Physician Leaders Speak Out On WSU-DMC
Crisis
Editor’s note: The following opinion piece by WCMSSM Past President
and MSMS board member Daniel Michael, MD, appeared in the March 5
edition of the Free Press. Immediately following Dr. Michael’s piece
is a letter to the editor penned by MSMS President AppaRao
Mukkamela, MD, in response to a March 4 editorial published by the
Detroit News.
DMC Cuts to WSU Would Damage Safety Net
When the
ground underfoot is continually quaking, it's only human nature to
seek a more stable place to stand.
Physicians of
the Wayne State University School of Medicine continue to be shaken
by a recent series of disputes with the school's longtime partner in
health care, the Detroit Medical Center.
When the DMC
recently announced the withholding of $10 million to $12 million in
state and federal dollars from WSU physicians who treat indigent
patients in Detroit -- money the School of Medicine already has
budgeted -- it created a ripple effect that is often unseen, but
certainly will be felt, by the general public.
We fear the
consequences may begin to unravel the already fragile health care
safety net in Detroit, leaving the city's most vulnerable patients
without access to the physicians they need, and affecting Michigan's
entire health care system.
Consider these
facts:
• WSU
physicians and resident physicians provide 80 percent of the care
for Medicaid patients and the working poor in Detroit. Physicians at
Wayne State agreed to take on the responsibility of caring for
indigent patients in partnership with the DMC with the expectation
of reimbursement as negotiated.
• WSU physicians are dedicated to the Wayne State University School
of Medicine, which is ranked among the top 20 percent of medical
schools nationally. About 60 percent of WSU's medical school
graduates stay in Michigan. Nearly every county in Michigan has a
Wayne State graduate practicing there.
• We already are facing a shortage of physicians in Michigan. DMC's
reimbursement cuts will exacerbate the problem. It's hard enough to
recruit top physician educators without this added trauma.
• Any one of the excellent physicians at Wayne State would have an
easier and more financially rewarding practice somewhere else. Most
physicians have spouses and children and mortgages and medical
school debt to consider. If the family as a whole feels uncertain,
the physician may seek a more stable place to practice.
• Physicians of the Wayne State University School of Medicine are
committed to the care of patients in Detroit who are uninsured and
underinsured. The accusation from the DMC that they are
overcompensated for this work does not seem credible. It seems
unwise for a hospital board and administration to break an agreement
and consciously or unconsciously upset one of their most important
constituencies, the physicians who actually provide the care to the
hospital's patients.
We are
encouraged by recent media reports about the hiring of an
independent mediator, and we hope for a swift settlement of this
dispute. Cascading events will erode health care not just for the
indigent of Detroit, but also for everyone in Michigan.
In the
meantime, it seems reasonable to expect the DMC to continue to make
payments to Wayne State as negotiated to keep the School of Medicine
operating as budgeted and the health care safety net intact.
A stable
relationship between the DMC and the WSU School of Medicine is
critical to the health of all Michigan citizens.
DANIEL
B. MICHAEL, MD, PhD, is a Detroit neurosurgeon, chair of the Wayne County
Medical Society Board of Trustees and speaker of the Michigan State
Medical Society House of Delegates. Write to him at
msms@msms.org.
Below is a response by MSMS President, AppaRao Mukkamala, MD, to the
Detroit News
regarding that paper's recent editorial on this subject.
March 4,
2008
LETTER TO
THE EDITOR
The Detroit News
615 W. Lafayette Blvd.
Detroit, MI 48226
Dear
Editor:
Your
diagnosis that the "Wayne State-DMC dispute requires quick action"
as noted in your Feb. 29 editorial is absolutely correct.
DMC's
recent unilateral cut in funding for indigent care provided by WSU
School of Medicine's faculty physicians is the latest uncertainty
that can have long-term negative effects for health care in Detroit,
Wayne County, and the entire state.
Uncertainty
makes it difficult to retain exceptional physician educators, it
makes it more difficult to recruit the best and brightest physicians
and students, and it does nothing to maintain the reputation of DMC,
Wayne State, and Detroit as a place of excellence in health care.
We need a
return to a healthy, respectful partnership between the DMC and
Wayne State if we are to educate the physicians Michigan needs, not
only for Detroit's health care safety net, but to provide doctors
for communities throughout our state.
Sincerely,
AppaRao
Mukkamala, MD, President
Michigan State Medical Society
East Lansing
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