Hey everbody, I just ran across this article on the washington post website. You can also read it at. <a href="http://www.washingtonpost.com/wp-dyn/articles/A54599-2002Jun14.html" target="_blank">http://www.washingtonpost.com/wp-dyn/articles/A54599-2002Jun14.html</a> Howard U. Programs Lose Accreditation Hospital Appealing Monitoring Agency's Ruling on Emergency, Pediatric Services By Avram Goldstein Washington Post Staff Writer Saturday, June 15, 2002; Page A08 The agency that supervises the nation's graduate medical education system has revoked the accreditation of residency programs in emergency medicine and pediatrics at Howard University Hospital. If the rulings by the Accreditation Council for Graduate Medical Education withstand appeals by Howard, the number of resident physicians treating emergency patients and children at the hospital on Georgia Avenue NW will drop sharply beginning July 1, 2003, and fall to zero a year later. Hospitals cannot employ residents in unaccredited programs. Without the 66 residents working in the emergency and pediatric departments, the hospital would have to reorganize and find attending physicians to replace them. Howard has one of the city's busier emergency rooms. Officials from the Chicago-based accreditation council said confidentiality rules preclude them from detailing what led to their actions, but they said the revocations could not come without years of warnings. Howard officials, including university President H. Patrick Swygert, declined to comment. In a written statement issued late yesterday, the hospital said it is appealing the rulings and addressing the accreditors' criticism. "We are confident that the accreditation for these programs will be restored," the unsigned statement said. "Our goal remains the full and unqualified re-accreditation of these programs." The appeal schedule calls for a February decision. Residents are new physicians in postgraduate training in their chosen specialties. They generally work long hours treating patients under the supervision of attending physicians. Hospitals pay residents relatively low salaries -- typically $40,000 a year -- while collecting millions in special training fees from Medicare and Medicaid. Accreditation standards cover all aspects of residency training, including teaching methods, working conditions, scrutiny of patient deaths and evaluation of residents. Howard has 350 residents in 25 specialty training programs, and a disproportionate number of those programs have been flagged by the accreditation council. In addition to emergency medicine and pediatrics, the council has placed Howard's anesthesiology, family practice, pathology, radiation oncology and urology departments on probation and given the pulmonary disease program the functional equivalent of probation. Moreover, Howard's management of all 25 of its programs has been labeled "unfavorable" by the council -- a finding that blocks Howard from launching any new or replacement residency program. A Howard professor with knowledge of Howard officials' thinking, who spoke on condition of anonymity, said the university has hired consultants to fix long-standing residency program problems and help pursue the appeals. Officials are preparing for the worst in case the appeals fail, the professor said. "You've got to always have a contingency plan, and they've shifted into that mode," the professor said. Another Howard professor who spoke on condition of anonymity said the council should not have acted so strongly against the emergency and pediatrics programs because it destabilizes a black medical institution when fewer than 4 percent of the nation's doctors are black. Few white physicians show much interest in treating patients in African American neighborhoods, so the action is insensitive, said the second professor, who is black. David Leach, the council's executive director, rejected that argument. "We refuse to accept the idea of lowering standards because they don't have resources," Leach said. "The message behind that is that the indigent of this country really don't deserve first-rate care, so let's develop two standards." Newton Osborne, a Howard professor who has worked with or overseen obstetrics and gynecology residency programs at four teaching hospitals, including Howard's until several years ago, said the fault lies with Howard's medical chiefs. "I had personal run-ins with them while I was chairman because I felt they were not doing what they had to do to protect the health and limb of the patients," he said. "Whenever I sent reports about things that were poorly managed, they would sit there for months and years." Osborne said Howard's leaders assumed that they were immune from council discipline by virtue of the facility being one of only three predominantly black teaching hospitals in the nation. "I guess the position of the other people is, 'If [the leaders] are not worried, why should we be?' " Osborne said.