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Published: Wednesday, 8/15/2007

Dispute between ProMedica and UT imperils education of 70 medical students

BY MEGHAN GILBERT AND JULIE M. McKINNON
BLADE STAFF WRITERS

ProMedica Health System has threatened to again yank educational programs for about 70 third-year medical students at Toledo Hospital, and ultimately 19 residents, unless the University of Toledo meets its demands, letters among leaders show.

Alan Brass, ProMedica's chief executive, last week indicated that medical students and residents from UT's Health Science Campus, formerly the Medical College of Ohio, may no longer be taught at ProMedica hospitals unless the nonprofit is given preferential business treatment.

That includes essentially having the university pick up at least part of the co-payment tab for UT Health Science Campus employees going to ProMedica doctors - a relationship that can't be extended to other local educational partners, including hometown rival St. Vincent Mercy Medical Center - and allowing the Toledo hospital system to select the university's team physician, according to a review of correspondence obtained by The Blade yesterday.

"For example, if the [co-payment] issue is not resolved soon, that will likely impact the willingness of the physicians to continue to voluntarily teach your medical students and residents," Mr. Brass wrote to UT President Dr. Lloyd Jacobs in an Aug. 9 letter. "If that is the case," Mr. Brass added, "having no teachers will impact our ability to implement the medical student and resident agreements in our hospitals. At the same time, the trust relationship between our sports medicine faculty and the university continues to become further strained."

The two business conditions and threat to doctors in training have become mired in negotiations for a contract that was to end yesterday. The proposed agreement would allow UT to continue sending third-year medical students to Toledo Hospital for obstetrics-gynecology and pediatrics rotations.

Late yesterday, ProMedica agreed to extend talks for the student contract for a third time, although a spokesman declined to say for how long.

Mr. Brass was not available for comment yesterday. ProMedica had no immediate comment on why business conditions were part of medical student negotiations, but the hospital system is committed to resolving the issues, said ProMedica spokesman Christine Wasserman.

Dr. Jacobs said he believes the sides will work out differences.

"I believe that fundamentally all of us recognize this is about students," Dr. Jacobs said yesterday. "And because this is about students, this is about the future - literally about the health care of our children and grandchildren in this community."

ProMedica has long had a rocky relationship with the former Medical College of Ohio, which doesn't deliver babies and relies on Toledo Hospital's large obstetrics unit to help teach medical students. The hospital system severed ties with the medical school in 1999, when the university was considering joining with Mercy Health Partners to establish St. Vincent Mercy Children's Hospital, but started to mend relations three years later.

UT, which merged with the medical school last year, also has some students doing obstetrics and pediatrics rotations at several other northwest Ohio hospitals, but none does as many deliveries as Toledo Hospital. The medical school has a few students doing family medicine rotations at other ProMedica facilities, including Flower Hospital in Sylvania.

The university will try to find other hospitals where it can place students if negotiations with ProMedica fail, said UT spokesman Matt Lockwood.

"We would be willing to explore any opportunity if it's a quality educational experience," he said.

The Blade yesterday obtained a series of letters dating to March between UT and ProMedica officials about medical student contract talks. They provide a glimpse, however, into a dispute that goes beyond a single contract. UT about a year ago started to waive or provide discounted insurance co-payments to Health Science Campus employees using its medical services. That has since been extended to more than 200 ProMedica doctors who teach UT students after Mr. Brass objected in April to UT's initial move, saying it has hurt their physician practices.

Another disagreement involves UT's team physician. In letters from Mr. Brass to Dr. Jacobs, Mr. Brass writes ProMedica should have the right to appoint UT's team doctor. UT officials contend they should mutually pick the team doctor. Dr. Roger Kruse, a ProMedica employee, is the Rockets physician whose contract expires July 1, 2009.

Contact Meghan Gilbert at: mgilbert@theblade.com or 419-724-6134.



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