conflict in a doctor speaking out for patients? A children's hospital board should welcome his views, not punish him.



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