In a withering assessment, leaders of the University of Miami are complaining strongly about the overall direction of the Jackson Health System and the doctors it is hiring.
Phillip George, a plastic surgeon who is chairman of the UM board of trustees, said he was upset about the quality of Jackson's new doctors. "I wouldn't send my family to many of them," he said.
The comment came Monday during a summit of leaders of two major South Florida institutions at a time when Miami-Dade's public health system is struggling with mounting losses -- and growing concerns about UM's ambitions since it purchased Cedars Medical Center, across the street from Jackson Memorial Hospital, in 2007.
For South Florida's consumers, the tension between the two healthcare giants raises questions about which is the best place to get treatment. For Miami-Dade's taxpayers, the question is how their money is being used at the Jackson system, which bears much of the burden for treating the poor and uninsured in the county.
On Tuesday, Gerald Kaiser, Jackson's chief medical officer, called George's statement about Jackson's doctors "ill-advised . . . We have been very careful in building up Jackson's medical group." He said doctors are "thoroughly vetted" to be of the highest quality and many have privileges at UM's hospital as well as at Jackson.
WORKING TOGETHER
For more than a half-century, the institutions worked closely together, with Jackson Memorial serving as the medical school's teaching hospital. But since UM first considered getting its own hospital several years ago, Jackson decided to build its own brand, hiring doctors and putting increased emphasis on its suburban operations at Jackson North and Jackson South hospitals.
At the summit Monday, William Donelan, the UM medical school's chief operating officer, decried Jackson's expansion strategy, which he said was trying to emulate the Henry Ford Health System in Detroit and its suburbs. "I don't think it's a winning proposition, frankly," Donelan said. He believes the public system's strength is Jackson Memorial, with its UM doctors, and that this should be emphasized.
The summit was called by Eneida Roldan, who became Jackson's chief executive in June, as one of a series of measures to turn around the struggling hospital. She said she was seeking a "transparent" sharing of data in which UM would detail what it is doing at its new hospital.
She said many at Jackson are concerned that UM doctors, who staff both hospitals, are sending patients with private insurance to its facility, while putting the poor and uninsured in the tax-subsidized Jackson Memorial.
"I do worry about what crosses the street," said Georgena Ford, a member of the Public Health Trust, which governs the Jackson system.
Pascal Goldschmidt, dean of UM's medical school, said at the summit that the new University of Miami Hospital was not doing anything to endanger Jackson. "We've done a lot of good things together," he said, but acknowledged the perception of distrust on both the UM and Jackson staffs "has worsened substantially."
On Tuesday evening, after seeing an early version of this story on MiamiHerald.com, Goldschmidt said he wanted to make clear that he respects the quality of Jackson's physicians, but that it was difficult for UM doctors to work alongside them because Jackson's doctors, as government employees, are protected from lawsuits while the employees of UM, a private institution, are not.
That often means, Goldschmidt said, that malpractice attorneys target UM's "deep pockets" in lawsuits.
Goldschmidt said Tuesday that UM's summit presentation was to "put issues on the table" but only with the goal of "making this relationship better."
At the summit, Jackson presented data that showed its number of patients with insurance dropping in recent months while uninsured patients kept increasing.
Jackson detailed its financials in an 18-page PowerPoint presentation indicating net contributors to Jackson income (led by thoracic surgery, rehabilitation and neurosurgery) and major money losers (transplant and liver-gall bladder procedures).
Donelan presented Jackson with a single sheet showing gross charges of the two hospitals over the past three years: Charges of UM's insured patients had increased at an annual rate of 44 percent while Jackson's grew by 7 percent.
Roldan said after the meeting that she hoped UM would provide a much more detailed analysis about the new hospital's patients and services.
Though the Jackson leader initiated the meeting, much of the discussion was dominated by UM executives, particularly Donelan, who warned he intended to speak "frankly, in plain language."
LACK OF INVESTMENT
Donelan described the process for determining the annual operating agreement between UM and Jackson as "insane." He complained about Jackson's lack of investment in new technologies, saying its radiation oncology equipment was "long overdue for replacement." And he berated Jackson for not cooperating with UM on malpractice lawsuits, in one case leaving the university to defend the mistakes of a Jackson nurse.
Donelan asked whether Jackson "is in a slide that it can pull out of" or whether it was declining into "just another gritty, charity-based hospital."
For the most part, Jackson officials listened without responding. John Copeland, chairman of the Public Health Trust, said UM had "put a stake in the ground" that could serve as a basis for future discussions.
PHT board member Jorge Arrizurieta acknowledged the operating agreement discussions were "archaic," but bristled at the suggestion that Jackson was "sliding into a hole . . . We have to work together to turn that question into a positive."
Leaders of both groups said they needed to find ways to remove the distrust and work together. Roldan said a smaller committee representing the two institutions should start meeting monthly, noting, "It's going to be some work to change a lot of things." To see more of The Miami Herald or to subscribe to the newspaper, go to http://www.herald.com. Copyright (c) 2009, The Miami Herald Distributed by McClatchy-Tribune Information Services. For reprints, email tmsreprints@permissionsgroup.com, call 800-374-7985 or 847-635-6550, send a fax to 847-635-6968, or write to The Permissions Group Inc., 1247 Milwaukee Ave., Suite 303, Glenview, IL 60025, USA.
