The recent legislation proposed by State Senator Kenneth LaValle to sever ties between Stony Brook University Medical Center (SBUMC) and the University has become a cause for concern among university officials. Officials say that every attempt will be made to preserve current joint structure between the University and the Medical Center.
LaValle’s proposed legislation calls for a new 15-member governing body for the hospital comprised of administrators, physicians, and local residents. The hospital would be given a new name: SUNY Hospital at Stony Brook. One of the governing body members would be President Shirley Strum Kenny.
Richard M. Fine, M.D., dean of the SBU School of Medicine, commented, ‘The current relationship between the Hospital, Medical School and University is absolutely the best model for serving our students, patients, faculty and the community. It is a model used by leading academic medical centers throughout the country, including the University of California system, Johns Hopkins, and the University of Kentucky.’
When asked about what actions the university is currently taking to prevent such a split, Fine said, ‘Stony Brook University is working cooperatively with our elected officials, community leaders, and the SUNY Chancellor and Board of Trustees to ensure that we remain the academic and medical leader that we are today.’
Furthermore, in citing academic institutions such as JHU, the University of California, and the University of Kentucky, which also currently function in symbiosis with medical facilities, Fine commented, ‘In each of these cases, the school and the medical center reap unique benefits from continuing and mutual interaction, benefits unattainable as independent or separate entities.’
Fine further elucidated on the benefits of having such a system here at the university. ‘The integration of the hospital with the research enterprise is critical,’ Fine said. ‘It helps take research from the bench to the bedside. Take for example, development of the virtual colonoscopy in which the hospital worked side by side with the Computer Science department on west campus.’
Concerning the possible impact of this split on the university’s reputation as a research institution, Fine said, ‘Competition for NIH funds is fierce as more grants are being applied for, and the percentage of grants awarded nationally has declined dramatically. To weaken our position in trying to get grants is not good for us or our patients. If a split takes place, the hospital would have likely to replicate the licensing technology function that currently exists within the university, as well as other infrastructure and resources that the university provides.’
Furthermore, for many students who work at research laboratories or participate in voluntary work, Fine said, ‘Students will always be welcome to volunteer. Participation in research could, however, be jeopardized.’
A testimonial statement given by Interim SBUMC CEO Fred Sganga on Dec. 11, 2006 affirmed the goals of the university against the potential legislative actions of the State. The statement was made to the Commission on Health Care Facilities in the 21st Century Report for the Committee on Health of the New York State Assembly.
Sganga said in his testimony, ‘The media and the public have focused on the seismic changes to hospitals across the state, including proposed closings and restructurings but our primary concern is the Commission’s policy recommendation that the Commissioner of Health undertake a comprehensive analysis of the feasibility of privatizing the teaching hospitals at Stony Brook, Syracuse and Brooklyn.’
Sganga further elucidated, ‘The best way to fulfill this mission for the 21st Century is to be what we are: the ONLY hospital that is an integral part of a medical school on Long Island’hellip;.We don’t fit the Berger Commission’s construct of hospitals in the region because we are not like others. We are fundamentally different from all other hospitals on Long Island including those such as North Shore and Winthrop that use the term ‘university’ in their names however, they do not have their own medical schools.’
The Berger Commission is the New York State Commission on Health Care Facilities in the 21st Century, headed by Stephen Berger, an investment banker, and created by Governor George Pataki and the State Legislature in an effort to curb the rising costs of healthcare throughout the state. Sganga, in his testimony, was responding to a report by the Berger commission that gave recommendations about what course of action to take with certain SUNY Institutions. One of the recommendations, as implied by the excerpt from Sganga’s testimony involves the privatization and restructuring of SBUMC.
While the State has been trying to ‘rectify’ the problem of rising healthcare costs and while university officials have been adamantly opposed to any idea that involves the word ‘split’ or ‘privatize,’ one SBUMC physician has decided to voice his opinion concerning the entire issue of the relationship of SBUMC with the University and the State.
Robert Parker, M.D., FAAP, professor and vice chair of Pediatrics for Academic Affairs, director of Pediatric Hematology/Oncology, and associate director of the Stony Brook University Cancer Center, acknowledged that there have been discussions over the years about the ‘status’ of the hospital.
Parker commented, ‘The state system is slow, cumbersome, and bureaucratic. Everything has to go through Albany. It’s like trying to turn an aircraft carrier.’ The state system did not allow SBUMC to adapt to the marketplace.
As Parker noted, a simple task such as adding an employee could take as much as 6 months, adding a piece of equipment could take as much as a year. He continued by stating that private institutions, on the other hand, have full control over their funds and can perform the same tasks in a fraction of the time.
As a result, Parker said, ‘Over the past several years, there has been a movement to become more proactive. There’s been discussion in the legislature to make the hospital more autonomous.’
Concerning the legislation proposed by LaValle, Parker could only surmise possible reasons for its proposal. He said, ‘If the legislation only creates a new governing body for the hospital, it’s likely that the changes are more of a direct response to the DOH rather than a means of changing the hospital’s link to the SUNY system.’ Parker was referring to the legislation as a response to the recent violations cited by the State Department of Health (DOH).
Parker continued, ‘There is the fact that Dr. Kenny doesn’t have any medical experience. Still, the recent involvement of the press might have been a factor. But the administrative hierarchy has always been this way since the hospital was opened.’ When he referred to the press, Parker was commenting on the recent string of articles in Newsday, which have attacked the management and leadership of SBUMC.
In the process of contemplating what he believed could have been contributing factors to LaValle’s proposed legislation, Parker did make several statements that he affirmed resolutely.
Parker said, ‘Senator LaValle’s legislation is intended to benefit the hospital to make sure it continues to benefit the need of the people. LaValle is a supporter of this hospital. He understands that we support the community. His district doesn’t even include Stony Brook. He should really be concerned with Mather and St. Charles.’ By Mather and St. Charles, Parker was referring to John T. Mather Memorial Hospital and St. Charles Hospital, both of which are located in Port Jefferson.
Parker continued, ‘We provide the largest amount of indigent care in the county. And we provide the same level of care for all patients. That is part our mission. When patients go to other private hospitals, those with lesser paying insurance are often given a lower level of care.’ Parker admitted, ho
wever, that it is difficult to assess what will happen to the academic programs, specifically the School of Medicine.
Parker said, ‘When there is cooperation between the hospital and academic programs, there is very little issue with utilizing hospital and academic resources. There is an alignment with the hospital and medical school goals. With the creation of a separate governing body, there is more opportunity for a disconnect. It all depends on how the governance is setup and how much support the hospital will give to its academic programs. It depends on how the board sees their position.’
As an overall outlook, Parker concluded, ‘There could be potentially be no change at all, or there could be small changes, or there could be big changes.’
Fine, speaking on behalf of the Medical School, stated, ‘We’re working diligently to maintain the existing structure because it works, and it’s a vital aspect of the medical school.’
