University Times

The interim dean of Pitt's School of Medicine will convene a meeting of medical faculty before the end of February to discuss the planned absorption of the University of Pittsburgh Physicians (UPP) practice plan by the UPMC Health System.

UPP was formed through a merger of the 18 clinical practice plans of medical school faculty. Like UPP itself, each of the plans was an independent corporation.

Assuming the special meeting agenda follows the one proposed by several medical faculty members last month in a memo to Interim Dean George Michalopoulos, the agenda will include discussions of: * The pros and cons of UPMC Health System's planned acquisition of UPP as a wholly owned subsidiary. Following presentations by Pitt and UPMC representatives, medical faculty would vote on whether or not they favored the acquisition.

* Changes in tenure and compensation for Health Sciences faculty that might result from the acquisition.

* Possible interference by UPMC Health System officials with the medical school's teaching mission.

* The working relationship between Pitt's yet-to-be-hired new senior vice chancellor for Health Sciences/medical dean and the president of UPMC Health System, given the former administrator's lack of control over UPP revenue generated by Pitt faculty.

Faculty Assembly voted Feb. 3 to approve a motion calling on Michalopoulos, who initially wanted to hold the meeting in mid-March, to schedule the meeting two weeks earlier in keeping with medical school governance rules.

Although Faculty Assembly is an advisory group and can't enforce its recommendations, Michalopoulos told the University Times he would follow the Assembly's request. He said this following an unusually stormy discussion of medical school affairs during the Feb. 3 Assembly meeting.

What prompted the Assembly discussion was a confidential memo from five medical faculty members, delivered to Sheldon Adler, senior associate dean of the School of Medicine, on Jan. 20. One copy included the faculty members' names and signatures. The names were deleted from the other copy, which Adler passed along at the faculty members' request to Michalopoulos.

The memo asked the interim dean to convene a special meeting of medical faculty within five weeks to discuss UPMC's planned acquisition of UPP. The medical school's plan of organization states that the dean must call special meetings "upon the written request of five or more members of the faculty. These meetings shall be called in a timely fashion and no later than five weeks after written request." Michalopoulos told Faculty Assembly he was reluctant to call a faculty meeting on the basis of an anonymous memo, especially because there had been a general faculty meeting just three weeks before, during which the UPP-UPMC merger was discussed. Also, UPP officials had scheduled meetings during the next several weeks with medical school departments to explain the rationale behind the merger.

Michalopoulos said he thought it would be better to wait until after the departmental meetings to hold the next school-wide faculty meeting. But the five faculty members who requested the school-wide meeting argued the opposite: that the larger meeting should come first, to give faculty an opportunity to learn more about the implications of the UPP-UPMC merger prior to the departmental meetings.

Regarding the anonymous faculty memo, Michalopoulos said he obtained the signed copy from Senior Associate Dean Adler to verify its authenticity. Then he replied in writing to each of the five faculty members, sending copies of his reply to Senior Vice Chancellor for Health Sciences Thomas Detre and other Pitt administrators.

The interim dean told Faculty Assembly he found it "distressing" that faculty were unwilling to sign the memo — a situation representing "confidentiality driven to absurdity," according to Michalopoulos. "I think if we don't hold the line and ask people to speak up, nothing will ever change" for the better at Pitt, he said.

Senate Vice President Nathan Hershey replied: "Well, George, I would say to you that if you found out why people were afraid to stand up or to speak out, you'd be really advancing the cause that you purport to support." Hershey chairs a Senate committee that is investigating the compatibility, or lack of it, between Pitt's academic mission and the business goals of UPMC Health System. As chairperson of the "compatibility committee," Hershey has been invited to address the special meeting of medical faculty.

Exchanges between Hershey and Michalopoulos grew heated during the Assembly meeting.

When the unsigned letter came to your attention, Hershey asked the interim dean, did Senior Associate Dean Adler tell you it had been signed by five faculty members? Yes, Michalopoulos answered, "but I considered it important for me to verify that this was the case." "You didn't trust the senior associate dean when he told you it was signed by the faculty members?" Hershey inquired.

"Yes, I trusted the senior associate dean," Michalopoulos replied. But he added that he viewed the anonymous letter as a corruption of the spirit of academic collegiality and, given the importance of a school-wide faculty meeting, he felt compelled to see the letter for himself to verify its authenticity.

At another point in the meeting, Michalopoulos complained that some faculty members circulated a memo paraphrasing a private discussion he'd had with Senior Associate Dean Adler. Michalopoulos said the memo violated his right to confidentiality.

"What, to you, makes a communication confidential?" Hershey asked the interim dean. "If you talk to your associate dean, is that confidential, or is that associate dean allowed to talk to other members of the faculty? Do people have to get clearance from you to speak to anyone within the medical school or the University?" Michalopoulos said he considered private conversations about sensitive academic issues to be confidential, and that persons privy to those conversations should confer with him before repeating them to others.

Radiology chairperson Richard Baron, who is president of UPP, said the medical school is suffering because of faculty misconceptions about the planned UPP-UPMC merger. He noted that the clinical practice plans have always been independent of the University and that UPMC provides $50 million annually to the plans.

"There's no one who cares more about the faculty than George [Michalopoulos] and I," Baron added. "George sticks his neck out far more than I do" to defend faculty rights, he said.

Michalopoulos argued against faculty portrayals of UPMC Health System as a negative influence on the medical school. He pointed out that medical school departments depend on UPMC subsidies. UPMC provides one-quarter of the psychiatry department's budget, for example, and one-third of the surgery department budget.

"Take away the UPMC subsidy and those departments would be destabilized," the interim dean said. "The real moral issue, the highest principle, should be the defense of the capacity of the faculty to carry on their scholarly activities, and that takes money and space. And we need to find the best solutions specific to Pittsburgh as to what the right thing is — getting away from internal ideas about specific personalities and the whole psychodrama of the intense entanglement between the University and UPMC. Let's look at these things with as cold and detached an approach as possible." Assembly member Nicholas Bircher, an untenured faculty member in the medical school's anesthesia department, identified himself as one of the five faculty members who wrote the meeting memo to Michalopoulos. He proposed what he called "an economically viable alternative" to the UPP-UPMC merger: "Faculty could remain under the control of the dean," Bircher said. "They [faculty] would be rented back to the UPMC Health System at a rate the dean determines and for the percentage of time that the dean determines. Otherwise, the 'U' comes out of UPMC." Bircher bristled at Michalopoulos's suggestion that he and his fellow letter-writers were "cowardly," as Bircher put it. "I can hardly be accused of standing in the background and not being critical of the present administration," said Bircher, a frequent critic of UPMC and Pitt Health Sciences officials. Bircher added that it wasn't his idea to send Michalopoulos an unsigned copy of the memo.

Regarding the request for a special meeting with an agenda drawn up by faculty, Bircher said: "I represent the clinical faculty at the grunt level. We as a group are tired of being treated as a group of homeless children to whom the rules of the orphanage are being introduced. And that is exactly the way the process has gone.

"We show up at meetings, we are told what is going to happen, we are told that we will become a wholly owned subsidiary of a system which — if you look at how they treat their nursing staff — no one would elect to work for. And we have no say in it whatsoever." After Bircher claimed that UPMC Health System President Jeffrey Romoff has "summarily removed" medical school department chairpersons who challenge his authority, Michalopoulos asked Bircher for an example.

Roger Simon of neurology, Bircher replied.

Michalopoulos said he and Senior Vice Chancellor Detre decided to remove Simon as chairperson. "Jeff Romoff had nothing to do with it whatsoever," Michalopoulos said.

Senate President Gordon MacLeod concluded the discussion by asking Assembly members to vote on the motion requesting a medical faculty meeting this month. The Assembly approved it by voice vote.

–Bruce Steele