June 26, 2008

More Input From Doctors Urged to Aid Kaleida-ECMC Merger

By Henry L. Davis

A major group of doctors Thursday called for greater physician input in hopes of advancing the consolidation of Kaleida Health and Erie County Medical Center.

The 450 physicians affiliated with the University at Buffalo School of Medicine and Biomedical Sciences called on the hospitals to require the involvement of doctors in major decisions and the creation of a physician committee to advise where to locate services or how to integrate them.

"We have a golden moment in Buffalo's history to take a quantum step forward in medicine," said Dr. Steven L. Dubovsky, chairman of UB's psychiatry department.

The physicians represent the doctors in UBMD, the university's practice plan. At ECMC, about 80 percent of the medical staff are UB- affiliated doctors, who both practice and teach. Many of the UBMD doctors also work at Kaleida hospitals.

Meanwhile, UB's vice president of health sciences, Dr. David Dunn, said he is prepared to remove the school's doctor-training program from ECMC if the hospital doesn't join in the consolidation.

Such a move would cause a huge headache for ECMC. Hospitals receive enhanced funding from Medicare for teaching residents and depend on the specialists-in-training to help care for many patients.

"I prefer that this not happen," said Dunn, who wants a centralized doctor-training program rather than having it spread among competing hospitals. "But we will align ourselves with whoever is willing to work with us."

The doctors' statement reflects concern that lawsuits and tit- for-tat ad campaigns will kill the consolidation.

It also attempts to remove an obstacle: ECMC's criticism that the consolidation is moving forward without an agreement specifying the medical center's future role in a combined organization. The state- appointed board overseeing the forced marriage has said it won't make deals to guarantee services.

The doctors said that the consolidation must leave both ECMC and Kaleida with viable campuses and that the strengths at ECMC and Kaleida should be recognized and strengthened. They offered as examples trauma, burn care, orthopedics and psychiatry at ECMC, and stroke, neurosurgery, cardiovascular care and pediatrics at Kaleida Health.

They also proposed a committee of UB-affiliated and community doctors to help plan services and any consideration of major changes.

"You can't guarantee hospitals certain services forever, but you can create a process that assures that decisions are made with careful consideration and strong physician input," said Dubovsky, one of 10 doctors on the UBMD management council who signed the statement.

Dunn said the board handling the consolidation will endorse the doctors' statement.

The Commission on Health Care Facilities in the 21st Century ordered ECMC and Kaleida to form a unified, nonpublic entity that includes UB. It imposed a deadline of June 30, although the legislative session is scheduled to end Tuesday.

Legislators in the Assembly on Thursday introduced a bill to consolidate the hospitals but made changes that turn the board that would oversee the hospitals into an advisory group. The State Senate is working on its own bill.

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Originally published by NEWS MEDICAL REPORTER.

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