02/01/18 Situation in the Pediatrics Department
The leadership of the Union has been following closely the various twists and turns in the matter of the future of the Wayne State University Department of Pediatrics. I have talked to departmental faculty members, and found among them a high degree of discomfort, dismay and disappointment. The crisis of leadership in the Department has been ongoing for some time, creating uncertainty and confusion. This communication to all the members of our bargaining unit is intended to inform you about this complicated, but very important, issue that has implications for all members of the University community.
According to the latest accounting from the Administration, there are 133 bargaining unit members in the Pediatrics Department, made up of 104 faculty clinicians, 28 assistant, associate and full professors, and an Academic Services Officer III. There have been negotiations between the University of Michigan Medical School, the President of the University Pediatricians (UP), and the leadership of Children’s Hospital of Michigan (CHM) about the possibility of the departmental faculty moving to the UoM. The likely terms of any such move are still unclear at this point. However, the loss of a Department of this size and importance, or even for a sizable portion of it, would be a disaster for any school of medicine. Given that Pediatrics is one of the leading Departments in the Wayne State University School of Medicine (WSUSOM), its loss would be particularly tragic for the School and the University.
The Union is very concerned with the turnover in the leadership of the Department. Having a revolving door situation in an academic department is never a good sign. Moreover, the process of the appointment of the latest candidate, Dr. Herman Gray, as Chair of the Department, is clearly in violation of the terms of Article XVII, Selection Advisory Committees, of the Collective Bargaining Agreement (CBA). The Union will proceed to seek a remedy to this violation, however, we do recognize that the wheels of the grievance process grind slowly, and the day-to-day process of running an academic department must be met with some immediacy. Until the issues are resolved, Dr. Gray is the legal Chair of the Department.
When one looks at the problems of the Department, dispassionately, they do not seem intractable. The Department’s clinical faculty members provide patient services at CHM. They supervise residents (physicians in training) there. The patient services are paid for by third-party payers: Medicare, Medicaid, other public sources and private insurers. Funds to reimburse WSU clinicians for these services are transmitted to the UP, the Pediatrics faculty practice plan. A small portion of these funds (now 6%) are then sent to the WSUSOM as the “Dean’s Tax,” under the terms of an agreement between the UP and the WSUSOM. The State of Michigan Medicaid Program transfers funds to the WSUSOM for the services provided to recipients enrolled in that program. These are then transferred to the Department to help pay salaries of the faculty. Other sources of salaries are the General Fund allocation to the Department and grant income.
The terms of these relationships, particularly the financial details, are negotiable. However, the range of financial details involved are not subject to great variations, and should be able to be resolved by reasonable negotiators. At present, the problem is that each side, the leadership of the practice plan and the WSU Administration, accuses the other of intransigence and bad faith negotiations.
However, new information has made it clear that there were many details of the negotiations between the leadership of the UP, UoM and CHM that had not been shared with the members of the Pediatrics faculty. These negotiations were long in the works, and were extensive enough that they had even been given a codename: "Project Treehouse." These were ongoing, before a teaching agreement between CHM and UP was signed, that did not include WSU. Cold water has been thrown on the negotiations by objections at the level of the UoM Board of Regents to the attempt by their Medical School to take an entire department away from a sister public institution.
On August 17, 2017, there was a meeting of members of the Department attended by President M. Roy Wilson, Vice President for Health Affairs David Hefner, and Dean Jack Sobel. By all accounts, the meeting was a disaster. President Wilson and his team read the riot act to the faculty. In the meeting, as summarized by the Interim Chair, Dr. Mary Lou Angelilli, “… the threats that were made were very disturbing … [and] we are pediatricians unaccustomed to this level of political pressure, intimidation and threats.” (Angelilli memorandum to Pediatrics Faculty, August 18, 2017)
At issue was the renewal of the teaching agreement between the practice plan, UP, CHM and the removal of WSUSOM from that agreement. In addition, the salary reimbursement agreement, to pay faculty, an existing one-page agreement under which they had been operating, which had been signed in 2003, was due to run out in March, 2018. President Wilson and Vice President Hefner demanded that the UP sign a new 25-page agreement, drawn up by the WSUSOM, that tilted power in its direction in the relationship. The faculty was threatened by President Wilson and Vice President Hefner with not being paid as of November 1, 2018, if the proposed agreement was not signed. Nevertheless, the proposed agreement was not signed, and the faculty members were paid in November, and have been paid regularly ever since.
Some of the funds involved are from Medicaid, currently about $10 million. The UP acknowledges that it owes the WSUSOM, through the Fund for Medical Research and Education (FMRE), about $5 million. The UP maintains that, in turn, it is due “approximately $6.3 million ... (from all University controlled sources).” (Angellilli memorandum)
As stated earlier, the UP leadership has been negotiating the possibility of leaving WSU. Any such negotiations are a complicating factor in the situation. Questions have been raised about the legitimacy of the leadership of the UP. There have been several lawsuits filed in relation to the Department, the one referred to earlier by three faculty members against the UP, charges its leadership with violating its bylaws in its operation.
Into this chaotic mess comes Dr. Gray, appointed by Dean Sobel, with the hope that his political and management experience can contribute to the development of a situation in which the Department of Pediatrics and its practice plan will remain with the WSUSOM. This is an enormous challenge, and Dr. Gray began well enough with a January departmental faculty meeting. When I met with Dr. Gray the week before that meeting, he expressed a reasonable openness and a commitment to do whatever he could to resolve the issues that separate the actors in this continuing drama. He made a similar commitment in later meetings with the members of the Department. There is a serious question as to whether or not Dr. Gray will be given sufficient latitude to act by President Wilson and Vice President Hefner. Their clumsy, “my way or the highway,” approach in dealing with Pediatrics in the past, did not provide an effective basis for a solution to problems in the present situation.
There is no doubt that this is a situation in which the WSU Board of Governors must provide the steadying hand on the tiller. What happens to the Department of Pediatrics has political ramifications that will affect the entire University’s future. The Pediatrics faculty, through its services at CHM, plays a key role in the health care of the children of Detroit and the State of Michigan. These services should be seen as a significant aspect of the mission of Wayne State University. It is a mission that should be kept in mind by all those who have a role in negotiating a solution to the problems of the present situation. Dr. Herman Gray, coming from his leadership post in the United Way for Southeast Michigan, has experience that could serve well in helping to find a way through this political morass, if he is given the room to maneuver and appropriate support.
The Union stands ready to do whatever it can to help resolve the situation in Pediatrics. We do not believe that it will serve the University, the School of Medicine, or the City of Detroit well, if the Pediatrics faculty leaves the University. We hope that a solution is found soon that keeps the Department as a member of the Wayne State University community.
---------------------Charles J. ParrishPresident, AAUP-AFT, Local 6075, WSU ChapterVice President-at-Large, AFT MichiganPresident, AAUP Michigan ConferenceMember-at-Large, National Council, AAUP5057 Woodward Avenue, Suite 3301Detroit, MI 48202313.577.1750