08/21/19 Update on Pediatrics

University Pediatricians at Wayne State University:
Here Yesterday, Gone Today

Charles J. Parrish, President
WSU AAUP-AFT, Local 6075

On August 6, 2019, The President of the University Pediatricians (UP), Dr. Mary Lu Angelilli, issued a statement announcing that a deal had been cut between the Director of Medicaid for the State of Michigan and the UP that will move the flow of Medicaid funds to it from Wayne State University Medical School (WSUSOM) to the School of Medicine at Central Michigan University.

This is almost the last step in the process of separation of the UP from the WSU. The UP had been the faculty practice plan for the WSU Department of Pediatrics for over two decades. The UP clinicians were compensated for the delivery of patient services primarily through Children’s Hospital. The conflict with the Wilson Administration has led to moving the affiliation of UP from WSU to CMU. There are a host of questions and disruptions that are unresolved in the pursuit of this by the UP leadership. There is no doubt that this was abetted by the reluctance of the Wilson Administration to deal with the UP and vice versa. The irony is that both sides maintain that they have always been open to negotiations with the other and blame the other for the lack of progress. But meanwhile, nothing got done.

Where Do We Stand Now?

The following is a brief summary of the situation as I see it:

1. Board of Governors Lawsuit Continues. The lawsuit over the question of whether or not the Board of Governors actions taken in the meeting in which the President, M. Roy Wilson, in his non-voting ex officio, was counted in order to establish a quorum, are still in court. A confusing ruling by Circuit Court Judge Cynthia Diane Stephens allowed WSU to act on the measures passed by the BOG in the questioned meeting, ruled against the plaintiffs on the open meetings issue of their suit, but allowed them to appeal the matter of whether the President legitimately could be counted as part of a quorum for the meeting. The plaintiffs have filed an appeal on the quorum issue with the Michigan Court of Appeals. If the plaintiffs prevail, it could negate the actions taken in the meeting in question, including the action on the acquisition of access to the building on Mack Avenue to house the new practice plan, Wayne Pediatrics, and force the Board to reconsider the matters in another meeting.

2. Conflict with UP. The tension with the WSU Administration and the UP has been long standing and has been primarily over finances. Issues came to a head in an August, 2017 meeting between the UP members and senior WSU administrators. President Wilson, Vice President for Health Affairs David Hefner and Dean Jack Sobel attended the meeting and demanded that the UP sign a new agreement with WSU. It was threatened that if the agreement was not signed, that the faculty would not be paid beyond November 2017. Such threats put increasing pressure on the UP leadership to pursue alternative options. Efforts by the UP leadership to get either the University of Michigan or Michigan State University to absorb the UP faculty became more intense. They ultimately failed.

3. Who’s to Blame? President Wilson blamed the UP leadership for the failure to get an agreement. He told Crains (August 8, 2019) that “the university was forced to create its own practice plan only after UP began planning in the fall of 2017 to leave Wayne State and began talking with the University of Michigan, Michigan State University and finally Central Michigan.” He failed to mention the contentious August 2017 meeting in which he threatened not to pay the faculty if the UP did not sign their new agreement. He also avoided discussion of the diversion of millions of dollars by WSU to its own purposes as “institutional adjustments.” These funds would have gone to the UP in Medicaid payments but for these diversions.

4. Wayne Pediatrics. The recruiting efforts of the WSU School of Medicine of clinicians to the faculty, led by the Chair, Herman Gray, of the WSU Department of Pediatrics, are proceeding. WSU has terminated a few faculty members associated with the leadership of the UP and is offering present faculty members two-year contracts with signing bonuses to stay at Wayne State and participate in the new faculty practice plan, Wayne Pediatrics (WP). Dr. Gray expressed concern to Crains (August 8, 2019) about whether the UP will oppose allowing WP physicians to practice at Children’s Hospital. Further, it is unclear as to whether or not the non-compete clauses of these faculty members’ employment contracts with the UP will be enforced. These factors introduce considerable uncertainty into the situation.

5. Rebuilding the Department of Pediatrics. In the mishandled politics of the Department of Pediatrics there is enough blame to go around. The past is past: the question is what to do in the future. The efforts to rebuild what was once one of our best departments, in clinical practice, in research and in teaching in the School of Medicine, are presently centered around the attempt to make the new faculty practice plan economically viable. The success of these efforts will depend where clinical practice will be carried out. Those faculty members who are primarily researchers will continue pretty much as they have in the past. But, the level of effort overall in rebuilding the Department should not be underestimated. It may take decades in the best of circumstances.

6. UP Becomes Just Another Physicians Business Group. There is little doubt that a goodly number of clinicians will remain with UP in its new form as a physicians’ business group. They will have to accept whatever faculty arrangements can be worked out with CMU and become faculty members in its medical school. The loss of prestige and collegial interaction that comes with being a faculty member in a department in a large research university will have to be accepted by those who remain with the UP as it becomes just another business group providing clinical services, primarily at Children’s Hospital.

7. The WSU School of Medicine Faces the Future. The problems of Pediatrics is but one of a series of complex issues that will shape the future of the WSU School of Medicine. The University is presently searching for a new Vice President for Health Affairs who will also be Dean of the WSU School of Medicine. The question can be raised as to what experienced medical school administrator would want to risk her/his career by plunging into a situation in which there are so many uncertainties? The question of a needed long-run hospital partnership is unresolved as are other serious issues.

8. Searching for a New Leader in Health Affairs. In a meeting between the Search Committee for the joint position of Vice President and Dean and the medical school faculty recently, I raised the question of whether or not we should delay the search and try to settle some of the unsettled dimensions of the present situation before proceeding with the search. President Wilson responded that he knew many people who he could convince to be candidates, and that he was sure that he could prevail on a well-qualified person to fill the position. I believe that that question remains open and that the alternative of delay should be considered. Both the University and the School of Medicine need stability. At present we do not have it.