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Hahnemann Hospital is Dying Putting Hundreds of Residency and Fellowship Spots At Risk
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Yay, happy for the residents.
www.inquirer.com
And hope this is true for the peds hospital; would be nice if the Philly med schools end up owning the children’s hospital (PCOM, Einstein, etc) for the sake of it keeping it in the Philly family.
www.inquirer.com
Hahnemann starts releasing stranded residents; St. Chris auction could see competitive bidding
The release of the doctors-in-training is a key step in the wind-down of operations at the Philadelphia safety-net hospital.
www.inquirer.com
And hope this is true for the peds hospital; would be nice if the Philly med schools end up owning the children’s hospital (PCOM, Einstein, etc) for the sake of it keeping it in the Philly family.
City demands say in sale of St. Christopher’s Hospital for Children; Hahnemann down to single patient
With Hahnemann University Hospital down to its last patient, city officials start to focus on proposed sale of St. Christopher's Hospital for Children.
www.inquirer.com
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Rich investors may have let a hospital go bankrupt. Now, they could profit from the land | CNN Business
For decades, Hahnemann University Hospital served as the main safety-net hospital for downtown Philadelphia's neediest residents. But soon, the doors will close, leaving a gaping hole in the city's ability to serve its poor. A private equity-backed firm bought the hospital and could let it...
May well be worse and more on the horizon for other hospitals.
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Rich investors may have let a hospital go bankrupt. Now, they could profit from the land | CNN Business
For decades, Hahnemann University Hospital served as the main safety-net hospital for downtown Philadelphia's neediest residents. But soon, the doors will close, leaving a gaping hole in the city's ability to serve its poor. A private equity-backed firm bought the hospital and could let it...www.cnn.com
May well be worse and more on the horizon for other hospitals.
Really shameful, if that was the plan.
D
deleted941485
I remember when Saint Vincent’s made quite a splash in NYC all those years ago. Prime real estate as well I believe. Big uproar and ultimately nothing really changed.
Since then, hundreds of hospitals across the nation continued to close in cities, suburbs, and rural areas. If you look at the data the actual number of hospitals peaked in 1975. It’s been a slow death since then. I expect that will continue to get worse. Best case scenario is flatline.
My question is how a hospital that had gotten so marginalized over the years for a myriad of reasons managed to accumulate such a giant complement of resident physicians? Where was the acgme in all this? Why did they get approved for so many slots? Can they honestly say the quality of their education was equivalent to any of the other rival hospitals in the area? Are the residents on the whole better off for it actually closing?
What about the attendings that will undoubtedly be out of job? I feel like essentially firing hundreds of physicians many of which have families will further depress employment prospects in the city’s at least in the short term.
I don’t expect any of the suits behind this deal to lose a wink if sleep over any of this. It sounds like This was a real estate deal at the end of the day.
Since then, hundreds of hospitals across the nation continued to close in cities, suburbs, and rural areas. If you look at the data the actual number of hospitals peaked in 1975. It’s been a slow death since then. I expect that will continue to get worse. Best case scenario is flatline.
My question is how a hospital that had gotten so marginalized over the years for a myriad of reasons managed to accumulate such a giant complement of resident physicians? Where was the acgme in all this? Why did they get approved for so many slots? Can they honestly say the quality of their education was equivalent to any of the other rival hospitals in the area? Are the residents on the whole better off for it actually closing?
What about the attendings that will undoubtedly be out of job? I feel like essentially firing hundreds of physicians many of which have families will further depress employment prospects in the city’s at least in the short term.
I don’t expect any of the suits behind this deal to lose a wink if sleep over any of this. It sounds like This was a real estate deal at the end of the day.
Rich investors may have let a hospital go bankrupt. Now, they could profit from the land | CNN Business
For decades, Hahnemann University Hospital served as the main safety-net hospital for downtown Philadelphia's neediest residents. But soon, the doors will close, leaving a gaping hole in the city's ability to serve its poor. A private equity-backed firm bought the hospital and could let it...
May well be worse and more on the horizon for other hospitals.
I am all in favor of arguing about the predatory role of hedge funds, but I think another really important factor here is Drexel’s behavior. I expect hedge funds to do what hedge funds do, I don't like it, but I can see it coming. Drexel is a nonprofit that pays no taxes, with a stated mission to educate and train physicians, but reading this article, it mentions that Hahnemann owes over a 100 million to Drexel university.
I dug into the court filings, and it looks like Drexel is the single biggest creditor to the Hedge fund that own Hanhamenn, and since the debt is overwhelmingly from before the land and the hospital were split apart, Drexel would get their money back from the asset sale even if the hospital collapsed.
So what i can see going on here is that Drexel was offered to buy Hahnemann by Tenet and they declined. They were offered to buy it from AAHS but they declined. If they bought it they would have to write off the loans to the hospital and stop recieving considerable interest income.
At the same time they have been building out their plan to relocate a large portion of their medical training program to Tower Health in reading. AAHS had an agreement with Drexel that they would work in good faith to drive more patient volume through the clinical practices of their faculty physicians. But pouring money into building a life raft for when the hospital you are bleeding interest payments from collapses, and the academic agreement with Hahnemann expires in 2022 around the time of the originally planned campus opening in Reading, is not a good faith effort.
Then Drexel (from what i can see in the court filings) argues against the residents being released right away and doesn't agree to releasing them until they have a bid in place from tower health and there are open house tours scheduled in Reading.
AAHS (Joel Freedman's hedge fund) actually runs several hospitals profitably without trying to strip there assets. They even run another Hospital sitting on rapidly appreciating land near an Urban Core (Howard University Hospital in Washington DC) and have made no effort, so far, to close and loot that hospital.
AAHS definitely does not care about the healthcare of Philadelphians, they do not care about the Residents, they do want to make a profit, they certainly thought the value of the land was an insurance policy to use if the investment didnt work out. But I dont think AAHS started out from the get go thinking about how to close the Hospital, they certainly got to that point quickly, and if it was there intention, they are bad at it. They owe almost 300 million dollars in debts backed by the land value, and looking at the St. Vincents real estate closure deal, they are going to get something around that much, or less (Center City is expensive but its not Manhatten for land values). Maybe Freedman has a plan to wiggle out from this in court, but everywhere i read that far and away the big winners will be the creditors, and Drexel University is the biggest one.
Hedge funds get the criticism they deserve. But i find Drexel's behavior even more galling, the hypocrisy of claiming to be holding the torch of education, improving humanity, etc. while milking money from a hospital for the underseved, and then claiming “this was a crisis thrown at our doorstep.”
They shouldn’t be allowed to escape from this smelling like roses.
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You can't really expect investors to keep the hospital open when the local government can't even be bothered to defend it. When St. Vincent's closed, there was at least some political effort to keep it open (with some grants from Albany, iirc) and then to try to sell it when that failed. There was endless coverage in the Times.
In the case of Hahnemann, the local media offered very little coverage until the closure was already announced and entire units were closed. Local leaders did little to defend the hospital. In fact, they made the closure easier to swallow, by making public statements about how other hospitals would be able to absorb the increased patient load. The only politician who spoke up for the hospital was Bernie Sanders, and he obviously doesn't hold office in PA.
This was a political failure as much as it was a business one. Now local leaders claim to want a say in St Christopher's future. I won't hold my breath.
In the case of Hahnemann, the local media offered very little coverage until the closure was already announced and entire units were closed. Local leaders did little to defend the hospital. In fact, they made the closure easier to swallow, by making public statements about how other hospitals would be able to absorb the increased patient load. The only politician who spoke up for the hospital was Bernie Sanders, and he obviously doesn't hold office in PA.
This was a political failure as much as it was a business one. Now local leaders claim to want a say in St Christopher's future. I won't hold my breath.
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And the drama continues. Hopefully this means residents aren’t forced to go to Tower Health, because they are people and they aren’t for sale!! Keep fighting guys.
www.inquirer.com
Good news for most residents however: “
As of Monday, fewer than five of 583 Hahnemann residents and fellows still need to find places to continue their medical training, a Hahnemann spokesperson said.
In at least two cases, whole programs have moved to new hospitals in the Philadelphia region.
Urology, with 10 residents, is moving to Main Line Health’s Lankenau Medical Center and Bryn Mawr Hospital.
In family medicine, 20 of 22 residents have agreed to follow faculty members to Tower’s Chestnut Hill Hospital.”
In a new twist, feds say proposed sale of Hahnemann’s residency program is illegal
Meanwhile, as of Monday, fewer than five of 583 Hahnemann residents and fellows still need to find places to continue their medical training, a hospital spokesperson said.
www.inquirer.com
Good news for most residents however: “
As of Monday, fewer than five of 583 Hahnemann residents and fellows still need to find places to continue their medical training, a Hahnemann spokesperson said.
In at least two cases, whole programs have moved to new hospitals in the Philadelphia region.
Urology, with 10 residents, is moving to Main Line Health’s Lankenau Medical Center and Bryn Mawr Hospital.
In family medicine, 20 of 22 residents have agreed to follow faculty members to Tower’s Chestnut Hill Hospital.”
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New update: future slots hopefully may go to actual Philly programs, and not Tower.
www.inquirer.com
The $55 million bid that won Hahnemann residency slots was ‘a big surprise’
The winning bid far surpassed the baseline bid of $7.5 million by Tower Health, which has an academic partnership with Drexel University.
www.inquirer.com
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New update: future slots hopefully may go to actual Philly programs, and not Tower.
The $55 million bid that won Hahnemann residency slots was ‘a big surprise’
The winning bid far surpassed the baseline bid of $7.5 million by Tower Health, which has an academic partnership with Drexel University.
So yeah those of us who have been saying that hospitals do nothing but make money off of residents by using them to avoid hiring more attendings/NPs/PAs...don't know how much more proof you need right here. Paid about $94,000 per slot which will still make them money because Medicare pays about $100,000 per slot total. They'd apparently love the extra free labor at all their hospitals.
So this is a dark turn:
Bankruptcy judge approves $55 million sale of Hahnemann residency program
The hospital plans to close its doors Friday. Its owner has been wrangling with the federal government for weeks over the residency program was an asset.
www.google.com
DOJ and CMS still have one more card to play, they can unilaterally (the federal governmeng can cancel any contract with anyone at anytime for no reason at all, and there is no right to sue for payment under sovereign immunity rules) cancel hahnemann’s medicare provider agreement before 5pm today which destroys the supposed asset (residency contracts) being sold, invalidating the sale. It would be an exceptionally agressive move that would likely upset hospitals, but few consequences beyond that.
Going forward CMS writes the interpretations of congress’s laws concerning how to define the sale of a hospital, and i suspect they will dramatically tighten the rules to say that all assets must be sold together else the resident contracts are voided and essentially returned to CMS to redistribute.
So i doubt that this will actually form a template for other sales, cause CMS getting DOJ involved shows they arr gery serious about preventing this going forwards and will slam the door shut by regulation on future potential sales of residents.
...but there always a risk this is the beginning of a more frightening era of residency programs (and residents) as asset collateral to be traded, its just ny personal hunch that CMS will land hard on closing the gate on this ever happening again
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Residents are now officially indentured servants, in case it wasn't clear before.
Residents graduate debt burdened by hundreds of thousands of dollars of medical school debt that they can not discharge. There is no other career option with a medical degree except to go through a medical residency. They are locked into contracts with residency programs and ERAS with no other options and no collective bargaining agreements. They have very limited mobility. If a position is lost for any reason, it can be very hard or impossible to get a new one. If a resident wants to transfer to a new program, the current program basically has to agree to it or they won't get a recommendation and probably cannot switch.
Now residents can be bought and sold as well. It's not exactly slavery--residents can still leave and not be forced back into their positions or jailed for leaving their positions. However, keep in mind that indentured servant contracts in the past could also be bought and sold.
This is an incredible injustice and a mockery of the entire training system.
Residents graduate debt burdened by hundreds of thousands of dollars of medical school debt that they can not discharge. There is no other career option with a medical degree except to go through a medical residency. They are locked into contracts with residency programs and ERAS with no other options and no collective bargaining agreements. They have very limited mobility. If a position is lost for any reason, it can be very hard or impossible to get a new one. If a resident wants to transfer to a new program, the current program basically has to agree to it or they won't get a recommendation and probably cannot switch.
Now residents can be bought and sold as well. It's not exactly slavery--residents can still leave and not be forced back into their positions or jailed for leaving their positions. However, keep in mind that indentured servant contracts in the past could also be bought and sold.
This is an incredible injustice and a mockery of the entire training system.
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So this is a dark turn:
Bankruptcy judge approves $55 million sale of Hahnemann residency program
The hospital plans to close its doors Friday. Its owner has been wrangling with the federal government for weeks over the residency program was an asset.
DOJ and CMS still have one more card to play, they can unilaterally (the federal governmeng can cancel any contract with anyone at anytime for no reason at all, and there is no right to sue for payment under sovereign immunity rules) cancel hahnemann’s medicare provider agreement before 5pm today which destroys the supposed asset (residency contracts) being sold, invalidating the sale. It would be an exceptionally agressive move that would likely upset hospitals, but few consequences beyond that.
Going forward CMS writes the interpretations of congress’s laws concerning how to define the sale of a hospital, and i suspect they will dramatically tighten the rules to say that all assets must be sold together else the resident contracts are voided and essentially returned to CMS to redistribute.
So i doubt that this will actually form a template for other sales, cause CMS getting DOJ involved shows they arr gery serious about preventing this going forwards and will slam the door shut by regulation on future potential sales of residents.
...but there always a risk this is the beginning of a more frightening era of residency programs (and residents) as asset collateral to be traded, its just ny personal hunch that CMS will land hard on closing the gate on this ever happening again
This ruling will be appealed. There is no chance that CMS will let this stand. Because of the apparent conflict between the Affordable Care Act and the Bankruptcy Code, the amount of money involved and the likelihood that this issue will reappear, this case will likely end up at The U.S. Supreme Court.
This whole business is obviously distasteful and scary to med students and residents. However, if the hospital's bond holders and other creditors aren't protected in those instances when they have an arguably legitimate claim to a class of a bankrupt hospital's assets, then it will be that much more difficult in the future for hospitals like Hahnemann to get credit and do business. You have to look at the long term implications of this mess.
Thank goodness the residents got placed.
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I'm afraid the question of involuntary servitude and the actual status of residents was settled with the Supreme Court's decision in the Mayo Clinic case regarding Social Security taxes.
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I agree that this situation is not good, and hopefully CMS will do something about it. But it's not quite as dire as suggested.
For the residents at Hahnemann, they were declared as orphaned via the usual process. I am almost certain funding was released to any program willing to accept those residents. Because Hahnemann was over their cap, the funding was pro-rated so all residents got some funding to their new programs. Whats being sold here are the rights, in the future, to those resident slots. ONce those residents graduate, those slots would have returned to CMS, and then there would be a process for reallocating them to current programs. Instead, because of this sale, the slots will revert to the group that purchased them. Whether this is "good" or "bad" depends upon ow you look at it -- the slots are staying in PHL (good if you're PHL), but have bypassed the usual mechanism where other programs whom might be deserving might get them.
No residents are being bought or sold, and no resident will have their transfer options affected by this, at least as far as I can see.
But there is an unstated problem with them staying in PHL, which (perhaps) will be the key of CMS's argument. When these programs take these new funding slots, they do NOT need to turn them into new residency positions. Any hospital that is over their cap can just keep the same number of residents, but get paid more for them. So part of the "pro" argument is keeping residents in PHL, but that may not happen.
For the residents at Hahnemann, they were declared as orphaned via the usual process. I am almost certain funding was released to any program willing to accept those residents. Because Hahnemann was over their cap, the funding was pro-rated so all residents got some funding to their new programs. Whats being sold here are the rights, in the future, to those resident slots. ONce those residents graduate, those slots would have returned to CMS, and then there would be a process for reallocating them to current programs. Instead, because of this sale, the slots will revert to the group that purchased them. Whether this is "good" or "bad" depends upon ow you look at it -- the slots are staying in PHL (good if you're PHL), but have bypassed the usual mechanism where other programs whom might be deserving might get them.
No residents are being bought or sold, and no resident will have their transfer options affected by this, at least as far as I can see.
But there is an unstated problem with them staying in PHL, which (perhaps) will be the key of CMS's argument. When these programs take these new funding slots, they do NOT need to turn them into new residency positions. Any hospital that is over their cap can just keep the same number of residents, but get paid more for them. So part of the "pro" argument is keeping residents in PHL, but that may not happen.
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Federal judge stays Hahnemann residency sale; St. Chris auction pushed to Thursday
If the sale of Hahnemann's residency programs falls apart, it could open the door the purchase of the hospital by a company that wants to operate it.
Throwawaydoc
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****hole hospital ran by some total dirtbags.
D
deleted814217
For anyone following this, hahnemann Residents got an email stating they were responsible for tail end coverage of malpractice as the parent company is going to stop providing coverage. The insurance they had purchased was claims based and not occurrence based. This will result in thousands of dollars of payment that residents can’t afford and is a violation of the match contract. Not that it matters to the acgme of course who has provided no help. With all that has occurred, I fail to see how an anti competitive nrmp system is in the best interests of anyone given they are unable to hold these academic insitutions to their own stipulations of a contract that we have no bargaining power or say in.
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Did their resident contracts stipulate tail coverage (which is the ACGME requires tail coverage seems likely)? If so, seems like a very easy breach of contract lawsuit.
TheSingularity
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Holy ****. Seriously there is no depths to which these douchebags will sink.
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With court approval debtors in bankruptcy, Hahnemann's status, may void a contractual obligation. It may be wise for medical students to examine the financial condition of the hospitals they have on their residency rank list.
"I. INTRODUCTION
The Bankruptcy Code, 11 U.S.C. § 365, provides that, subject to court approval and certain limitations discussed below, debtors can assume or reject any executory contract or unexpired lease. It is an area of the law described as a "thicket . . . where . . . lurks a hopelessly convoluted and contradictory jurisprudence." In re Drexel Burnham Lambert Group, Inc., 138 B.R. 687, 690 (Bankr. S.D.N.Y. 1992) (quoting Andrew, Executory Contracts Revisited: A Reply to Professor Westbrook, 62 U. Colo. L. Rev. 1 (1991)). "n no area of bankruptcy has the law become more psychedelic than in the one titled 'executory contracts.'" Drexel Burnham, 138 B.R. at 690 (quoting Westbrook, A Functional Analysis of Executory Contracts, 74 Minn. L. Rev. 227, 228 (1989))."
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Another Hahnemann refugee. This is bad. Like really, really bad as in jeopardize your ability to practice medicine or cost us 10s of thousands of dollars bad.
whyy.org
Hospitals commonly require proof of tail coverage from past jobs. We are in a position where we might not be able to provide that.
Everyone keeps looking to the closure of St. Vincent's hospital as it is the best precedent anyone has for this. From what I can tell they were in the same position regarding their tail coverage - the hospital refused to provide it, even for attending physicians. The residents and attendings each filed separate suits in the courts, which eventually settled out as a malpractice fund to provide payout in the case of coverage.
I'm worried that this is something that we, ourselves, have to undertake.
This affects far more than the near 600 residents that were employed at the time of closure, anyone who trained at Hahnemann from January 2018 up through the time they departed.
Former Hahnemann residents fear they could lose malpractice insurance
A former Hahnemann residency program director is warning that residents may be left without malpractice insurance to cover their time at the hospital.
whyy.org
Hospitals commonly require proof of tail coverage from past jobs. We are in a position where we might not be able to provide that.
Everyone keeps looking to the closure of St. Vincent's hospital as it is the best precedent anyone has for this. From what I can tell they were in the same position regarding their tail coverage - the hospital refused to provide it, even for attending physicians. The residents and attendings each filed separate suits in the courts, which eventually settled out as a malpractice fund to provide payout in the case of coverage.
I'm worried that this is something that we, ourselves, have to undertake.
This affects far more than the near 600 residents that were employed at the time of closure, anyone who trained at Hahnemann from January 2018 up through the time they departed.
D
deleted814217
yep and I think that’s what it’ll have to come to. They are supposed to having a conference call today per our former leadership so will know more, but looks like we will have to ultimately go to the courts
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I’m one of the residents that lost their job shortly after, when Ohio Valley Medical Center closed. This has got me worried too. The owner of OVMC/EORH is known for shady financial dealings as well
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D
deleted814217
Yet again the lack of acgme oversight or help through this process has been appalling. They have done nothing and responded with nothing. Drexel is also significantly to blame for distancing themselves from the situation
our contracts promised us occurrence based insurance yet we were given claims based insurance. Right alone that is a breach of contract. We have no choice as residents but to sign our contract yet the acgme, which enforces all this is silent on the matter as well as silent when the situation was occurring regarding the release of funding. Imo this proves they have no business or grounds for an anti competitive “match” or running it when they are powerless and just profit off theprocess with very little say or control.
our contracts promised us occurrence based insurance yet we were given claims based insurance. Right alone that is a breach of contract. We have no choice as residents but to sign our contract yet the acgme, which enforces all this is silent on the matter as well as silent when the situation was occurring regarding the release of funding. Imo this proves they have no business or grounds for an anti competitive “match” or running it when they are powerless and just profit off theprocess with very little say or control.
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Unfortunately, Drexel is more interested in real estate investments than their own students, never mind residents. They'll gladly sit on their hands (but, I really really hope I'm wrong).
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The situation is horrible for multiple reasons. You're angry, and rightly so.
The ACGME has very little say over the situation. They accredit programs. This hospital closed, they really can't help. Once the institution / program is closing, they have no leverage with which to exert any change.
I agree it's a breach of contract for your contracts to state that you should get occurrence based, yet you got claims based. Unfortunately, the remedy for that isn't the ACGME, it's in the courts. And since the whole place is in bankruptcy, it will be difficult / impossible to proceed with a separate claim. Even if the institution wasn't closing and this was noticed, your remedy would still be through the courts, although in that case the ACGME could threaten to withdraw accreditation from the whole institution if they felt they were being fraudulent -- but that only acts as leverage if the institution / program wants to continue.
This has nothing to do with the match. Without a match, the same problems arise.
The ACGME has very little say over the situation. They accredit programs. This hospital closed, they really can't help. Once the institution / program is closing, they have no leverage with which to exert any change.
I agree it's a breach of contract for your contracts to state that you should get occurrence based, yet you got claims based. Unfortunately, the remedy for that isn't the ACGME, it's in the courts. And since the whole place is in bankruptcy, it will be difficult / impossible to proceed with a separate claim. Even if the institution wasn't closing and this was noticed, your remedy would still be through the courts, although in that case the ACGME could threaten to withdraw accreditation from the whole institution if they felt they were being fraudulent -- but that only acts as leverage if the institution / program wants to continue.
This has nothing to do with the match. Without a match, the same problems arise.
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who are they gonna sue? The hospital that has no money? To get told they’re the 100th creditor in line when it finally gets to court a few years later?
D
deleted814217
while it’s true that there isn’t anyone at PAHS left and this will get tied up, the sponsoring institution of Drexel per our contracts does have responsibility to provide us with professional
Liability insurance. That is verbatim in the contract and on the match list and program it is written as Drexel/Hahnemann and worded as the sponsoring institution. There are still some residencies and fellowships left and there is a medical school there (of which i was an alma matter I am sad to say in the light of this). So there does exist some leverage the ACGME and LCME and governing bodies can exert. They are choosing not to yet again abdicating their responsibility to residents which isn’t surprising. Yet again I still firmly maintain there is less of a chance they would have got away with this necessarily in a free market vs non competitive set up where is there is different oversight (aka not the same organization choosing not to do anything). It will probably come to a lawsuit but in the meantime there is no way many of can afford this. If this is how medicine treats and advocates for people entering the field it’s no wonder people are quickly disillusioned with this career. I caution anyone reading this thread to go into any career that experiences delayed gratification to this degree because nothing is guaranteed and there is no such thing as a truly honored “contract”. No one is really looking out for but yourself and while the science and practice of medicine is fascinating make your mint somewhere else when you still can.
Liability insurance. That is verbatim in the contract and on the match list and program it is written as Drexel/Hahnemann and worded as the sponsoring institution. There are still some residencies and fellowships left and there is a medical school there (of which i was an alma matter I am sad to say in the light of this). So there does exist some leverage the ACGME and LCME and governing bodies can exert. They are choosing not to yet again abdicating their responsibility to residents which isn’t surprising. Yet again I still firmly maintain there is less of a chance they would have got away with this necessarily in a free market vs non competitive set up where is there is different oversight (aka not the same organization choosing not to do anything). It will probably come to a lawsuit but in the meantime there is no way many of can afford this. If this is how medicine treats and advocates for people entering the field it’s no wonder people are quickly disillusioned with this career. I caution anyone reading this thread to go into any career that experiences delayed gratification to this degree because nothing is guaranteed and there is no such thing as a truly honored “contract”. No one is really looking out for but yourself and while the science and practice of medicine is fascinating make your mint somewhere else when you still can.
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Email from Hahnemann PD:
threadreaderapp.com
Thread by @KittyKatzMD: " University Hospital closure update: resident physicians being told to purchase tail end malpractice insurance because our old emp […]" #Hahnemann #HahnemannUniversityHospital
Thread by @KittyKatzMD: " University Hospital closure update: resident physicians being told to purchase tail end malpractice insurance becauds of dollars out of our pockets. All because a for-profit company fe […]" #Hahnemann #HahnemannUniversityHospital
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The history of the issue is well documented.
"The Court finds that plaintiffs adequately have alleged a common agreement to displace competition in the recruitment, hiring, employment and compensation of resident physicians and to impose a scheme of restraints that has the purpose and effect of fixing, artificially depressing, standardizing and stabilizing resident physician compensation and other terms of employment among certain defendants"
Look here:
Also:
Jung v. Association of American Medical Colleges - Wikipedia
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We just keep getting screwed. I never regretted fellowship and I never regretted moving to Philadelphia until the past few days. Trying to advance my medical training has been nothing but a complete and utter disaster so far.
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Is there a way to "fix the system" so that there can an occurrence based policy for ACGME residents and fellows provided through ACGME/Medicare/federal government or subsidiary thereof? For instance, this could be an occurrence based insurance fund charged through fees on the resident and fellow slots that would be paid by the hospital. I thinking along the lines of the Canadian Medical Protective Association if I understand the set up in Canada. Has this ever been entertained in the US?
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It would be very complicated. If residents and faculty have separate insurers, it creates a situation where each insurer could try to get the other to be responsible. Some hospitals are self insured. Hospitals would not be excited to pay more for insuring people they are already covering.
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We don't have to guess if the match is better than no match -- there was a time before. And from every account I've read about it, that time was worse for residents. Since an MD without a residency is mostly valueless, hospitals have too much power without the match.
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I am happy to debate the pros and cons of the match with anyone who wishes. But this thread is the wrong place. Let's leave this to the Hahnemann residents to discuss their plight. Whether you like or dislike the match, it has little to do with their awful situation. I'm going to copy these posts into a new thread, feel free to join me there.
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deleted814217
The overwhelming continued silence of the ACGME, powers to be, Drexel medicine and several others continues to be nothing short of criminal
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While definitely ridiculous and embarrassing, it is miles from criminal.
Also, as has been discussed by calmer mind above, ACGME really has nothing to do with this. They can force programs out of existence but can't really do anything to make them remain.
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I’m obviously overstating using the word criminal perhaps but breach of contract (by Drexel not acgme) could be argued as such since it’s the sponsoring institution. And ACGME has no power I get that-would be nice if they made a statement saying they support the residents and this isn’t acceptable.
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Doesn’t seem like anyone really is stepping up. Nice job PAmed society. No pressure whatsoever on anything on Drexel or anyone but the residents to step up and pay themselves. Not really addressed how this will happen or where people will come up with the money but doesn’t really seem to
Matter. Are these organizations made up of physicians so far removed from residency that they have forgotten what it is like? Only thing they can do is complain how much harder they had it and ignore everything else I suppose.
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I never practiced bankruptcy law, so I am just an amateur here. It seems to me that the residents as a group have a claim against the bankruptcy estate for a benefit akin to wages. A claim for wages and benefits earned up to about $13,000 per employee should take priority over other creditors' general unsecured claims. I think these residents should get together and hire a lawyer.
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Well, it does seem that the AMA has actually stepped up...kinda pleasantly surprised that they have done so!
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deleted814217
For anyone still following there is representation for residents however were told there is no chance anything will be fixed in time and the organization has no money. There was a webinar yesterday where people were advised to buy their own insurance or ask the hospitals and organizations for coverage. Some people were lucky and had their hospitals cover the cost. For others who they said no the cost runs from 15-30,000k plus at leastdepending on speciality-looks like either run the risk of not buying it or get the cash because the deadline is too soon for any relief organization to help.
1)looks like most people are advised to take more loans as that is the only way
2)breach of contract doesn’t seem to mean much as there is no assets on hand to pay for this.
3)quoted costs for tail coverage were about 3 million. Drexel almost certainly has this money yet has washed their hands clean.
4)organizations like the NRMP and the ACGME have this cash and their failure to protect residents should necessitate they pay for the coverage imo.
almost willing to bet some of the poster here will say it is not their responsibility and it is the residents to buy this.
1)looks like most people are advised to take more loans as that is the only way
2)breach of contract doesn’t seem to mean much as there is no assets on hand to pay for this.
3)quoted costs for tail coverage were about 3 million. Drexel almost certainly has this money yet has washed their hands clean.
4)organizations like the NRMP and the ACGME have this cash and their failure to protect residents should necessitate they pay for the coverage imo.
almost willing to bet some of the poster here will say it is not their responsibility and it is the residents to buy this.
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Hahnemann cheated the residents by not providing adequate medmal insurance. If possible, they should be held to account. Ultimately the venture capitalists who owned it will sell the property and make an enrmous amount of money. I have no idea if there's a legal way to ensure that once that happens, that everyone who was hurt in this process is addressed. Unfortunately, that will take years and may be impossible.
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I would not recommend anyone rank a Drexel residency, or interview for one. I would recommend you go overseas before you consider Drexel as a medical school. Drexel behaved shamefully towards its residents and cut us loose the second it looked like they would have to exert any effort on our behalf. They are not to be trusted to look after you or take care of you or protect you. They should not even be allowed to participate in medical education, but our current system of medical training allows them to continue to do so without consequence.
My program (Pulmonary/Critical Care) had an accreditation visit in the fall of 2018. The ACGME signed off on the validity of our program and the contracts we signed, but somehow did not notice that Hahnemann was already violating those contracts by providing claims made insurance. What good did the ACGME do with our money?
I paid thousands of dollars to the ACGME to participate in the Match. We give up huge amounts of rights to participate in the Match and are told it's for our own good. Hahnemann was not at the top of my list, but because of the match I had no choice but to sign a contract with a hospital that was already breaking that contract. I did what we are all supposed to do.
I am told that we have we pay into the Match as it's a program that is fair, that looks after us and protects us from predatory residency programs, protects us from abuse. There should be no doubt in anyone's mind that those protections are all hollow.
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deleted814217
100 percent they are hollow, but apparently according to the veterans here this would happen on the “free market” and we are all “entitled” people anyway who whine about stuff, (of course never mind that it actually did happen under the match, which looks out for us and is so fair and so on and so forth). The ACGME come to think of it and the nrmp almost certainly has excess funds. They take how much of our money for what exactly? yet when it comes time to this they advised the residents to take our extra loans. (Obviously for some specialities like OBGYN the cost can be >30k) and act like that’s their good deed for the day. Everyone says how terrible this is and so forth but nobody has really actually done anything (not that I expect them too anyway).
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Again this whole thread begs the question of why exactly anyone would go to medical school these days? Just to potentially get ****ed over by the residency program that they are basically forced to sign a contract with just by virtue of participating in a match system? people talk about how other systems aren’t much better but they’re neglecting the total other option which is going on right under our noses with NPs and PAs....no residency.
Why if I was in college would I not just go be a NP or PA, don’t rack up the debt, don’t have to deal with the whole residency system to begin with and start getting paid real money after a couple years of post-bac work? Oh yeah and as PA you could literally work in GI one year and Derm the next and not worry about basically being locked into one speciality for the rest of your life without significant effort? Move to an independent practice state and do whatever you want.
We won’t let a 4th year med student cut a toenail without supervision but fresh BSN-NPs are running circles around us working ED fast tracks or post-surgical floors or med onc floors etc etc a week after they graduate.
Why if I was in college would I not just go be a NP or PA, don’t rack up the debt, don’t have to deal with the whole residency system to begin with and start getting paid real money after a couple years of post-bac work? Oh yeah and as PA you could literally work in GI one year and Derm the next and not worry about basically being locked into one speciality for the rest of your life without significant effort? Move to an independent practice state and do whatever you want.
We won’t let a 4th year med student cut a toenail without supervision but fresh BSN-NPs are running circles around us working ED fast tracks or post-surgical floors or med onc floors etc etc a week after they graduate.
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Just curious, Was Drexel the last program in your ROL?
You are right though, if they just underwent a review, that should have been noted that the med Mal was claims based and not occurrence based.
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No, it was not. Like many I was dissatisfied with my match result because I did not get my #1, but once I started to settle in and adjust to the area I realized that I did match to a great program with great people.
It is a tragedy that it was managed by the greed driven filth at Drexel and Paladin Healthcare.
