ProMedica, University of Toledo partner to lure docs

5/17/2010

After years of strained relations, the University of Toledo and ProMedica Health System are forming an health education partnership that will expand their resident programs - and help both of them attract doctors.

Under the proposed agreement pending final approval today, UT will manage resident programs at all ProMedica facilities, including Toledo Hospital. A board with equal representation from both UT and ProMedica will oversee the academic partnership.

The relationship also will strengthen opportunities for UT students at the medical school, the former Medical College of Ohio, as well as those in nursing, pharmacy, and other health-related fields, said Dr. Jeffrey Gold, UT provost and executive vice president for health affairs and medical college dean.

"We're just so much better together than we are separately," said Randy Oostra, ProMedica's president and chief executive.

When the pact officially begins July 1, ProMedica will have 38 residents, 15 or so more than in the current academic year. That number eventually could reach 100, and the partnership will help ProMedica recruit doctors for its hospitals throughout the region, Mr. Oostra said.

Plus, the partners believe the relationship will result in more resident and fellowship programs at ProMedica hospitals in areas that could include plastic surgery, ophthalmology, emergency medicine, and pediatric specialties. And ProMedica patients will have access to clinical trials performed through UT, giving the area a bigger share of Ohio's research dominance currently focused in Cleveland, Columbus, and Cincinnati, Dr. Gold said.

"It's high time that northwest Ohio create a little departure from that," said Dr. Gold, noting UT is involved in about 680 clinical

trials.

UT's board of trustees is expected to vote today on the proposed partnership, which ProMedica's board approved last week. Dr. Gold and Mr. Oostra sat down together with The Blade last week to share details of the plan, acknowledging that much work is yet to come.

Dr. Atul Grover, chief advocacy officer for the Association of American Medical Colleges, commended the pending relationship last week. Among other benefits, it's a good way for ProMedica to build a residency program and for UT to provide more educational opportunities, he said.

"There's bound to be bumps in the road as you try to merge the two cultures," Dr. Grover said. "It's a fairly unique approach."

Dr. Gold said the partnership with ProMedica will not imperil its medical education relationships with other hospitals and offices, including Mercy, St. Luke's Hospital in Maumee, and St. Mary Mercy Hospital in Livonia, Mich. Some existing residency slots could be shifted around, though, he said.

Mercy has its own graduate medical education program that was established in 1893. It has more than 185 residents, some through partnerships with UT - such as a pediatric dental surgery program started a few years ago - and with hospitals in Michigan, said Dr. Imran Andrabi, president and chief executive of Mercy St. Vincent Medical Center.

"We continue to have a really good relationship with the University of Toledo," he said.

With 42 residents in emergency medicine alone, Mercy has one of the biggest and most complex such programs nationwide, Dr. Andrabi said. Mercy is expanding its internal medicine residency, and it has had good luck retaining doctors in the area, he said.

"We keep between 50 percent and 55 percent of our graduating residents in the northwest Ohio and southeast Michigan area, particularly in emergency medicine," Dr. Andrabi said.

Concerns about retention locally have grown in recent years as relations between ProMedica and UT became rocky at a time when the nation is facing a physician shortage. Instability and too few residency slots made some newly minted doctors opt to leave northwest Ohio and UT, a troubling trend because doctors tend to stay where they do their residencies.

ProMedica temporarily severed ties with the medical school in 1999 when it considered joining with Mercy to establish what is now Mercy Children's Hospital.

Then, three years ago, bitter negotiations mired in business-related issues - including financial incentives encouraging employees on the UT Health Science Campus to go to the University of Toledo Medical Center for treatment - nearly scuttled medical student rotations at Toledo Hospital.

A state commission even was formed to look at why most graduating medical students don't stay in northwest Ohio for their residency programs. There was no consensus, however, about how to solve the problem among members from ProMedica, Mercy, UT, and elsewhere.

State Rep. Randy Gardner (R., Bowling Green), the commission's chairman, said the effort did at least help air debates and share information. He received some information about UT and ProMedica's pending partnership last week.

"It appears that two very big players in health education and health care in northwest Ohio have come together in a meaningful way," he said. "That has to be good news for our region."

More health-care positions and research will help economic development in the region, which will benefit from spin-off jobs and spending, both ProMedica's Mr. Oostra and UT's Dr. Gold said.

All together, UT has about 175 students in a medical class, up from about 145 students five years ago, Dr. Gold said. And it has 270 residents working in 18 locations, up from 206 residents five years ago, he said.

Some additional resident positions created for the partnership could be federally funded, Dr. Gold said. The government is considering redistributing some of about 3,000 residency slots that are open as part of health-care reform, he said.

Collaboration to improve health care is critical as reforms proceed, Dr. Gold and Mr. Oostra said.

"There's no question that the whole method for delivery of quality health care is changing," Dr. Gold said. "We know that there needs to be substantial change in the way we deliver health care."

Contact Julie M. McKinnon at:

jmckinnon@theblade.com

or 419-724-6087.