wonder how the ACGME and RRC is going to take this....

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

oldjeeps

Senior Member
15+ Year Member
Joined
Nov 13, 2004
Messages
687
Reaction score
0
Just when everyone wasgetting comfortable that the issues had settled down at the DMC and Wayne State...

DMC to cut pay to WSU doctors
Money for care of poor to shrink $12 million
February 8, 2008
http://www.freep.com/apps/pbcs.dll/article?AID=/20080208/BUSINESS06/802080326

By PATRICIA ANSTETT

FREE PRESS MEDICAL WRITER

The Detroit Medical Center plans to reduce payments to the Wayne State University School of Medicine by $12 million a year, beginning Monday, in a dispute over whether the medical center pays doctors too much to treat poor patients.

WSU administrators were reeling on Thursday from the announcement, which they received Feb. 1.

A contract with DMC announced Nov. 23 calls on the DMC to give WSU $19,167,435 a year for 3 1/2 years for care of indigent patients. The money mostly helps pay salaries of WSU doctors who treat indigent DMC patients.

A portion of the money arrives twice a month; the DMC gets the money through Michigan's Medicaid program, particularly a fund known as disproportionate share payments that help to pay for care for poor patients.

A $12-million reduction leaves WSU $7 million to pay for indigent care. In 2007, WSU provided $50 million worth of care for poor patients, said Doug Czajkowski, executive director for external affairs. WSU receives money from other parts of the Medicaid budget, as well as federal funds, to pay for the $31-million balance its doctors provide in care for the poor, Czajkowski said. "This puts us in an incredible dilemma," Dr. Robert Frank, WSU's associate dean of medicine, said Thursday. "It's hard to tell doctors not to see patients, particularly vulnerable patients they've cared for for years. This could put a big hole in the safety net. We'd like to avoid the L word, for layoffs."

Frank said WSU has no further information about references DMC made in the letter to overpaying doctors to care for poor patients. He declined to release the letter.

WSU plans to evaluate the impact of the cuts for each department by Monday, Dr. Robert Mentzer Jr., dean of the school of medicine, wrote in an e-mail Wednesday to physician department heads at the school. "We are exploring several options in response to this action," Mentzer wrote. The action was "completely unexpected" and "contrary to our signed" agreement with the DMC, Mentzer wrote.

The reductions will be made retroactively to October 1, 2007, the DMC told the medical school in the letter.

Mike Duggan, president and chief executive officer of the DMC, Ben Carter, chief operating officer of the DMC, and DMC spokeswoman Rebecca Christensen did not return calls for comment.

The sparring over money is the latest in more than a year of continued fighting between the two long-time health care partners.

Last year, the two sparred over WSU's opposition to the DMC providing space to Michigan State University's College of Osteopathic Medicine for one of two metro Detroit campuses, a battle WSU lost.

DMC and WSU signed their 3 1/2 year agreement after Gov. Jennifer Granholm intervened in late January 2007 and named a negotiator to achieve a settlement, because negotiations between the two partners already were strained.
 
Just when everyone wasgetting comfortable that the issues had settled down at the DMC and Wayne State...

DMC to cut pay to WSU doctors
Money for care of poor to shrink $12 million
February 8, 2008
http://www.freep.com/apps/pbcs.dll/article?AID=/20080208/BUSINESS06/802080326

By PATRICIA ANSTETT

FREE PRESS MEDICAL WRITER

The Detroit Medical Center plans to reduce payments to the Wayne State University School of Medicine by $12 million a year, beginning Monday, in a dispute over whether the medical center pays doctors too much to treat poor patients.

WSU administrators were reeling on Thursday from the announcement, which they received Feb. 1.

A contract with DMC announced Nov. 23 calls on the DMC to give WSU $19,167,435 a year for 3 1/2 years for care of indigent patients. The money mostly helps pay salaries of WSU doctors who treat indigent DMC patients.

A portion of the money arrives twice a month; the DMC gets the money through Michigan's Medicaid program, particularly a fund known as disproportionate share payments that help to pay for care for poor patients.

A $12-million reduction leaves WSU $7 million to pay for indigent care. In 2007, WSU provided $50 million worth of care for poor patients, said Doug Czajkowski, executive director for external affairs. WSU receives money from other parts of the Medicaid budget, as well as federal funds, to pay for the $31-million balance its doctors provide in care for the poor, Czajkowski said. "This puts us in an incredible dilemma," Dr. Robert Frank, WSU's associate dean of medicine, said Thursday. "It's hard to tell doctors not to see patients, particularly vulnerable patients they've cared for for years. This could put a big hole in the safety net. We'd like to avoid the L word, for layoffs."

Frank said WSU has no further information about references DMC made in the letter to overpaying doctors to care for poor patients. He declined to release the letter.

WSU plans to evaluate the impact of the cuts for each department by Monday, Dr. Robert Mentzer Jr., dean of the school of medicine, wrote in an e-mail Wednesday to physician department heads at the school. "We are exploring several options in response to this action," Mentzer wrote. The action was "completely unexpected" and "contrary to our signed" agreement with the DMC, Mentzer wrote.

The reductions will be made retroactively to October 1, 2007, the DMC told the medical school in the letter.

Mike Duggan, president and chief executive officer of the DMC, Ben Carter, chief operating officer of the DMC, and DMC spokeswoman Rebecca Christensen did not return calls for comment.

The sparring over money is the latest in more than a year of continued fighting between the two long-time health care partners.

Last year, the two sparred over WSU's opposition to the DMC providing space to Michigan State University's College of Osteopathic Medicine for one of two metro Detroit campuses, a battle WSU lost.

DMC and WSU signed their 3 1/2 year agreement after Gov. Jennifer Granholm intervened in late January 2007 and named a negotiator to achieve a settlement, because negotiations between the two partners already were strained.


Similar problems with Grady Hospital in Atlanta. Note major hospital in LA closed due to lack of funding. This could be a large problem for urban hospitals that care for the poor.

A whole lot of mismanagement and some greed and some outright fraud could cause any major urban hospital to fail.
 
Similar problems with Grady Hospital in Atlanta. Note major hospital in LA closed due to lack of funding. This could be a large problem for urban hospitals that care for the poor.

A whole lot of mismanagement and some greed and some outright fraud could cause any major urban hospital to fail.

The problem of health care funding in Detroit, as in Atlanta, LA, and any big city, has been unfortunate, difficult, and long-standing.

The outright war between the Detroit Medical Center and WSU is new as of DMC administration brought in after 2003. This "pay cut" for WSU in the middle of the term of a signed agreement appears to be just another step in their plan to sabotage the relationship.
 
To make a prediction on the original question: the ACGME will do nothing. They haven't done anything so far. The demanded a contract between the two. There is still no contract years later and the only thing to come out of this is the accreditation of new programs. If WSU didn't withdraw their ortho application, who knows? maybe that would have gotten approved too.

What depts had people layed-off? Has it changed the student or resident rotations at all?
 
Yup... this is a warning to academic centers (who will not heed this of course cause they dont read up on medical news like this).

But really, lets not overhype this mess. The hospital will not pay the academic docs as much cause they are not making the hospital money.

Solution: 1) Find another hospital and work with it (Stupid option) 2) Start a serious itemized review of what you should and should not treat in each department.

If it doesn't make money, you should not be doing it unless it is charity. That's the hard truth of hospitals and medicine. You gotta stay floating.

E.g. an appendectomy done by an academic surgeon, take the income from insurance - costs and divide by the number of hours from your time for care and followup. It will come out somewhere around 40-50 dollars per hour. If you moonlight you can make more....so why do an appendectomy?

Basically what I am trying to say is that academic medicine will lose money for not-so profitable cases and sometimes they need a hard push to make it all work.
 
E.g. an appendectomy done by an academic surgeon, take the income from insurance - costs and divide by the number of hours from your time for care and followup. It will come out somewhere around 40-50 dollars per hour. If you moonlight you can make more....so why do an appendectomy?

.

Who does the appy then? surg resident? family med resident?
 
So, because physicians will not see non-paying, high-demand, likely-to-sue patients, they will be laid off?

How can anyone put up with that crap as an MD? There are plenty of patients to treat, and plenty who will pay. When will people realize that free-ride healthcare doesn't work, will never work, and even at the limited level we have now, is BANKRUPTING our country. Half of our healthcare is completely socialized, and the other half is fascist, in that the private sector is indirectly controlled by the government. When will Americans wake up? Good gosh, I need to spend less time reading about this stuff..

Just when everyone wasgetting comfortable that the issues had settled down at the DMC and Wayne State...

DMC to cut pay to WSU doctors
Money for care of poor to shrink $12 million
February 8, 2008
http://www.freep.com/apps/pbcs.dll/article?AID=/20080208/BUSINESS06/802080326

By PATRICIA ANSTETT

FREE PRESS MEDICAL WRITER

The Detroit Medical Center plans to reduce payments to the Wayne State University School of Medicine by $12 million a year, beginning Monday, in a dispute over whether the medical center pays doctors too much to treat poor patients.

WSU administrators were reeling on Thursday from the announcement, which they received Feb. 1.

A contract with DMC announced Nov. 23 calls on the DMC to give WSU $19,167,435 a year for 3 1/2 years for care of indigent patients. The money mostly helps pay salaries of WSU doctors who treat indigent DMC patients.

A portion of the money arrives twice a month; the DMC gets the money through Michigan's Medicaid program, particularly a fund known as disproportionate share payments that help to pay for care for poor patients.

A $12-million reduction leaves WSU $7 million to pay for indigent care. In 2007, WSU provided $50 million worth of care for poor patients, said Doug Czajkowski, executive director for external affairs. WSU receives money from other parts of the Medicaid budget, as well as federal funds, to pay for the $31-million balance its doctors provide in care for the poor, Czajkowski said. "This puts us in an incredible dilemma," Dr. Robert Frank, WSU's associate dean of medicine, said Thursday. "It's hard to tell doctors not to see patients, particularly vulnerable patients they've cared for for years. This could put a big hole in the safety net. We'd like to avoid the L word, for layoffs."

Frank said WSU has no further information about references DMC made in the letter to overpaying doctors to care for poor patients. He declined to release the letter.

WSU plans to evaluate the impact of the cuts for each department by Monday, Dr. Robert Mentzer Jr., dean of the school of medicine, wrote in an e-mail Wednesday to physician department heads at the school. "We are exploring several options in response to this action," Mentzer wrote. The action was "completely unexpected" and "contrary to our signed" agreement with the DMC, Mentzer wrote.

The reductions will be made retroactively to October 1, 2007, the DMC told the medical school in the letter.

Mike Duggan, president and chief executive officer of the DMC, Ben Carter, chief operating officer of the DMC, and DMC spokeswoman Rebecca Christensen did not return calls for comment.

The sparring over money is the latest in more than a year of continued fighting between the two long-time health care partners.

Last year, the two sparred over WSU's opposition to the DMC providing space to Michigan State University's College of Osteopathic Medicine for one of two metro Detroit campuses, a battle WSU lost.

DMC and WSU signed their 3 1/2 year agreement after Gov. Jennifer Granholm intervened in late January 2007 and named a negotiator to achieve a settlement, because negotiations between the two partners already were strained.
 
Top