The Detroit Medical Center has banned faculty pediatricians from Wayne State University from working at DMC Children’s Hospital of Michigan, a development university officials said threatens patient care during the coronavirus pandemic.
It’s another wedge in the 100-year-old partnership between the eight-hospital health system that cares for much of Detroit’s under-served population and its historic academic partner, a relationship which nearly ended a year ago in a contract dispute.
In a Tuesday morning letter to faculty, WSU School of Medicine Dean Mark Schweitzer said he had been informed by the DMC and its for-profit owner, Dallas-based Tenet Health, that its faculty pediatricians could no longer practice at Children’s Hospital in Detroit.
The DMC did not respond Tuesday to a request for comment.
“This egregious act appears to be the latest in Tenet’s ongoing effort to irreparably harm the Detroit Medical Center’s decades-long relationship with Wayne State University and its School of Medicine,” Schweitzer said in his letter to faculty.
The ouster affects about 25 pediatricians who remained on the Wayne State faculty after University Pediatricians, the group practice representing about 220 Children’s Hospital pediatricians, moved last year to align with Central Michigan University’s medical school. The new affiliation was formalized in January.
The Wayne State University School of Medicine formed its own group practice, called Wayne Pediatrics, in April 2019. In October, the university threatened to fire 110 pediatricians on its faculty if they didn’t leave University Pediatricians for the Wayne State pediatrics group. A deadline was later rescinded.
About 80 WSU faculty pediatricians chose the CMU-affiliated University Pediatricians group, said Dr. Herman Gray, chair of pediatrics at the Wayne State University medical school.
Wayne State faculty pediatricians were blindsided by the ban, which Schweitzer learned of last week, Gray said.
“The DMC has an open medical staff, meaning that if you have the credentials to be accepted on staff, you’re on staff until you resign or make a violation of bylaws, which happens rarely,” Gray said Tuesday.
University officials learned of the new policy after a pediatrician emailed the DMC administration about a rumor that Wayne State faculty could no longer practice at Children’s, he said.
The doctor was initially assured by DMC Chief Operating Officer Dr. Audrey Gregory that the rumor was not true, according to Gray, but was later informed that University Pediatricians has an “exclusive contract” with Children’s Hospital.
“Why are they doing something, particularly in the midst of a pandemic, that jeopardizes patient care?” Gray said, noting the policy could keep some children from getting care at Children’s from doctors whom have treated them their entire lives.
Pediatricians in turmoil
University Pediatricians has represented pediatricians at the DMC for about 30 years, but the group practice began seeking independence from Wayne State during the past several years, Gray said.
University Pediatricians did not respond Tuesday to requests for comment.
“They wanted to be in a children’s hospital, they wanted to be considered academic physicians … but they didn’t want to take directive from the university,” Gray said. “The relationship just deteriorated.”
University Pediatricians formally severed its relationship with Wayne State University in March 2018, but payments for the physicians’ services continued to flow through the university — giving rise to disputes.
According to Gray, University Pediatricians owes about $25 million to the university for a portion of the payments the university made to doctors that were supposed to be returned to Wayne State because of the new relationship with CMU.
At the same time, University Pediatricians claims that Wayne State has held on to about $60 million in federal Medicaid funding it says is owed to the doctors. The money is intended to increase access to health care by providing incentive payments to doctors who treat large numbers of patients on Medicaid, the federal health insurance program for the poor.
In April, Wayne State University prevailed in one of two lawsuits involving the University Pediatricians group.
Michigan Court of Claims Judge Cynthia Stephens dismissed a complaint filed against WSU by the University Pediatricians.
The doctors accused the university of skimming the funds partly to financially cripple the pediatrics group as university officials planned to make the five-hospital Henry Ford Health System the school’s primary medical partner.
Academic mission disputed
Despite the apparent ban on Wayne State pediatricians, the DMC touted its historic academic mission in an annual report submitted to the Michigan Attorney General’s office on April 10.
“The DMC has fully complied with its obligation to support the system’s historic mission of undergraduate and graduate medical education, nursing education and allied services education,” the DMC stated in the report.
But the health system’s relationship with its historic academic partner has deteriorated sharply in the past few years, putting at risk the medical attention provided to high numbers of indigent and under-served residents in the nation’s poorest big city.
A training program for neurosurgeons at the DMC has lost its accreditation, jeopardizing the reputation of the health system and its longtime academic partner, Wayne State University.
The Accreditation Council of Graduate Medical Education withdrew accreditation from the program earlier this month following a site visit on Sept. 18. Accreditation is set to end on June 30.
Gray said about 300 pediatric residents rotate through DMC Children’s Hospital of Michigan annually.
He said he does not believe the health system’s pediatric residency programs will be affected by the current discord. But he worries about how it will affect the most vulnerable patients.
Some members of Wayne Pediatrics are specialists in areas of medicine that are not represented in the University Pediatricians group. Others will be forced to stop seeing patients they’ve been treating for years.
“There are two doctors at Children’s Hospital who have taken care of all of the children and young adults with AIDS and HIV disease,” Gray said.
“Both of those two doctors are in Wayne Pediatrics — who’s going to take care of HIV children and young adults in the hospital? What happens if one of those patients is admitted to the hospital, and the people who are the experts are not allowed to practice there?
“At the very least, this decision interferes with the normal physician/patient relationship,” he said.
“At its worst, as with the HIV situation, the patients are actually in jeopardy because they don’t have access to the doctors who have cared for them for a long time, and who are the experts in their care.”
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