UI-Carle relationship under microscope


URBANA — A $100 million educational and “translational sciences” building. Hundreds of physicians, scientists and engineers working alongside students. Spinoff biotechnology companies. Revenue-generating patents. A whopping 5,600 jobs by 2035.

In recent speeches around the community, University of Illinois Chancellor Phyllis Wise has evoked Daniel Burnham and his “make no little plans” declaration, and when it comes to the proposal for a revamped medical school here, no one has said these are little plans.

But exactly which plans are seriously being considered, and what might actually come out of this effort, are not entirely clear.

Good idea or bad? Tell Tom Kacich about it here

Two weeks after the public release of a consultant’s report that was months in the making, about an idea that has long been bandied about, most officials from the UI and Carle Health System, the university’s potential clinical partner, are staying publicly quiet. Consultants hired by the UI and Carle also did not respond to requests for an interview.

And those who are talking say it’s too soon to discuss it in much detail.

Some question the timing of the proposal, given the university’s uncertain budget picture (units earlier this year were told to brace themselves for the possibility of 12.5 percent cuts) and other developing challenges: a possible spike in faculty and staff retirements due to changes in the pension law, recruiting concerns caused by pension reductions, and a recent reorganization of the university’s health enterprise. The decision also could pit the Urbana campus against the medical enterprise in Chicago. 

And with much higher property bills recently landing in mailboxes, some also have expressed concern about the property tax implications of this new entity — particularly in Urbana, which lost millions in taxable income due to a state law and court decisions allowing not-for-profit hospitals to exempt the value of their charity care.

The recommendation from consultants Tripp Umbach of Pittsburgh calls for a new college of medicine to replace the current medical school at Urbana, which is now a regional campus of the UI’s College of Medicine in Chicago. It would be independently accredited and overseen by a private, possibly not-for-profit 501(c)(3), established jointly by the UI and Carle.

Central to the vision is the ability to tap into the campus’ strengths and reputation in engineering research such as bioengineering and supercomputing. Start-up costs for the first five years are estimated at $100 million, not including a $100 million building envisioned for the future.

UI Trustee Tim Koritz, the only medical doctor on the board, called it an “interesting idea that warrants looking into.”

“Obviously it would play heavily on already great capability at the Urbana campus in computational capability and engineering, In the medical field, bioengineering is going to be at the forefront in the near future, he said.

Also hot: neuroscience. And to create computer models of the brain with 2 billion neurons requires tremendous computer capability, Koritz said.

UI President Bob Easter described the proposal as “an idea that’s on the table,” and said it would go through the usual review by the academic senates and the UI Board of Trustees. Ultimately, it would have to be approved by the Illinois Board of Higher Education. Carle’s board would also have to approve it.

“We haven’t gotten to the specifics of how will it look, how will it be structured. It just came out,” said Stephanie Beever, Carle’s senior vice president for system strategic development.

The fundamental question for the university, Easter said, is how to address the growing need for researchers at the Urbana campus to have better access to practicing physicians, as scientific fields increasingly demand.

“Can we provide that through the existing arrangement, or is there a different arrangement that would be more successful? There’s no question that the programs in Urbana need an opportunity for greater engagement with people who are practicing physician-scientists,” Easter said.

Easter declined to characterize the views of UI trustees on the proposed medical college, saying they have not had any “substantial discussions” yet. He said the topic will likely come up at the board’s retreat in July, which trustees have said will focus on critical challenges facing the university. Board chair Christopher Kennedy could not be reached for comment.

“My stance is, do what’s best for the University of Illinois in total,” said Koritz, an anesthesiologist at Rockford Memorial Hospital and a former clinical professor at the UIC College of Medicine’s Rockford campus. “I’m willing to talk to all people involved and hear all arguments. I hope the board will come to a conclusion to benefit everybody.”

Koritz chairs the board’s health affairs committee, which also hasn’t discussed the proposal yet. The board is busy dealing with what Koritz called a “potentially huge problem,” a mistake in the new pension law that has prompted thousands of employees to consider retiring this summer or risk losing a year’s worth of benefits.

“That’s on the front burner. We’re trying to get that fixed before the legislature adjourns for the summer,” he said.

 

Chicago weighs in

It’s been no secret that Urbana would like to have its own medical school, said Philip Patston, chair of UI Chicago Senate Executive Committee and professor in the College of Dentistry. Urbana’s peers such as the University of Wisconsin, University of Michigan and University of North Carolina all have medical schools, campus leaders have often pointed out.

“There always has been the perception they would like to have their own (medical college in Urbana), but I don’t think it was generally realized” among UIC faculty that something with such depth in planning had been in the works, something “more serious than being on the wish list. And the relationship with Carle was not necessarily anticipated,” Patston said.

The Chicago senate is assembling a committee that will evaluate the report and consider what impact it could have on the college of medicine’s budget and the recruitment of faculty and students, on the medical school’s regional campuses, and the wider implications for that campus as a whole, Patston said.

Over the years, individuals from Chicago and Urbana have collaborated, but more on an individual basis than systemwide, Patston said. The new UI Labs digital manufacturing initiative based in Chicago and involving engineering faculty from Urbana should allow more collaborations, he said, “but the distance and separation is not conducive to collaboration. Each school has its own unique interests. I don’t know if we have the development and infrastructure to allow those things to happen.”

Bioengineering and biomedical science are burgeoning fields, and the fear at Urbana is that the campus won’t be able to continue to attract top researchers without a stronger medical component.

Urbana researchers collaborate with colleagues at many of the top 10 medical schools across the country, including Harvard and the Mayo Clinic. But that’s not the same thing as building a team that works together to develop an idea, turn it into a prototype, take it through clinical trials and produce a new drug or medical device ready for the marketplace, officials said. It’s much easier to walk across campus than to fly to the East Coast or even drive to Chicago.

Easter acknowledged that Urbana vs. Chicago issues “have come up in some conversations,” but added, “We are the University of Illinois. And I hope wherever we go that we achieve an end — whether that’s maintaining the current arrangement or something different — that does as much as possible to serve the citizens of the state and the needs that we have to do scholarship across the University of Illinois.”

He also emphasized that the UI Chicago medical enterprise, with its seven health sciences colleges, is uniquely positioned to take advantage of trends in health care — a more comprehensive approach to medical care and a focus on prevention and reducing illness through public health.

“It’s one of the most complex, complete arrangements of health sciences in the nation,” with colleges or schools of medicine, pharmacy, dentistry, nursing, applied health sciences, public health and social work, Easter said.

 

The money question

What’s critically important in Koritz’s view is that the new entity not pull any state funding away from the existing medical school structure.

Among the questions the UI Chicago Senate committee will be asking: “What is the mission of the university? We’re not a private school ... regardless of the decrease in state funding. We’re a state school. What is its mission for training doctors for the state of Illinois? If we are going to be constrained by budget cuts and retirees, what can we do? Can we expand in times of shrinking budgets?” Patston said.

“The whole issue of funding is the big worry,” he said.

In recent years, the health affairs enterprise at the university has undergone periods of change. Not long after he arrived at the UI in 2010, then-president Michael Hogan created a new vice presidency to oversee the UI’s vast medical operations and hired Dr. Skip Garcia to fill that role.

Last year, trustees, under Easter’s recommendation, reversed that decision after Garcia left. A new position, vice chancellor for health affairs, was created and that person will oversee the hospital and clinics as well as the health sciences colleges, which includes the College of Medicine. Jerry Bauman is filling that role until a permanent administrator is hired. Easter said he hopes that search can begin soon, now that the search for a new UI Chicago chancellor is under way.

Patston said UI Chicago faculty have not been told by administrators how the medical school proposal will move forward or at what rate.

The consultants outlined an ambitious timeframe. They recommended the UI and Carle choose a new name immediately in order to distinguish the school from the UIC College of Medicine, to develop a business plan and financial model by September and get started on the accreditation file. A dean should be hired in 2015 and fundraising should be ongoing, they said.

“The timeframe is important. If this is forging ahead to start right away, we need to be quick. If the proposal is for planning purposes and more deliberation, we may have more time for in-depth study. We’re in the dark about the extent to where this is at,” Patston said.

Urbana senate chair Roy Campbell, a computer science professor, said Wise has not approached him yet about a senate discussion.

“It’s an exciting proposition,” he said. “I think the proposal probably needs some more flesh to it, more analysis” about ramifications for Chicago and Urbana and the relationship between the two. 

Don Chambers, who chairs the health affairs committee for the University Senates Conference, a group of faculty from the three campuses that advises Easter, has not taken a position on the recommendation.

“I am for building strong medical education and strong medical research on both of the campuses and helping them synergize so we can become as excellent as possible,” he said. “We owe nothing less to the citizens of the state and our patients.”

 

 

To do list for the new UI/Carle medical school, per the advice of Pittsburgh
consulting firm Tripp Umbach:

 

✔ 

Immediately: Choose a new name. One that “incorporates both partners ... to avoid confusion with the current UIC College of Medicine.”

 

✔ 

By September this year: Develop business plan and financial model.

 

✔ 

Also this year: File application for accreditation, which will be finalized in 2015.

 

✔ 

2015: Hire a “founding dean.” This person should be “a nationally recognized leader in engineering and science-driven medicine.”

 

✔ 

2016: Recruit and/or retain five assistant professors, five full professors, 20 clinical research faculty and 20 clinical teaching faculty. They will teach and conduct research with partners at Carle and other UI colleges. Also in 2016: hire 12 employees who will handle accreditation, fundraising, administration, student support and other areas.

 

✔ 

Fall 2017: Admit first
students.

 

✔ 

Ongoing: Raise money. Tripp Umbach estimated $100 million for the five-year start-up phase, which includes $25 million for facility upgrades. The consultant also called for establishing an endowment fund of $200 million. A new building is estimated at $100 million.

Christine des Garennes

 

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Barb.Yats wrote on May 04, 2014 at 4:05 pm

The University should create it's own hospital system in Champaign to conduct research with the ability to refer patients to any hospital it so chooses. Going in to a business relationship with Carle is a terrible idea. Don't be fooled by their non - profit status, they are purely for profit and the organization is ran by nurses and people with businesses degrees who have no sense of what it is like to actually care for and treat people of this community. Carle hires 80% of their doctors from students who have done residencies and internships here and people of this community need understand those doctors are generally the bottom 10-20% of their class and most are foreign trained. Those doctors continue to recieve a base salary and a bonus bad on their RVU's meaning the more often they are patients and the more they bill, the bigger their paychecks become. Carle is truly a corrupt organization at the top levels in HR and administration. What makes Carle so successful is that they own the market and no one with smaller businesses or practices can compete because they havea built in referral system with health alliance (hells alliance). If the University wants to establish a medical school, it should be in independent of a private organization such as Carle. Carle used to be the leader in health care in this area, but now they are the leader because patients have no other choice. Carle HR will tell employees if they don't like something or aren't being paid fairly, they can leave, because they know you don't have any other options anyway. There are great people at Carle, there are some great doctors at Carle, but more and more it is being run by unqualified physicians assistants and nurse practitioners because they can pay those staff less, bill under a physician for reimbursement and make a large profit. I understand that is the trend happening in health care, but there is really an abuse of this when these doctors don't really even have the time to adequately supervise these practitioner's. Departments are ran by individuals who don't even have a health care degree, just a business degree or a master's degree in health administration. The goal of each department is to increase revenue and find cost savings, there is rarely an emphasis or measure of increasing better patient outcomes because that would take a provider with a higher level of skill and there just simply aren't always enough of those to go around. The University should help the community establish a public health care system that is owned by the people of the community, I believe this is how Springfield Memorial operates. There should be no conflict of interest and there is you much of that if a partnership with Carle is formed.

Lostinspace wrote on May 04, 2014 at 5:05 pm

Whew! I'm impressed by your passion! Waiting to see what others say.

ROB McCOLLEY wrote on May 05, 2014 at 2:05 am
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Barb, if your description is apt, it sounds like a perfect fit for the U of I.

 

Perhaps the U can purge its teaching & research staff entirely, and replace them with adminstrators trained in writing grant proposals, and attending conferences.

puppetsareawesome wrote on May 05, 2014 at 12:05 pm

Wonderful idea, Barb.  Better idea than with Carle, that's for sure.  Could you possibly get your idea out there so the option of partnering with Carle isn't as likely?  

ScienceBatboy wrote on May 06, 2014 at 12:05 am

Anyone that thinks this is a good idea should Google what happened to Carle's former Vice President for Research, Dr. Suzanne Stratton.  She tried to enforce proper research practices there.  I won't spoil the surprise, but our local hospital made the New York Times and garnered writeups in books on research ethics.  Her lawsuit is one of the search results easily discoverable, and this was covered in the News-Gazette, which seems to have developed amnesia here.