Document from the collections of the AAMC Not to be reproduced without permission THURSDAY, WEDNESDAY, 9:00am 6:30pm 1:00pm 2:30pm 8:00pm One June June Dupont 30, COUNCIL 29, Washington association medical JOINT Farragut EXECUTIVE Monroe Monroe West Dupont COTH COTH Chevy COTH Circle, 1983 ADMINISTRATIVE 1983 June MEETING ADMINISTRATIVE ADMINISTRATIVE ADMINISTRATIVE OF N.W./Washington, ADMINISTRATIVE Chase East Room TEACHING 29-30, Room COUNCIL Hilton SCHEDULE Room colleges 1983 BOARD Hotel HOSPITALS BUSINESS D.C. BOARD BOARD BOARD of BOARD 200381(202) american MEETING MEETING DINNER LUNCHEON MEETING 828-0400 Document from the collections of the AAMC Not to be reproduced without permission IX. IV. VI. I. III. VIII. VII. V. XI. X. Payment Plan of Loan Department Teaching Review ECFMG and Statement B. Match A. Adjournment Call COTH Consideration Research o o o Initiatives Staff Membership to Membership Forgiveness Constitutional Issues Philadelphia, The of St. Baptist Birmingham, Wichita, for ADMINISTRATIVE COUNCIL Action Order Setting and Careers Report of Washington 1983 of Joseph Germantown Physician Principles Medical Teaching of for June 9:00am-1:00pm Medical Applications COTH OF AGENDA Kansas Minutes for Medical TEACHING Dealing Alabama 30, Spring Physicians Pennsylvania Hilton Center Issues Hospital Services BOARD Centers Hospitals 1983 on Center Meeting with NIH HOSPITALS Hotel MEETING in PGY-2 in Activities a Executive Executive Agenda Executive Executive Agenda Agenda Agenda Executive Agenda Page Page Page Page Page Page Page Page - - - - - page page page page page 62 Council 57 49 Council 10 36 29 28 1 Council Council Council 18 60 68 56 78 Document from the collections of the AAMC Not to be reproduced without permission John James Joseph STAFF Mary Kat Thomas Richard Nancy Melissa August William John Sheldon Glenn C. Irwin Spencer PRESENT James Jeptha Robert Earl Mitchell Haynes Thomas S. A. M. V. J. E. D. R. Goldberg W. J. C. G. Turner E. Rice, W. M. McGrane H. D. Sheehan T. S. Foreman, Frederick, Seline Bentley, Mitchell T. Association Bartlett, Kennedy, Isaacs Swanson, Smith Frank Dalston, Knapp, Cooper, Robinson, Wubbold King Rabkin, COTH Chairman MD PhD PhD Administrative Jr., MD MD PhD MD, Chairman MD, AHA -Elect of Secretary April MD Immediate American Representative 21, Medical Board 1983 Past Meeting Chairman Colleges I. Call to Order order at 9:00am in the Mr. Frederick called. the:meeting to Before moving Farragut Room of the Washington Hilton Hotel. by tradition the COTH ahead to the agenda, be indicated that Past Nominating Committee' is chaired by the'COTH Immediate one at-large Chairman, and includes the current Chairman and Committee, appointed member. Dr.. Rabkin will chair the Frederick has Mr, Frederick will serve with him, and Mr.. in Miami appointed Fred Cowell of Jackson Memorial Hospital Diir. Cowell has agreed to be the third member of the Committee. the first to serve. A memorandum will go out to the membership week in May asking.fOrtheir suggestions. agenda before it Mr. Frederick stated that the Board had a full and add a so he planned to get through Item VIII by 10:30am; of what needed discussion Of the Medicare cost report to the list Cooper and to be discussed by 10:30am. At 10:30am, Dr- remainder of Dr. Kennedy were to join the group to discuss the no need to discuss the agenda. Thete.was consensus that there was agenda Item XI - MCAT related projects.
Consideration of the Minutes to approve the ACTION: It was moved, seconded, and carried minutes Of the -April 21, 1983 Administrative Board Meeting.
III. Membership Applications Based on staff Dr. Bentley reviewed the Membership applications. action recommendation and Board discussion, the following was taken: to approve ACTION: It was moved, seconded, and carried
(1) LUBBOCK GENERAL HOSPITAL, Lubbock, Texas for full membership;
THE METHODIST HOSPITAL, Houston, Texas for full membership;
(3) LATROBE AREA HOSPITAL, Latrobe, Pennsylvania for corresponding membership;
(4) TULSA MEDICAL EDUCATION FOUNDATION, INC,, Tulsa, Oklahoma for corresponding membership.
During the course of discussion with regard to membership was raised, applications, the issue of the size of residency programs Hospital particularly in the context of discussing the Germantown of whether and Medical Center application. In addition, the question • Document from the collections of the AAMC Not to be reproduced without permission a the Dr. "Ethical Paul recommended VI. San choice V. of of be that surrounding education. Mr. meeting. for IV. the Dr. discussion These ACTION: ACTION: of on required based all set in American addressing this questions Knapp Francisco. Frederick meeting Knapp past consortia members a Starr, of Baltimore, matters organization if United Criteria Location program COTH discussion, consensus Concerns 11 to indicated arrangements The reviewed at that since Following Medicine, author General medical years. of belong related States reviewed the general should and the should less It full programs. staff for the appointments information Center that It application a for It of the Maryland. consortium 1978, financing and June a was was statements was 1985 of the extent chiefs maintaining as Entry that He Session service discussion than or in the
staff constitute to to might be Economic subject this the moved, moved, be a agreed the could titles Administrative began part-time the and COTH prepare following this condition the planned 50 held in book of to six make discussion interim with of indicated Following (and be was at residents of or Spring Graduate policy not the seconded, service which seconded, - matter that that for of the over 3 cities Realities". entitled, an the of the membership education 2 discussed arrangements a a regard be around cost) changing discussion basis. - the appropriate report the list Germantown actions of were San 1983 any hospital's the until statement made Meeting were or acceptance that that Medical there COTH issues brief Board and Diego of and of salary to staff and circulated the AAMC chiefs in The that the foundation also ethical graduate as less COTH medical were was will the General carried carried San discussion, general was meeting. by to would Social was Annual surrounding June acquire Hospital had Education speaker will money medical raised. discussed. meeting suggesting members than of taken: Francisco. have a have of the been general values education school meeting, in be medical Session be to that the theme Meeting Transformation four was should the been possibility more the the for direct prepared staff and derived in which A group in it available the meeting and membership residency faculty Based number fall sites second that the title, 1984 consensus Medical the was over and be on and issues the have from and will for a for in 3
winter of 1982, and which were endorsed by the Executive Council at its January 1982 meeting. The one change is an addition that requires that the criteria, apply to all fifth pathway students as well as other individuals who are to enter graduate medical education programs.
ACTION: It was moved, seconded, and carried to recommend that the AAMC Executive Council approve the policy statement as worded in the Executive Council agenda book.
VII. Elaboration of Transitional Year Special Requirements permission permission August Swanson, MD, Director of the AAMC Department of Academic Affairs joined the Administrative Board for a discussion of this without without item. There was extensive discussion of the purpose of transitional programs and the extent to Which they Complicate the environment and to some degree increase the costs of education. However, Mr. Frank pointed out that the policy decision concerning the reproduced reproduced ,establishment of the transitional year residency is already be be accepted and the purpose of this document is to set forth the
to to special requirements for review and accreditation of these programs. Not Not ACTION: It was Moved, seconded, and carried to recommend that the AAMC Executive Council approve the Special year residency. AAMC AAMC for the transitional
Requirements the the
VIII. Medicare Cost Report of of
While several major hospital and healthcare organizations are supporting the elimination of the Medicare cost report, AAMC staff general impression that COTH members have more collections collections have been of the :to lose than gain from the report's elimination. To ensure that the the staff was reflecting the position of the Administrative Board, a
supplemental' agenda' item requested the Board to consider whether from from the AAMC should advocate elimination or retention of the cost report, and cited advantages of eliminating or retaining the cost report. in an active discussion involving numerous board members, it was of the cost report involved relatively Document Document agreed that (1) preparation small incremental costs for COTH members; (2) some advantages for eliminating the cost report were disadvantages for COTH members (i.e., forces HCFA to set prospective rates for all hospital services and prevents cost data from being used to set prospective prices); and (3) the cost report provided the data base for payment systems modifications, adjustments, exceptions, and analysis. At the Same time, board members felt that the benefits of the cost report 'could be enhanced if the report itself was modified and reduced to retain primarily the items necessary for prospective payment system design, execution; and evaluation.
4 Document from the collections of the AAMC Not to be reproduced without permission • • considering students those emphasized, directors Dr. available. have programs are taken directors director X. members environment national number related and pointed alert Each are departmental examples current chairmen, dean Southern to designed job hospital. Thus, They IX. payment they discussion Dr. became He the ACTION: review indicated Cooper the beginning in Council Cooper been two and also covered who but participants the of Medical National Regional Reimbursement apparent presenting forthcoming out that to provisions for matching applying could of day four seminar Deans to compete developed residency there and and AAMC the recognized discussed the with joined He the have where that the of hospitals use calling this seminar chairmen, more that the to at of legislation then Education) have recently staff Meeting, Deans should It modified, establishment Residency was monitoring them in Seminars the contributed implement. there least his be for for was program the unique material the the Donald was of to subsequent independent alerted program a a teaching made single for this will colleagues, and Spring the has residency and joint an general important dean, the and new Board advocate moved, are one and issued that early excellent AAMC directors available value Young, developed on less sign and/or topic Matching DRG-based provide Medicare and physician a and hospital than having the directors uniform departmental learning Meeting. - Prospective meeting to The physician great the seconded, of contribution consensus its discussions, burdensome 4 5 decisions). up control hospital of retention of a positions Board briefly. management MD could -- a place Deans seminar hopefully reduction students a implications getting the task Program the idea. many of a on legislation and match detailed prospective director reimbursement to experience. proposal have that closely opportunity a However, be -based regulations. excessive systems NRMP would Truman discuss and force on seminars regional Payment chairman will absorbed of Medicare and He (e.g., this outside several begun would the (Trends consequences at particularly carried and These in an noted discussion from welcome call to also physician least that affiliated Esmond overall that part in information in on this appropriately that payment and convince requirements to certain be directed basis actions, and a No to effectively. greater under the prospective cost attention the matching that in address a that skirt of to some major two agenda Physician the Dr. action specially the engage did Graduate the time GME NRMP. provide the to report. regulations an departmental system, of and TEFRA at the AAMC specialty institutions Cooper opportunity a hospitals. program the hospital at affiliated the depth. increasing positions he issues the Board fine to the item. allocated plans was provide in AAMC to hospital was on at key an It 5
Dr. Cooper explained that in the mid-1.970's, the number of positions offered in the match and the number of U.S. graduates maintained a ratio of 2:1. He stated that this ratio is getting close to unity in the current year and has created a great deal of concern among the deans. Be noted that other issues highlighted at the Deans Spring Meeting in relation to residency training were the lack of primary care/ambulatory care teaching opportunities and the need to identify new sources of revenue to support programs.
XI. The President's Commission for the Study of Ethics in Medicine and Biomedical and Behavioral Research: AAMC
Support for Renewal permission permission The authority for the President's Commission for the Study of Ethics in Medicine and, Biomedical. and Behavioral Research expired on without without March 31, 1982, but Senator Edward Kennedy is -attempting to renew its authority through fiscal year 1986. Dr. Thomas Kennedy told the Board that the Senator had requested the AAMCs support for this effort.- Dr. Kennedy referred the Board to page 29 of the Executive reproduced reproduced Council- agenda for background information on the issue. He informed
be be Board members that Senator Kennedy's proposal had. already received
to to support in Congress without being introduced as a bill. Not Not Mr. King stated he favored the Kennedy proposal because current ethical medical questions, such_as the "Baby Doe" issue, will
continue to be a problem. Dr. Rabkin concurred, suggesting that the AAMC AAMC Commission was a body from which one could expect a more thoughtful the the approach than that exhibited by FIBS in issuing its "Baby Doe" of of regulation.. Mr. Robinson stated that the AHA probably would support the bill, but it Was waiting to hear the arguments of hospital
direCtOrs opposed to the Commission. collections collections Dr, Kennedy described.,the,problems.he foresaw with renewing the the the Commission, which were (1) the executive director has been difficult to deal with; (2) the enthusiasm of the current from from Commission members is waning; (3) recent appointments to the Commission have been disruptive; and (4) in the absence of a specific set of issues to address, the Commission appears to be a
body in search of a problem. In response to Dr. Kennedy's concerns Document Document Dr. Foreman suggested that the Association ought to support the concept Of - a national independent body to examine ethical issues. This suggestion met with general approval. No furtheraction was taken.
XII. Legislative Update
Dr. Kennedy and Ms. McGrane presented an overview on activities related to NIH Budget and. Renewal legislation and Animal Welfare bills now in Congress. They noted that the proposed FY 1984 NIH budget is approximately $4,077 million, some $73 million more than .the previous year. Because the Administration desired 5,000 new and competing renewal research grants, the NIH has redistributed about $141 million to these grants from other programs such as - 6 -
centers, clinical trials, and biomedical research support grants. The AAMC and 127 other organizations have called for a minimum $487 million increase in the FY 1984 NIH appropriation in order to adequately maintain current programs and provide $33 million for growth.
Dr. Kennedy reported that for the third time since 1979, the Congress has embarked on yet another effort to reach consensus on legislation renewing a number of expiring authorities for the NIH. As in the past, the House and Senate have adopted very divergent approaches: the Senate bill sponsored by Senator Orrin Hatch, albeit with important exceptions that seem to grow permission at every stage of the legislative process, provides for a simple reauthorization of expiring authorities; the House version, introduced by Rep. Henry Waxman, includes in addition to necessary without renewals, a host of disease-specific "baubles", managerial directives and a major recodification of Title IV of the Public Health Service Act. reproduced Dr. Kennedy noted that Rep. Waxman was using his bill as a vehicle be to offer favors to his colleagues in the House, while the Senate to sponsors have been a great deal more statesmanlike. He explained that Rep. Madigan Not had approached the AAMC for support of a counterproposal by him in the House that would call for a simple reauthorization. However, Mr. Madigan's bill could be defeated in the Health AAMC Subcommittee which Mr. Waxman chairs and which is well stacked in his favor. He believed chances were somewhat better in
the the full Committee, but that it would be difficult of at best.
Animal welfare legislation has been introduced by several members of Congress. Rep. Walgren was successful in his efforts to append animal welfare amendments collections to the House NIH renewal legislation. These amendments pose significant problems and the AAMC opposed the them. Rep. Madigan offered a substitute amendment which would require a comprehensive 18-month study of current animal welfare
from activiites by the National Academy of Sciences. At present, the amendment and the similar legislation introduced in the Senate by Senator Hatch have been supported by the AAMC. Senator Dole
Document has also sponsored a bill which presents considerable problems.
XIII. Regulation on "Nondiscrimination on the Basis of Handicap"
Dr. Knapp described the highly emotional atmosphere surrounding the issuance of these regulations dealing with the withholding of nutrition or medical treatment from critically ill infants. He asked Ms. Seline to describe the problems with the rule and what had transpired since its issuance. Ms. Seline referred the Board to page 32 of the Executive Council agenda for background information on the issuance of the rule. She then informed the Board that after the agenda item had been prepared, the AHA, the Hospital Association of New York State, and Strong Memorial Hospital had filed suit in the Federal District Court in New York They raised similar issues to those in the AAP, NACHRI suit,
7 summarized in the agenda, and requested a. temporary restraining order. The New York judge issuedthe TRO. Then on April 14, the District Court judge in Washington struck down the rule in a decision that is applicable nationwide. His decision was based soley on HHS' failure to follow normal procedures in issuing and implementing the rule; however, he. used strong language in denouncing the rule's substance.
The Board *briefly discussed this item... Several .members expressed Concern over the manner in which HHS intruded into the practice of medicine and the involvement of individuals with little knowledge
of the issue. peithission peithission ACTION: It was moved, seconded, and carried that it be recommended that the Executive Council instruct without without the Association to write a letter to HHS in response to this rule.
XIV. Department of Teaching Hospitals Activities and Initiatives reproduced reproduced be be Dr. Knapp indicated that during the past three years there has been to to particular emphasis on the. issues of diagnostic case mix and hospital
payment methods. Five publications have resulted from this effort. Not Not Attention to this subject will remain high; however, data gathering and publication efforts will not be pursued with the same intensity. for a review of the department's project
AAMC AAMC The time is appropriate activities. The first set of items concerns the matter of educational
the the programs or seminars on case mix prospective payment. Dr. Knapp of of indicated that for the time being this issue was covered in Dr. Cooper's report on the seminars being designed .for the dean, department chairmen, and teaching hospital colleagues. Given the
limited amount of time available, he suggested that this item be collections collections placed on the June agenda for review once again, but that the matter the the of medical education costs in teaching hospitals be discussed briefly in the time available. There was considerable discussion of from from the various ways to think about the costs Of graduate medical education. The point was made several times that in some services and at the higher levels of graduate medical education, the service by the resident more than compensated for the stipend the Document Document provided resident was paid. In other words, in the absence of the resident, other physician, nursing or allied health manpower would have to be hired to provide the service. At the Same time it was recognized that the extent to which this conclusion may be reached depends on the level of the house officer and the extent to which medical students are involved in the provision of the service. The overall cost picture depends on the mix of programs and involvement of undergraduate medical students as well as the mix of first year and senior level house officers. Document from the collections of the AAMC Not to be reproduced without permission • other function It The would a cost the educational discussed can at enough XV. consensus the was enough advent meeting would be, alternative June also Adiournment net where given under in revenue of revenue pointed that was support Board the HMO's, educational the any adjourned this long forms meeting be can out payment the review preferred generated issue run be that of proper at and generated financing, support probably of levels should 9 the 12:50pm. 8 should departmental use provider to issue for is support of be to not be deemed a the this of support various organizations the major be "allowability" question the the activities. net first to item revenue. issue. types educational education, be item for will needed. of and The to discussion services, be of There issue be and With whether the is was COTH Membership Requirements
At its April meeting, the COTH Administrative Board asked staff to review
Council membership criteria to ensure (1) a clear and consistent distinction is
being made when applicants are categorized as corresponding or full members and
(2) that cOrresponding membership in the name of a non-hospital entity such as a
consortium is not being used to avoid participatiOn as a full Council member. In
addition, the Board sought information on hospitals .which appeared to qualify for
full membership but which had never elected to join the Council. This report
permission permission presents background information on COTH membership and discusses each of the
issues raised by the Board. without without
BACKGROUND reproduced reproduced
be be The Council of Teaching Hospitals was organized within the Association of to to related Not Not American Medical Colleges in 1965 to provide representation and services
to the special needs, concerns and opportunities facing major teaching hospitals. AAMC AAMC
Originally limited to a single class of "full" teaching hospital members,
the the of of corresponding membership was added in the mid-70's to provide hospitals with
small medical education programs and other medical education entities with an collections collections
opportunity to receive AAMC mailings and participate in open COTH meetings.
the the from from Under present membership practices, full teaching hospital membership is
limited to not-for-profit -- IRS 501(C)(3) -- and publicly-owned hospitals which Document Document sponsor, or significantly participate in, at least four approved, active
residency programs. At least two of the approved residency programs must be in
the following specialty areas: internal medicine, surgery,
obstetrics-gynecology, pediatrics, family practice, and psychiatry. Other
considerations evaluated in determining a hospital's participation in medical
education activities are:
1
10 Document from the collections of the AAMC Not to be reproduced without permission • to exceptions (e.g., specialized services specialty For increase In psychiatric membership the participate the • • s e Teaching to Non-profit case consortia, them; the the the the education. the the education; year medical proportion and annually hospital to may of objectives institutions significance significance availability number proportion presence publications. 1983-1984, the and hospital speciality in apply school and the foundations, requirement based of meets which governmental of for internship AAMC's (in of members and full-time teaching on the - of of and are corresponding the hospitals the full-time the the the the In filled activity membership governance, of hospital. degree increase federations) receive addition, COTH hospital's hospital's four and hospital hospital chiefs -- by Administrative equivalents) residency of of residency the foreign such membership. criteria in the their of organization, undergraduate membership and financial educational full the as service not medical medical children's, medical positions cost COTH programs range eligible within which Board or of representatives Corresponding school's support dues of education director clerkships; graduates; and living programs the are
in provided AAMC for is are committee rehabilitation, filled, framework relation authorized for teaching involvement and $2,275. index. to of organizations medical that Council members the medical and are to structure. of hospital the affiliated Dues the eligible to bed the in are and make size, Document from the collections of the AAMC Not to be reproduced without permission eligible the Memoranda; eligible for following Housestaff affiliation and corresponding which publications: applications are Differentiating evaluating surveys. increased Board's • • • The COTH are members clinical members affiliation members scope to for Administrative eligible is characteristics: COTH, Policy; attend agreement quarterly teaching -- organized annually membership. Corresponding of COTH membership are Types which have belong the CAS, education for all COTH Report; hospitals with major clerkships and of meetings. and must hospital to teaching open as within Executive Board COTH an the COD corporate applications reflect for educational include membership President's AAMC accredited of organized dean's Memoranda; Members the or undergraduate hospital and the Council meetings Salary changes corresponding AAMC a organizations residenciesprovided letter copy to dues commitments so U.S. to Weekly 12 Survey; Journal membership and in of determine that provide are of recommendation medical the the of and to Activities its Teaching membership. presently cost of and receive graduate hospital rather full both as Medical are school. whether other of reflected
not patient members the living than Hospitals -medical and $770 Report; medical periodic eligible Education; the following Completed the -- as per index. care applicant reflect by are formal individuals, Assembly students, school year. is the
publications for services. reviewed responsible Survey size Hospitals the Dues is and of at and and The first two characteristics are easily operationalized into membership
criteria. The third, the major teaching hospital dimension, is more difficult,
especially because the operational criteria for this dimension generally
separates full and corresponding members. Using the 1983 COTH Membership
Directory, Tables 1 and 2 provide an empirical description of the present, full
COTH members having small numbers of residency programs or residents. Table 1,
which shows general hospitals, shows that three present members report less than
the minimum of four programs: permission e VA Medical Center 2 programs
Clarksburg, West Virginia
without
e Iowa Methodist Hospital 3 programs reproduced Des Moines, Iowa
be
to
Not e Ball Memorial Hospital 3 programs
Muncie, Indiana
AAMC
the of Under present membership criteria, each of these hospitals should be
re-classified as a corresponding member. When the data on number of residents is
collections examined, seven additional hospitals are found to have less than 30 FTE the residents:
from
e Hospital of the Good 6 residents, 10 programs
Document Samaritan
Los Angeles, California
e Jewish Hospital 8 residents, 4 programs
Louisville, Kentucky
13 Document from the collections of the AAMC Not to be reproduced without permission distribution a members members While While with residents, presence hospitals require Infant's minimum an Table some the additional a with with of Hospital • • • • minimum with number Board of 2 given 9 San Riverside St..Mary's four shows Riverside, Rochester, Tuscon Tuston, suggests at VA West VA these residents major Medical Medical is least the Francisco, of of or Roxbury, in quantitative COTH authorized seven Medical residents educational more either Providence Arizona number that four Hospital Center California Center Hospital at member New hospitals residencies Massachusetts criteria Schwab programs California Center of York 21 to is specialty or programs, yardstick would commitments. set make Rehabilitation 30 for may have as FTE exceptions appear have 14 full a have Subgroup hospitals between residents. for membership less 10 21 25 24 26 -use to incorrectly COTH residents, residents, residents, residents, residents, than require and 30 for membership in C with and in determining criterion. This specialty 30 12 Table fewer 40 residents specific residents at reported 8 17 5 11 11 would residents. programs programs programs could programs 1 programs than shows hospitals, provide general consideration the while 4 be six residencies. Women expanded number This the 18 COTH the and Board of to if Staff Recommendation
In order to help promote a commonality of interest among hospitals with full
membership in the Council of Teaching Hospitals, it is recommended that hospitals
with fewer than 30 residents be classified as corresponding members.
It is further recommended that staff annually validate the data on general
hospitals with full membership reporting fewer than 4 residencies or 30
residents. If the hospital cannot show 4 or more programs or 30 or more
the be reclassified as a corresponding permission permission residents, it is recommended that hospital
member. without without
Consortia as Members reproduced reproduced
be be In the past decade, many hospitals have established multi -unit systems, to to
consortia, and associations in efforts to adapt to the changing hospital Not Not environment. Under the present COTH membership criteria, a group of hospitals
AAMC AAMC each presently eligible for full membership could minimize their dues by joining the the of of as a system, consortia, or association. Not only would fewer entities pay dues,
but the non-hospital nature of the applicant entity would result in its
collections collections classification as a corresponding member. the the
from from In addition to the reduction in dues revenue, membership in the name of a
non-hospital entity alters the relationship between the AAMC and the nation's
Document Document teaching hospitals. Currently, AAMC staff have direct access to hospital
executives because the hospital is the member and the CEO is generally the
institutional representative. If hospitals joined as groups, membership
services and staff requests would flow via the new entity to the hospital. Staff
believe this would dramatically reduce the effectiveness and usefulness of the
Council. Staff Recommendation
In light of the Council's purpose to serve the needs of hospitals and the adverse
impacts group membership could raise, it is recommended that corresponding
membership for multi -hospital systems, consortia, foundations, and associations
be granted only when each hospital qualifying for full membership within the
entity has joined as an individual member.
It -is further recommended that the Southwestern Michigan Area Health Education,
Center-which joined as a corresponding member in 1978 and which includes at least peithission peithission two nonmember hospitals in Kalamazoo be allowed to continue its corresponding without without membership. "Grandfather" .status should also be Considered for the Tulsa Medical
Education Foundation which joined in April, 1983. reproduced reproduced
be be Potentially Eligible Non-Members
to to Not Not Table 3 contains a list of non-member general hospitals listed in the
AAMC AAMC .ACGME's 1983/1984 Directory of Residency Programs which meet two criteria: the the of of medical school affiliation and at least four residency programs including two
from the COTH-required six. For each hospital the number of operating beds is
collections collections shown. Where a hospital has only a limited or graduate affiliation, that the the
relationship is identified. It should be recognized, however, that not all of from from the listed hospitals probably have the necessary signed affiliation agreement
with a college of medicine. Document Document
With the exception of a small number of public hospitals and two university
hospitals (Tulane and Tennessee at Knoxville) the list appears to include
primarily community hospitals expected to have relatively small residency
programs. Any effort to recruit new members from the listed hospitals should
concentrate on the few major institutions included in the list.
16 Document from the collections of the AAMC Not to be reproduced without permission •Subgroup Subgroup Subgroup St. St. Roger Stamford Methodist, Mary Riverside VA Wake St. St. Emanuel, Harrisburg Hamot, Miriam Crawford Public VA Iowa Jersey Episcopal Hospital Franklin Ball Berkshire Presbyterian, United Worcester VA Tuscon Jewish Frankford Hospital VA Madison VA VA Medical Medical Medical C: B: Medical Medical A: Medical Francis, Mary's, John's Luke's, Imogene County, Methodist Memorial Williams, Erie Sponsor of Shore Health Sponsor Health Medical Hospital, of Hospital, Sponsor of COTH
General Portland Hospital, of Square, Long, less Hospital, Hospital, Medical City at Hospital, less Dallas Center, Center, Center, Hospital Mercy, Center, Center, Center, Rochester Good Milwaukee General Basset, Tulsa NC Medical least Services, Hospital, Hospital, Dallas than Atlanta or Hospital Center Hospital or or than Providence Samaritan, Providence Baltimore Louisville St. participate Center participate participate Des Shreveport CT White West San 40 Clarksburg, Philadelphia CA 40 Philadelphia Hospitals 40 Cooperstown Center Louis NY residents. Moines residents. Francisco FTE Johnson Seattle Roxbury Muncie River Table residents. Los in in in with 17 Junction WV City Angeles more 4 1 4 or Small or than fewer fewer Programs Residencies Number 4 residencies 10 10 12 14 10 17 11 11 residencies 12 6 6 6 9 9 7 residencies 5 5 8 9 9 7 4 4 5 5 7 4 4 4 4 4 3 3 2 4 4
of Residents Reported 62 34 87 33 32 52 95 35 34 34 51 24 33 33 39 10 32 37 30 38 with 26 21 47 40 48 33 35 36 39 32 30 31 25 with 6 6 having 8 a a total total a total Document from the collections of the AAMC Not to be reproduced without permission • St. Hospital Schwab Women Hospital Western Chicago Boston COTH Margaret's and Rehabilitation Specialty Psychiatric, for Infants, Special Hospital Hospitals Providence Pittsburgh Surgery Hospital, for Table with 18 Women, Three 2 or Fewer Programs Number 1 1 1 3 1 Residencies of Reported Residents 55 12 19 40 9 Table 3
• List of General Hospitals which are Potential COTH Full Members
Alabama Carraway Methodist Medical Center 617 beds Birmingham
Cooper Green Hospital 191 beds Birmingham
Lloyd Noland Hospital 309 beds Fairfield
permission Arizona Kino Community Hospital 213 beds Tuscon without California David Grant USAF Medical Center 290 beds Travis Air Force Base reproduced
be Kaiser Foundation Hospital 479 beds to Fontana Limited Affiliation
Not Kaiser Foundation Hospital 584 beds Los Angeles Limited Affiliation
AAMC White Memorial Medical Center 377 beds the Los Angeles of Highland General Hospital 270 beds Oakland Graduate Affiliation collections Kaiser-Permanente Medical Center 263 beds the Oakland Limited Affiliation from Naval Regional Medical Center 276 beds Oakland
Kaiser Foundation Hospital 306 beds Document Sacramento
San Bernadino County Medical Center 315 beds San Bernadino
Naval Regional Medical Center 614 beds San Diego, California
Letterman Army Medical Center 380 beds San Francisco
San Francisco General Hospital 445 beds San Francisco
19 St. Mary's Hospital and Medical Center 525 beds. San Francisco
Santa Clara Valley Medical Center 427 beds San Jose
Santa Barbara Cottage Hospital 465 beds Santa Barbara Limited Affiliation
Kaiser Permanente Medical Center 329 beds. Santa _Clara Limited Affiliation
San Joaquin General Hospital 233 beds Stockton Limited Affiliation
Colorado peithission peithission Fitzsimons Army Medical Center, 554 beds
Denver without without Denver General Hospital 310 beds Denver
Rose Medical 'Center 400 beds
reproduced reproduced Denver
be be to to St. Joseph Hospital 551 beds -
Not Not Denver Limited Affiliation
Delaware
AAMC AAMC VA Medical Center 336 beds
the the Wilmington of of District of Columbia Providence Hospital 355 beds
Washington Limited Affiliation collections collections Reed Army Medical Center 962 beds the the Walter
Washington from from Florida St. Vincent's Medical Center 518 beds
Jacksonville Limited Affiliation Document Document Orlando Regional Medical Center 1004 beds Orlando Limited Affiliation
Baptist Hospital 520 beds Pensacola Limited Affiliation
Sacred Heart Hospital 339 beds Pensacola Limited Affiliation
University Hospitals and Clinics 128 beds Pensacola Limited Affiliatio411
20 Georgia Georgia Baptist Medical Center 525 beds Atlanta Limited Affiliation
University Hospitals 693 beds Augusta (not Talmadge Memorial)
Eisenhower Army Medical Center 759 beds Fort Gordon
Memorial Medical Center 465 beds Savannah
Hawaii Kaiser Foundation Hospital 166 beds
Honolulu permission permission
Kuakini Medical Center 250 beds
without without Honolulu
Queens Medical Center 506 beds
Honolulu reproduced reproduced 308 beds be be St. Francis Hospital
to to Honolulu
Not Not Tripler Army Medical Center 560 beds
Honolulu AAMC AAMC Illinois the the Columbus Hospital 530 beds of of Chicago Graduate Affiliation
• Frank Cunco Memorial Hospitals 186 beds
Chicago Limited Affiliation collections collections
the the Louis A. Weiss Memorial Hospital 372 beds
Chicago from from Ravensworth Hospital Medical Center 462 beds Chicago
Document Document St. Francis Hospital 469 beds Evanston
Indiana St. Joseph Hospital 414 beds Fort Wayne Limited Affiliation
St. Vincent Hospital 605 beds Indianapolis
Kentucky NKC, Inc. (Norton-Childrens) 553 beds Louisville
3 21 Document from the collections of the AAMC Not to be reproduced without permission Massachusetts Louisiana Maryland Michigan .Conway . Prince Pineville Kalamazoo Flint St. South Smith McLaren Boston Cambridge Cheverly Kalamazoo Ingham Earl Houma Greater Long NaVal. Monroe Mercy Baltimore Baltimore Baltimore Borgess Bronson Bethesda Baltimore Boston Cambridge Tulane University Lansing Lafayette. Baton New Agnes Orleans K. Memorial
Rouge Hospital Hospital Louisiana Baltimore George's City Medical Memorial Medical Hospital Hospital Long Methodist Baltimore . , Hospital Hospital Medical Hospital Memorial Hospital center Center General Hospital Medical County Medical Hospital Center Hospital Hospital General Hospital Center Center 22 '262 183 205 284 217 Limited 407 183 350 500 213 469 462 716 496 436 182 473 478 beds beds beds beds beds beds beds beds beds beds beds beds beds beds beds beds beds beds Affiliation Document from the collections of the AAMC Not to be reproduced without permission Nebraska New New Mississippi Missouri St. St. Albany Pontiac Pontiac St. St. Jersey St. St. Saginaw Lincoln Metropolitan Mercy Coney Keesler Omaha St. Jersey Saginaw Lansing Newark New New New New La Bishop Buffalo Royal U.S. United New New New William York Jersey Guardia Peter's Peter's York York York York York York Brunswick Louis Louis Louis Lawrence Louis Air Island Hospital Oak Hospitals Clarkson City City Hospital AFB Beaumont General General Infirmary/Beekman City City City City City Force County City Hospital Hospital Medical Medical Hospital Hospital Hospital (Bronx) (Brooklyn) Hospital Medical Memorial Hospital Hospital Medical Hospital Hospital Center Center Center Hospital Center 5 23 621 608 Limited 420 534 538 Graduate Affiliation 473 437 433 926 325 550 524 200 392 302 360 380 226 beds beds beds beds beds beds beds beds beds beds beds beds beds beds beds beds beds beds Affiliation Document from the collections of the AAMC Not to be reproduced without permission Ohio North North 'Jewish St. Riverside' Toledo Toledo Toledo St. Mercy Columbus Mt. St. Cincinnati Cleveland Fargo Grand Durham United Fargo Dakota Pitt Greenville Durham St. Syracuse Schenectady Syracuse Ellis South Crouse Oceanside Staten New Lutheran New Wyckoff New Vincent's Carmel Vincent Luke's Dakota Carolina Joseph's York York York County Hospital Forks -Irving Hospital Nassau Hospital Hospital Hospital County Island Heights City City Medical City Hospital Hospital Hospital Charity Memorial Hospital Communities Hospital General Memorial Hospital (Brooklyn). Hospital Center Hospital Hospital Hospital Hospital Hospital 6 24 .496 .Graduate 723 Limited 270 350 616 422 747 261 464 183 483 422 490 478 Graduate 401 532 Limited 422 437 beds beds beds beds beds beds beds beds beds beds beds beds beds beds beds beds beds beds Affiliation Affiliation Affiliation Affiliation Toledo Hospital 785 beds Toledo
U.S. Air Force Medical Center 350 beds Wright-Patterson AFB
Oklahoma Presbyterian Hospital 407 beds Oklahoma Graduate Affiliation
St. Anthony Hospital 684 beds Oklahoma City Graduate Affiliation
Hillcrest Medical Center 646 beds Tulsa
St. John's Medical Center 752 beds peithission peithission Tulsa
without without Oregon Good Samaritan 539 beds Portland
Hospital 451 beds reproduced reproduced St. Vincent's
be be Portland to to Pennsylvania Not Not Abington Memorial Hospital 469 beds Abington
AAMC AAMC Allentown Hospital 318 beds
the the Allentown Limited Affiliation of of Sacred Heart Hospital 205 beds Allentown Limited Affiliation collections collections St. Luke's Hospital 440 beds
the the Bethlehem from from
St. Vincent Health Center 605 beds Erie
Polyclinic Hospital 556 beds Document Harrisburg
Shadyside Hospital 464 beds Pittsburgh Limited Affiliation
Reading Hospital 622 beds Reading
South Carolina Charleston Memorial Hospital 154 beds Charleston
Richland Memorial Hospital 611 beds Columbia Document from the collections of the AAMC Not to be reproduced without permission -Utah South Tennessee Texas Salt Salt San El Fort St. Holy Houston Houston Temple VA Olin St. El El John Jefferson Beaumont Austin Brooke Sioux Sioux Central Knoxville Texas Thomason Nashville Nashville Metropolitan Baptist4-Hospital ColuMbia. Nashville University VA Paso Paso Paso Medical Medical Joseph Antonio Dakota Thomas peter Teague Lake Lake Cross Worth Tech Falls Valley Army Texas Army General Davis City City Hospital Smith Hospital Center Hospital Health Hospital Center Medical Veterans Hospital Nashville Medical Medical Hospital Hospital Hospital Center Center Center Foundation Center General 8 Hospital 26 Limited Limited 692 Limited 887 737 343 587 Graduate Limited Limited 465 404 319 1164 357 571 488 724 484 460 179 288 beds beds beds beds beds beds beds beds beds beds beds beds beds beds beds beds beds Affiliation Affiliation Affiliation Affiliation Affiliation Affiliation Virginia Arlington Hospital 350 beds Arlington
DePaul Hospital 402 beds Norfolk
Naval Regional Medical Center 524 beds Portsmouth
Roanoke Memorial Hospital 675 beds Roanoke
Washington Swedish Hospital Medical Center 653 beds
Seattle permission permission Virginia Mason Hospital 321 beds
Seattle without without Sacred Heart Medical Center 518 beds Spokane
reproduced reproduced Madigan Army Medical Center 340 beds
be be Tacoma to to
West Virginia Not Not St. Mary's Hospital 440 beds
Huntington AAMC AAMC Wisconsin the the La Crosse Lutheran Hospital 447 beds of of La Crosse Limited Affiliation
St. Mary's Hospital 440 beds
Madison collections collections the the St. Joseph's Hospital 524 beds
Marshfield Limited Affiliation
from from Document Document
9 27 MEMBERSHIP APPLICATIONS
Three hospitals have applied for membership in the Council of Teaching Hospitals. The applicants and the staff recommendations for type of membership are:
HOSPITAL STAFF RECOMMENDATION
Baptist Medical Centers Full Membership Birmingham, Alabama• permission permission • The Germantown Hospital Corresponding Membership Medical Center without without and Philadelphia, Pennsylvania
St.. Joseph Medical Center Full Membership
Wichita-, Kansas
reproduced reproduced
be be
to to
Not Not
AAMC AAMC
the the
of of
collections collections
the the
from from Document Document
28 Document from the collections of the AAMC Not to be reproduced without permission • II. Membership with IRS I. ** * A. 501(C)(3) INSTRUCTIONS: HOSPITAL HOSPITAL a For The were One medical (Adult (City) (Area Average Patient Title Total Licensed Hospital Hospital Name excluding expansion fiscal clinic not in of IDENTIFICATION OPERATING
of -- Live Code)/Telephone the occupied & school Birmingham Service Daily Hospital's year Pediatric at Address: Hospital's Bed Name: and Council COUNCIL Births: newborn): documents Complete Return information each programs Capacity publicly
Census: accredited 1981-82 Suite Council One Association Washington, DATA until Data hospital OF Baptist (Street) of the Chief Dupont TEACHING Chief all (for at (Section 200 Teaching APPLICATION November the completed Number: owned for (Section of both Sections 2.161 Executive 1 by Medical the hospitals for
Teaching Executive Circle, 877 BMC-Montclair 115* of D.C. HOSPITALS the hospitals 3201 hospitals ( most "C American V) Hospitals &
29 P application, Liaison IV), -4th 205
December, (I to FOR Centers r ‘ 20036 N.W.
recently (State) f Officer: -V) Hospitals •
actually Officer: the:
medical and MEMBERSHIP ASSOCIATION Ave. )
having added
Admissions: Visits: Visits: Medical of Committee is & the
this 322-9320 South BMC-Princeton 1982. limited completed had & 199 supplementary supporting a President Emmett Alabama surgical Clinic: Outpatient Emergency Colleges application. OF documented 916 licensed AMERICAN on to Johnson beds Medical fiscal not residents combined
Room: -for-profit MEDICAL in beds, or affiliation year) use. Education. (Zip) but COLLEGES 40,008 42,119 only. 3,612** these -- 35222 agreement Document from the collections of the AAMC Not to be reproduced without permission . A. MEDICAL C. B. Other: Psychiatry Pediatrics Family Medicine Surgery Clinical Ob-Gyn Please Providing academic Does Undergraduate Medical in Clinical Total Total Staffing Hospital Number Financial Number Education?: undergraduate NONE EDUCATION the Appointed Supervising With House Operating Payroll Practice complete of of Pathology Radiology year: Services Services hospital Data Expenses Clerkships Medical Personnel: Physicians: Data Staff DATA Expenses: to the Expenses: medical Stipends Faculty: YES for: the School with have following Education Hospital's Clerkships a Full Part Full full-time education Faculty & -Time -Time: Number -Time:
Fringe information 101,541,076 47,160,362 16 13 •Active Appointments: Salaried 3 of Offered
during salaried 3,475 Benefits: 721 Medical on the Chiefs Students Director your most Clerkships Number Staff: of 1,298,300 hospital's recently 349,000 Service Taking of 60 62 34 17 of 0 0 0 2
Medical 280 149 completed (list participation Elective Are Required Required Elective Elective Elective Elective or Required Clerkships services): Document from the collections of the AAMC Not to be reproduced without permission B. Graduate Please offered Type 'As in indicate Residency First Medicine Surgery Pediatrics Ob-Gyn Psychiatry Family Other: 2 Path Diag. Flexible Practice directors. should director. Flexible As Association graduate defined accredited of A Year Rad. complete & and be Medical only
C = reported filled. medical graduate by Positions First and/or FTE Offered the by the 57 24 Education 14 4 0 0 8 0 0 5 positions the year LCGME following education under the If program Council the residents Liaison Positions Directory Canadian the and hospital by acceptable reporting information clinical on 21 U.S. 14 8 3 5 individuals Committee Medical in Grads Filled of & 31 participates Categorical* Approved service only to Education on on two or assigned Medical full-time Positions your Graduate Residencies. of by
Foreign more in and hospital's the of Graduates 0 0 0 1 combined to 1
Categorical supervising Medical the equivalent Filled hospital applicant American
First participation programs, Education. Accreditation Date of program
positions hospital. programs program 1982 1972 1959 1944 1969 the Medical Year of ProgramL Initial , IV. SUPPLEMENTARY INFORMATION
To assist the COTH Administrative Board in its evaluation of whether the hospital fulfills present membership criteria, you are invited to submit a brief statement which supplements the data provided in Section I-III of this application. When combined, the supplementary statement and required data should provide a comprehensive summary of the hospital's organized medical education and research programs. Specific reference should be given to unique hospital characteristics and educational program features.
V. SUPPORTING DOCUMENTS
A. When returning the completed application, lease enclose a copy of the hospital's current medical school affiliation agreement.
B. A letter of recommendation from the dean of the affiliated medical school must accompany the completed membership application. The letter should clearly outline the role and importance of the applicant hospital in the school's educational programs.
Name of Affiliated Medical School: Univ. of Ala. School of Medicine
Dean of Affiliated Medical School: James A. Pittman, Jr., M.D.
Information Submitted by: (Name) John M. Packard, M.D. (Title) Director of Medical Education
Signr of Hospital's Ch Executive Officer: (Date))-ez,-- /6.F
Em2ett.Johnson Presieetit
32 Document from the collections of the AAMC Not to be reproduced without permission (DME) elects care warehouse who office affiliated, Medical Montclair a Additional its member community, continued stration being been budgetary and and a immediately in at corporate rather both 1982 organizational a continuing is centers; one management who trained of building the the "As The The The Because hospitals. activities Medical Baptist Centers." when This The of Centers quality complex have of both and and and with reports "In "Will Board Chief educational state the Department multi Baptist headquarters system Birmingham a a the our long Princeton; other administrative a witness last school been medical medical varying fulfillment people which high-rise Medical multi health Centers: bases the -hospital Executive of contract organization, Mission and participate directly tradition structure, supportive includes added, year. functions Trustees, Medical It institution, -hospital region. of houses for and to education of Baptist staff related is degrees programs Centers nursing which Statement the with one apartment Medical for communities headed the system. Officer of to SUPPLEMENTARY Centers of two Executive love support in the which owned and fine Our of a pertaining this the houses Hospital, a AAMC education services. of it system, co seeks and and in total management The rehabilitation by the programs -equal President. Education seems of dedication success that was of mission, reputation allied The sets and APPLICATION is carry complex an the 33 Mission Baptist for God FOR we of to the the of Committees opened a rewritten: internship Director Birmingham worthwhile two voluntary Etc. 900 for fully serve all improve forerunner policy through to STATEMENT system. on over corporate the including health, leased coordinates for we information the educational and Medical students undergraduate, to the Department we The its affirm by integrated the and hospital; entire education the The have enjoyed health the Jesus of were doors DME and providing pastoral Baptist ensuing community not to elderly officers; appoints of Medical the Baptist health Centers, -for-profit, of outline chairs that is Christ, started the system. medical system, and in professional various of and an was teaching two Association care The sixty present 1922. Education high Medical and ex status graduate provides hospitals Medical the research the -officio has ambulatory and briefly reaffirmed in The Baptist and laundry, handicapped; and libraries President, Education categories the years. Almost become a Baptist hospitals, have church Education. admini- general has - PAGE 2
all medical Committees at both teaching hospitals. Policy concerning which is education programs is made by the Medical Education Council, of the President, chaired by the Director of Medical Education and composed Vice Presidents the Executive Vice President for Finance, the Executive Chief Residents from 'both teaching hospitals, the Program Directors and the meets quarterly. of all residency programs. The Medical Education Council
Resources for educational purposes, including space, personnel written institu- and financial support, are allocated centrally according to tional policies.
Undergraduate medical education has been provided by the Baptist 0 to eighteen Medical Centers for at least ten years. At any one time, twelve or clerkships third and fourth year medical students are assigned for electives students (surgery and OB/GYN) at the Baptist Medical Centers. Most are sD, students from the University of Alabama School of Medicine, but occasional in 0 from other medical schools choose electives with us. The elective in cardiology at BMC-Princeton has been selected as the best- elective of Alabama -0 a community hospital by the graduating seniors at the University of Medicine for the past six years. -0 School 0 sD, Our residency programs consume most of our resources. An operational based system involving the residency program directors has been developed .0 the O on institutional policies for the selection of the teaching staff, among O selection of residents, the appointment of residency physicians residency the accredited programs, the addition of new or deletion of current dismissal programs, and for the supervision, evaluation and advancement or for the of residents. We have had a written policy assuring due process residents for over five years.
O We also undertake a periodic analysis of each program based on O the following factors:
1. The resident's evaluation at the end of each rotation of the rotation itself and of the attending physicians. 2. The faculty evaluations of the residents. at the semi-annual faculty 0 • 3. The evaluation of the program meetings. 4. The subjective impressions of the Program Directors and the Director of Medical Education based on discussions O with colleagues at the various national meetings of Program 121 Directors, Association of American Medical Colleges and the Association of Hospital Medical Education. • The evaluation of the results of the In-Training and American Specialty Board Exams. 6. Discussions at the quarterly meetings of the Medical Education Council. on Graduate 7. The period surveys by the Accreditation Council Medical Education, and its predecessor, the Liaison Committee on Graduate Medical Education. (None of our residency programs has been put on probation nor approval withdrawn in the past fifteen years.)
We are considering ways to formalize this periodic analysis of each program in order to involve the administration to a greater extent,
34 PAGE 3
and to provide written comments and evaluations. This may involve inviting Program Directors from other hospitals to make consultation visits between the formal surveys carried out by the ACGME.
Continuing medical education for the medical staffs of our major and affiliated hospitals is a rewarding (and time-consuming) part of the medical education program.
Both BMC-Montclair and BMC-Princeton have been accredited by the Medical Association of the State of Alabama for granting Category I credit for continuing medical education programs, according to the criteria for the Physicians Recognition Award of the American Medical Association. Over nine hundred conferences were given last year by our teaching staff supplemented by visiting faculty, and were attended by over 14,000 health permission professionals.
Support for our medical education programs should be judged without not only by the budget, personnel and facilities provided by the institution, but also by the strong support on the part of the medical staffs. Over 230 of the active and associate medical staff members, out of a total of 280, have applied for and been selected as voluntary faculty. Two- reproduced thirds of these have faculty appointments at the University of Alabama be School of Medicine. A considerable number were full-time medical school to faculty members before entering private practice. Not Our research efforts thus far have been quite limited, but the Board of Trustees has recently given approval for the position of Director
AAMC of Research,and we are currently recruiting a person of national reputation to stimulate more clinical research by our volunteer faculty. the of A final word is in order concerning our relationships with the University of Alabama Medical Center in Birmingham (UAB) which was recently formalized in the attached affiliation agreement. Departmental letters
collections of agreement have been in effect many years, as well as an affiliation agreement with the School of Community and Allied Health. As mentioned the above, medical students are regularly assigned to the Baptist Medical Centers for electives and clerkships. Some of our residents also rotate from to UAB for required or elective rotations, and a number of our volunteer faculty teach on a regular basis at UAB, while UAB faculty participate in lectures, consultations and teaching rounds UAB's Lister Hill Library
Document of the Health Sciences provides notable back-up for our two hospital medical libraries. The relationships between the School of Medicine and the Baptist Medical Centers has been cordial, enduring and mutually beneficial. Our formal affiliation agreement will strengthen these ties and ensure a continued association to the mutual benefit of the hospitals and the teaching program of the School of Medicine. The University of Alabama in Birmingham University of Alabama System Medical Education Program/Office of the Executive Dean (205) 934-5391 University of Alabama School of Medicine / (205) 934-5391 College of Community Health Sciences, Tuscaloosa / (205) 348-7942 School of Primary Medical Care, Huntsville / (205) 539-7757 May 11, 1983
Richard Knapp, Ph.D. Executive Director Council of Teaching Hospitals One Dupont Circle, N.W. Washington, D.C. 20036
Dear Dr. Knapp:
The undersigned, as Dean .of the University of Alabama School of Medicine, UAB, has reviewed the application of the Baptist Medical Centers for membership in the'Council of Teaching Hospitals--Associa- tion of American Medical Colleges. The data and information, as they relate to the School of Medicine and our relationships, are accurate and factual.
Over the past several years, prior to the development of our recent-formal affiliation agreement, the Baptist Medical Centers, through a number of informal arrangements with our various depart- mental chairmen, had developed a substantial number of cooperative programs in undergraduate and graduate medical education. Through these arrangements, the Centers have provided clinical experiences for our residents in some specialties that are not available in our University Hospital or in our other affiliated hospitals. Our resi- dents will now have these experiences through our formal affiliation agreement. Further, the Centers have provided both elective and required clerkships annually for a substantial number of our junior and senior medical students.
In summary, the Baptist Medical Centers are community hospitals of widely recognized excellent teaching programs in undergraduate and graduate medical edutation and other health professions. It is my opinion that the applicant fully meets the criteria for COTH membership and that approval of this application will add excellent teaching hos- pital Members to the Alabama membership of the Council. Sinc
James A. ittman, Jr., M.D. Dean University of Alabama School of Medicine
University Station / Birmingham, Alabama 35294 An Affirmative Action / Equal Opportunity Employer
35 Document from the collections of the AAMC Not to be reproduced without permission II. Membership with IRS I. A. 501(C)(3) INSTRUCTIONS: HOSPITAL HOSPITAL a medical (City) (Adult (Area Average Title Total Patient Licensed Hospital Hospital Name excluding in ' of
IDENTIFICATION OPERATING . of 1 -- Code)/Telephone the . _ l & ivetiths: school Philadelphia _Daily Service Hospital's Pediatric Address: Bed Hospital's and Name: Council COUNCIL newborn): documents Complete Return information Capacity publicly Census:
accredited Association Suite One Council Washington, DATA Data The OF (Street) the of Chief Dupont
TEACHING Chief all Germantown (for (Section 200 APPLICATION Teaching completed Number: owned (Section of Sections ended: Executive by 282 218 361 the
Teaching Executive Circle, of D.C. HOSPITALS the hospitals One most ( American V) Hospitals
Hospital 6/30/82 application, Liaison IV), 215 (I Penn to FOR 36 20036 N.W. recently (State) Officer: -V) Hospitals • Officer: the: and MEMBERSHIP ASSOCIATION ) Boulevard
having
Admissions: Visits: Visits: of Medical Committee and is the 951-8000 this
Pennsylvania limited completed Presi Medical Mr. supplementary supporting a Clinic: Outpatient Emergency Colleges application. documented OF Joseph den AMERICAN on to Center t Medical fiscal not F. Room: -for-profit MEDICAL or Farrell affiliation year) Education. (Zip) 25,210 50,101 8,597 COLLEGES -- 19144 agreement ,) Document from the collections of the AAMC Not to be reproduced without permission [. *Students A. MEDICAL C. B. Other: Psychiatry Pediatrics Family Surgery Clinical Providing academic Medicine Ob-Gyn Please Does Undergraduate in Clinical Total Total Emergency Staffing Hospital Number Number Financial Education?: None undergraduate EDUCATION the Appointed Supervising With rotate House Operating Payroll Practice complete of of Renal Services year: Services hospital Data Expenses Clerkships Medicine Medical Personnel: Physicians: Data Staff fLum Medical DATA Expenses: to the Expenses: None medical Temple Faculty: Stipends for: the with School have following Education Hospital's Clerkships a Full Part Full University full-time education Faculty & 12 -Time Number -Time: -Time: $ $ 5 5 2 2
Fringe information 21,092,255. 35,951,812.
* Salaried Appointments: Active Offered of '
during salaried Benefits: 808 266 37 Medical on the Chiefs Students Director your Medicine Clerkships most 12 Number 5 5 2 2 Staff: 720,000. of 50,000. hospital's recently Service Taking of of
Medical completed (list participation Are Required Required Required Elective Required: Elective Required Clerkships services): or Document from the collections of the AAMC Not to be reproduced without permission • • ***Through **Through *Through B. 'As Graduate Type Please offered 2 Other: Psychiatry First Surgery indicate Residency in Pediatrics Family Medicine Ob-Gyn directors. director. should As Association Practice Flexible Flexible Pathology Radiology Orthopaedic Surgery Radiology alliliation affiliation affiliation graduate accredited defined of Year complete and he
only
Medical = reported filled. graduate medical by First and/or Positions FTE Offered with with with the by 10 the 1 1-2 4 4 2 3 Education . the positions year LCGME The The Temple following education under the
program If Council Medical Hospital residents Liaison the Directory Positions the Canadian University and 10 hospital by acceptable 1 1-2 3 4 2 2 clinical on reporting information U.S. College Committee individuals of Medical in of Grads Filled the & Categorical* participates School Approved service of University
to only Education on on Pennsylvania two assigned Medical of Graduate full-time Positions your of or Residencies. Medicine by
2 and more the Foreign of in hospital's of Graduates to combined Pennsylvania Categorical supervising Medical the
hospital equivalent Filled applicant American
First
participation Education. programs, program Accreditation Date of
programs program 1952 hospital. positions Medical Year the * * of * * * Program Initial , 4 Document from the collections of the AAMC Not to be reproduced without permission IV. V. SUPPLEMENTARY SUPPORTING A. B. Signature Information To a this data medical given hospital must A clearly outline When Dean school's hospital's Name *See brief letter assist application. should returning of accompany of Attachment to of DOCUMENTS statement education
Affiliated Affiliated Submitted fulfills unique of educational Hospital's the INFORMATION current provide recommendation COTH
the the hospital the I -by: which and present Administrative When medical completed completed Medical Medical a role Chief programs. (Title) comprehensive research (Name) combined, supplements characteristics and membership
Executive from school School: School:
application, membership importance :Vice Mr. programs. the Board the affiliation J. President Leo Temple the summary 39 dean
Officer: criteria, Donald supplementary M. data in of application. (Date) and of Specific
Henikoff, University its lease the of the Caccia educational
provided agreement. evaluation you the applicant
affiliated enclose are reference hospital's statement M.D. School in The invited
Section program a hospital of letter copy medical of whether should and organized to
Medicine of features. I should -III submit required in the school be the the of Document from the collections of the AAMC Not to be reproduced without permission of Hospital to care created These resident Hospital. direction tional following maintaining resident included the specialization resident physicians." 1980's, demonstrate training extensive Center sibility significant program activities Medicine, tion. medical sities. supervising at in this has, specialty Item SUPPLEMENT ATrACHMENT "intern." its the training, turn It rendered In In of Since IV institution Chief educational unit Hospital. could Training was of two 1895 1874 from necessity, practitioners. of and that was physician, physicians was of Some of a Obstetrics training boards, Also, postgraduate and 1874 TO #1 Resident at new the not two the step physician, the young at in for these a two boast freestanding the In by he In brief ONE THE of The medical the this positions, until century, popularity the Hospital's year programs when light the forward. at pass inpatient this positions Hospital's has educational By PENN physicians. through COUNCIL "resident Germantown program fully programs through perceptions changed increased this area i.e., highlights A Physicians interns time period, and the been the 1936 his context, BOULEVARD of the director, /".",12€1/12kell'12/ study The the time, of Gynecology, approved have first start State the the a "residency" freestanding actively OF "Chief At of by that care were true past over licensed pulmonary desire role which Hospital's were physician" TEACHING changing Hospital. name that the the until, programs in run the of the of of "resident Licensing would the in era created and the a served of State Hospital's eligible Resident World residency this a the "residency" was time, physicians particular now the to and Hospital's of affiliations full continuing the years Pathology, medical in be disease community programs intergrate HOSPITALS medical officially at Hospital. numbered fully rich postgraduate intimately Bureau • 1918, War requirements posts a at Hospital Throughout available the course doctor" January 40 Examination the sort to - The for II, training history Medicine" Hospital training doctor meet approved time, were became disease six and was of of climate educational Germantown their commitment prior nine. The from at and APPLICATION with both as came 5, "apprenticeship" Medical changed PHILADELPHIA, These through such the involved ,wa, formalized "residents" to large Pulmonary entering proved subsequent residency and Germantown an 1983 for more licensing the to programs employed programs. medical supervise before residency varying speciality. patient to This and and positions educational two tradition the a late concerning The Licensure, from Hospital and to the 1 "Chief "resident to efforts following in / change, physicians, advent 4 appointment the a Germantown as efforts more be Disease. programs 1800's care in needs the school's PENNSYLVANIA 6.44z/-6„wel "resident clearly examination. its Hospital years, since the programs, existed a education Surgery, successful Resident will education first distinct took This of popular in for and institution reflecting training of medical an the physician" their through medicine of the and the "resident defined educational was serve the first another inspection and under Hospital, at Hospital at physician" true his number various to Internal univer- 19144 - respon- and and begun physicians educa- Medical the the in educa- of Surgery." and to the the the at the and of Supplement to the COuncil of Teaching Hospitals Application January 5, 1983 Page 2
Immediately following the end Of the war, 1946, the Hospital moved further adding two residency programs, Radiology and Pediatrics, fully approved and intergrated into its educational efforts. There were, then, freestanding postgraduate residency training programs in six specialties and one subspeciality„
In the early 1950's the Hospital reached its zenith of freestanding residency programs with seven, Urology being added by 1953. The medical education climate, however, was changing. In early 1949, the Hospital entered into an affiliation agreement with the Jefferson Medical College for the training of undergraduate to be medical students. Affiliation agreements with medical schools would prove such as German- the wave of the future for the involvement of community hospitals, town, in both undergraduate and graduate medical education.
The .Hospital continued .with its freestanding residency programs through permission permission the 1950'S and. 1960's and it was not until the 1970's. that formal affiliation with the Medical School of Temple University, the Hospital of the University of Pennsylvania, the Medical College of Pennsylvania that the Hospital's affiliated without without residency programs came into being. At the present time, through the major affiliation with Temple University, the Hospital provides postgraduate residency training in Internal Medicine, Surgery, Obstetrics and Gynecology, as well as undergraduate training for third and fourth year medical students. The affiliation reproduced reproduced residency agreement with the Hospital of the University of Pennsylvania provides be training in Orthopaedic Surgery. The affiliation with the Medical College of to to Pennsylvania provides postgraduate training in Pathology. The Hospital continues program in Diagnostic Radiology. Not Not to.operate a freestanding residency
The attached copy of the Hospital's 1980 Annual Report may provide further inti-rest in postgraduate medical AAMC AAMC insight into the Hospital's commitment and
education.
the the
of of
collections collections
the the
from from Document Document
41 Document from the collections of the AAMC Not to be reproduced without permission • bce: of Aging from responsible and a Center which Temple Temple LMWpb If in Currently Hospitals One " Suite Dear Washington, Richard Director Department Association ;mp,uTomvp).1 . for LEO Dean . 1 teaching These Teaching Best I Philadelphia. I Medical Medical a Dupont M. & Joseph Hugh can our Dr. am • • serve as 200 Vice •itwaziaisa HEN1KOFF, has University University 1Z;) wishes writing Affairs M. relationships third be well. Knapp: President A Maker the of ] institution a for Circle, Knapp, J Farrell of Hospitals for as Center. D.C. of major the M.D. medical further in a and Teaching American SCHOOL 3400 PHILADELPHIA, TEMPLE TU-556-00 OF operation in basis AAMC the Hospital School Germantown THE 20036 Ph.D. commitment fourth support N.W. NORTH COMMONWEALTH The Centennial new of for residency that assistance for are Hospitals Medical the of Department OF year. of the year clinical such rotate BROAD of should Medicine MEDICINE the Association has PENNSYLVANIA to membership Germantown C as UNIVERSITY that program Colleges SYSTEM the outpatient been STREET in through well properly 42 of activities this educational over Germantown OF a as Family HIGHER is major ogram of Hospital on process other the a integrated, Yours American be 19140 Leo the long clinics January EDUCATION Practice teaching Germantown 1384-1984 of a M. Hospital residents Council member process period truly, please our and Henikoff, at 24, Medical Institute Medical Germantown at and affiliate of of of 1983 let and and Hospital from Temple the time. students Teaching me Colleges. M.D. Medical is Center Council truly know. on is of Document from the collections of the AAMC Not to be reproduced without permission Sinc RMK/am supervision, Board information instruction to Department Because Richard Director Thank did comprehensive President Philadelphia, that Teaching of Dear membership At One The Mr. May be its required not Penn Joseph Germantown 5, • • • Suite the Mr. you. has considered 1983 only no no, April the M. address 200/One Hospitals application Boulevard Farrell: tabled full-time full-time Kn of in F. is is supplemental $50,000 clerkships and Meeting, Teaching statement Pennsylvania the Farrell provided available. Hospital Dupont the educational further action Ph.D. Council. reviewed association medical in salaried salaried way showed: Circle, the Hospitals hospital and in for on describing and statement for Administrative N.W./ which Therefore, the 25 19144 clinical While Germantovin Medical 'chiefs ' instruction Council Director FTE application costs educational 43 residents, the included colleges faculty of Center clerks membership, if for of Board n, service, Hospital's D.C. by Board Germantown Medical of supervising resources, until 20036/(202) with June and recognized supervision the american of residents and I such Education, the Board 10, the application request Hospital application 1983. 828-0400 supplemental faculty. clinical Council also the . and ; the a presence noted wishes for of - A/i-nwri-decuin/
ONE PENN BOULEVARD • PHILADELPHIA, PENNSYLVANIA 19144
J. DONALD CACCIA VICE-PRESIDENT June 8, 1983
Richard M. Knapp, Ph.D. Director, Department of Teaching Hospitals Association of AmericanNedical Colleges Suite 200 One Dupont Circle, N.W: Washington, D.C. 20036
Dear Dr. Knapp,
The attached statement prepared in response to your, May 5, 1983, correspondence, addresses the concerns you expressed about The Germantown Hospital and Medical Center's application for membership in the Council of Teaching Hospitals. Should any further clarification be required, please let me know. Thank you.
Sincerely,
Donald. Caccia ice President JDC:jmc cc: Mt. Joseph F. Farrell, President Mr. Hugh J. Maer, Executive Vice President
44 Document from the collections of the AAMC Not to be reproduced without permission of FACULTY major clinical forty-five CLINICAL responsibilities assigned appointments his/her University RESPONSE Pennsylvania Every Of 1. 3. 2. affilate. one rotation. RESOURCES
"only a "no for SUPERVISION quested specialty. represents Obstetrics one annual Medical "no supervisor with $250,000.00 programs attending to TO site basis, positions Hospital acting resident of hold service POINTS fill hundred on full-time full-time of their Pennsylvania the activities, $50,000.00 , the faculty expenses to with its (Pathology) In this at Schools and Chairman and has
In and fill the supervisors. participation RAISED Germantown they dollars staff and addition, and and attending forwarded THE (includes role greatly Medical Medicine clinical the Hospital APPLICATION salaried salaried fifty medical this positions Gynecology for with provide, GERMANTOWN with at in of on various School with paid function. supervision, Germantown. SUPPLEMENTARY hospital faculty medical increased a whom active Surgery, Center the dollars with with a OF full-time maintains chiefs Director student supervisor to the We typical and of over at TEACHING department chief FOR we which our HOSPITAL Germantown the are either medical majority Medicine has supervision costs members staff are Medicine, MEMBERSHIP of an indicated Medical the currently The TO rotating application of residents, provides assignment historically 45 including These basis affiliated above individual service": HOSPITALS STATEMENT (attending members, for Temple responsibilities Medical duties AND staff chairman from of (Orthopedics), physicians faculty School that since supervising MEDICAL these of in through Radiology, - searching renumeration members Temple, of University of consists our Education": this show COUNCIL #2 While on provided contractual and the this utilized staff) being above.) the as affiliates members teaching a coordinating no CENTER $50,000.00 Germantown on growth a voluntPPr the twenty-one residents individual at Pathology, for full-time faculty": liason at of or for a of School by Germantown to the rotating information the this Temple, an two share efforts. relationships Germantown. in The the for these with individual services our Medical medical is Hospital rotating of duration position. and Germantown the include, the faculty hold salaried This over and the educational individuals the basis Medicine, their Hospital, on teaching clinical re- - College of Hospital's figure students is ° by Total of Document from the collections of the AAMC Not to be reproduced without permission -addition, for four conference. general closed surgical Rounds presentations and attending EDUCATIONAL chairman. education basis. one as process there chairman direct schedule residents Cases specialty cipates providing writing on may physicians CLINICAL and availability, appropriate. a the the basis a be In days Daily The In In In Orthopedics In daily are are resident circuit are clinical supervised the discussion weekly numerous surgical addition addition Radiology, Surgery in and services. resident outlining and SUPERVISION a a staff of several with supervision (two reviewed and there presented the basis are Department medical. week INSTRUCTION case Case medical service of and students general television a teaching and responsible to :supervising for supervision and with is presentation. to educational to member and management through discussions, presentations other ataff by a of clinical the one daily residents discussion a the the Obstetrics service.
Pathology, awl chief. students anywhere (CONTINUED) current attending Surgical on of surgical various respectively),are being educational of in sessions, above program at by clinical Medicine, Temple hookup our Radiology for of supervision least the are physicians, opportunities In assigned conference descriptions topics. and from Depending a Student of attending the programs and the session physicians and Attendance these because the attendings. his for weekly between various both residents. a conferences residents Gynecology clinical one the specific activities daily responsibilities role all has" cases various 46 and Also, of to for medical Surgical . of is and these upon is Teuiple a staff. house handled clinically case a basis. four is exist for Resident daily of provided the all held activities. specific (since supervision clinical via is the required educational Attached a services and groups smallnumber morning presentations provided and attending students and students the similar twice on Oncology conference a directly service, rounds. television there attending to Conference a all responsibility is of and of topics daily, report at a our with is as in affiliated the procedure of residents week and and are general physicians. Conference these with instruction a' a case the of own When those with typical residents attending physicians supervisor residents weekly, residents are no staff. and and and hookup, residents featuring direct residents the load daily medical an discussed. other nature the students involves students is and institutions department of attending monthly and CPC and entire and followed, clinical conferences provided, individual and The students meet on topics since for in students) case a monthly on and these students. and attending a weekly each a the In Grand order parti- one residents with to Document from the collections of the AAMC Not to be reproduced without permission WEEKLY DAILY DAILY WEEKLY WEEKLY WEEKLY WEEKLY WEEKLY WEEKLY WEEKLY WEEKLY WEEKLY WEEKLY WEEKLY WEEKLY WEEKLY Mon Mon Wed Wed Thu Tue Fri Wed Wed Fri Wed Tue Tue Fri Fri Mon Mon Tue Tue Tue Tue Tue thru thru 10 14 14 17 20 21 27 24 28 28 28 8 3 7 12:00 12:00 11:00 12:30 11:45 12:15 12:15 12:15 12:15 8:00 8:00 Friday Friday 8:00 8:00 9:30 2:00 4:00 4:00 8:00 4:00 4:00 3:00 7:45 7:00 4:00 7:30 8:00 PM PM PM PM PM PM PM PM PM PM PM PM AM PM PM AM AM AM AM AM AM AM AM AM AM AM JUNE (Mon., (Mon., (Mon. (Note House (see "Pathophysiology Medical (Note Radiology Medical Practice Surgical Departments Pectoris", Medical Surgical Director, CPC Ob/Gyn Orthopedic Neurology Grand Surgical Surgical Surgical Division, Coronary CONTINUING CONTINUING CONTINUING ference, The Therapy, Oncologic Neutron Hypertension", Hahnemann Alan Surgical Department CONTINUING CONTINUING Radiology Neuroradiology Ob/Gyn Anesthesiology,Conference Surgical CONFERENCE. THE - Germantown GERMANTOWN S. Notes 1983 Staff 1) 1 Rounds and Tues., Tues., Department Department Residents Students Berger, Residents Radiation and "Principles Student Meeting. Conference Conference University Conference Conference Care Conference Conference
Departmental Thurs.) Department Hospital; Conference, Hahnemann University Conference, - EDUCATION Teaching EDUCATION EDUCATION Irving 1, EDUCATION EDUCATION of Invited of 2) STAFF from
Thurs., Thurs., 2 Unit, Surgery, Eric Hospital Internal Conference, HOSPITAL M.D., and Conference Conference and Morning Conference Temple Therapy", M. Meeting Meeting MEDICAL - - - - - Rounds, - 4). Assistant Likoff Hospital. of Finkenstadt, LUNCHEON CONFERENCE, Herling, and CONFERENCE, Hosp. of Management CONFERENCE, CONFERENCE & Department Current & Oncology (Note Stephen Orthopedics Urology E.N.T. Vascular Conference, Pennsylvania MORBIDITY Fri.) Fri.) Medicine and Radiation (Notes AND Clinical Report (Note
EDUCATION (See (Combined Cardiovascular House Medical Melvyn 1 MEDICAL 47 Problems (See D. Professor (See M.D., and 1 of Notes 3) "ENT of "Pulmonary Silberstein, Tumor and M.D., AND Staff Therapy, Aspects and 2) Jay Note Richter, Angina Notes Otolaryngology, Director, Center. School PROGRAM CENTER Family with MORTALITY Update 2) 1,2 W. Con- Pulmonary 4) Invited of 1,2 MacMoran, of Inst. weekly and Radiation of American M.D. Artery - and M.D. Medicine. 4) Radiology Surgical Auditorium 1983" Dr. Doctors' Committee Auditorium Auditorium Auditorium Surgical Surgical Auditorium 3rd Doctors' Auditorium Auditorium Surgical Radiology Surgical Doctors' Recovery Auditorium Surgical 4). Fl. Lerner's. M.D. Floor Founders' Dining Conf. Dining Conf. Conf. Conf. Dining Conf. Room Conf. Dining Conf. Conference 2 - Office Room South Room Room Room Room Room Room Room Room Room Room Bldg. Rm. • Note 1 This conference will be held weekly at this time and place. Note 2 Credit given for Category I by AMA and PMS. Note 3 Approved for 1 Credit Hour by the AANA. Note 4 Continuing Education LUNCHEONS are held on Fridays at 11:45 AM in the Doctors' Dining Room and precede the CONTINUING EDUCATION CONFERENCE.
permission
without
reproduced
be
to
Not
AAMC
the
of
collections
the
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Document Document from the collections of the AAMC Not to be reproduced without permission II. Membership with IRS I. A. 501(C)(3) INSTRUCTIONS: HOSPITAL HOSPITAL a medical (Adult & (City) (Area Average Total Patient Licensed Title Hospital Hospital Name excluding in
of IDENTIFICATION OPERATING Live
of Code)/Telephone -- the school Service Daily Hospital's Pediatric Wichita Bed Hospital's Address: and Name: Council COUNCIL Births: newborn): documents Complete Return information Capacity publicly Census:
accredited
Association Suite Council One Washington, DATA Data OF (Street) of the St. Chief Dupont
TEACHING Chief all (for (Section 200 Teaching APPLICATION owned Number: completed Joseph (Section of Sections 1.253 Executive by the Executive Teaching Circle, 600 415 D.C. of HOSPITALS the hospitals 3600 most ( Medical 49 American V) Hospitals
application, IV), Liaison 316 (I to FOR East 20036 N.W.
recently (State) Officer: -V) Hospitals • Officer: the: and MEMBERSHIP ASSOCIATION Center )
having Harry Admissions: Visits: Visits:
Medical of ,Committee is 685-1111 the
this
limited completed Mother
Kansas supplementary supporting a Executive Clinic: Outpatient Emergency Colleges application. OF documented AMERICAN on Mary to Medical fiscal not Anne Director Room: -for-profit MEDICAL or affiliation McNamara year) Education.
(Zip)67218 164.527 COLLEGES 36.804 17.878 -- agreement B. Financial Data
Total Operating Expenses: $ 64,777.844
Total Payroll Expenses: $ 37346,110
Hospital Expenses for:
House Staff Stipends & Fringe Benefits: $ 515,676 Supervising Faculty: $ 100,387 C. Staffing Data
Number of Personnel: Full-Time: 1.407 Part-Time: 451 Number of Physicians:
permission Appointed to the Hospital's Active Medical Staff: 399 With Medical School Faculty Appointments: 223
without Clinical Services with Full-Time Salaried Chiefs of Service (list services):
Radiology Rehabilitation Family Practice Emergency Medicine
reproduced be Pathology Alcohol Treatment 06 Anesthesia
to
Not Does the hospital have a full-time salaried Director of Medical Education?: No
AAMC III. MEDICAL EDUCATION DATA
the
of A. Undergraduate Medical Education
Please complete the following information on your hospital's participation in undergraduate medical education during the most recently completed
collections academic year:
the Number of Are Clerkships Clinical Services Number of Students Taking Elective or
from Providing Clerkships Clerkships Offered Clerkships Required
Medicine 1 2 Elective
Document Surgery
Ob-Gyn
Pediatrics 2 20 Elective
Family Practice 1 3 Elective Psychiatry 3 3n Flpctive
Other: Radiology 1 4 Elective
Pathology 1 14 Elective Document from the collections of the AAMC Not to be reproduced without permission B. Graduate Please offered Type in indicate Residency First Medicine Surgery Ob-Gyn, Pediatrics Psychiatry Family Other: lAs 2 Tarim. Pathology Anesthesiology FP Flexible 77TETZT Practice-SJMC should director. Flexible As Association -Salina graduate defined accredited of Year complete , and - te Medical only
1 7 s.
= reported filled. Medical graduate by Positions
First and/or
FTE Offered
the by the 22 Education 12 8 4 4 1 positions
the year LCGME following education under the
If program -
Council the residents Liaison Positions Directory Canadian the and hospital by acceptable reporting information clinical on U.S. 22 10 individuals Committee on 4 2 Medical
in .Grads Filled of & 51 participats Categorical* Approved service
only to
Education on'your -
two or assigned Medical full-time Positions Graduate by of Residencies.
in Foreign hospital's more and the of Graduates - 4 combined to
Categorical supervising Medical the equivalent Filled hospital applicant American
participation First
programs,' Education. Accreditation Date of program Sept. June Feb. May July Nov.
-hospital. positions programs program the Medical Year of 1972 1979 1975 1976 1955 1977 1977 Program Initial city-wide SJMC , L IV. SUPPLEMENTARY INFORMATION
To assist the COTH Administrative Board in its evaluation of whether the • hospital fulfills present membership criteria, you are invited to submit a brief statement which supplements the data provided in Section I-III of this application. When combined, the supplementary statement and required data should provide a comprehensive summary of the hospital's organized medical education and research programs. Specific reference should be given to unique hospital characteristics and educational program features.
V. SUPPORTING DOCUMENTS
A. When returning the completed application, lease enclose a copy of the hospital's current medical school affiliation agreement.
of recommendation from the dean of the affiliated medical school permission permission B. A letter must accompany the completed membership application. The letter should MTH)/ outline the role and importance of the applicant hospital in the
without without school's educational programs.
Name of Affiliated Medical School: University of Kansas School of Medicine-Wichita
reproduced reproduced Dean of Affiliated Medical School: William J. Reals MD
be be
to to
Not Not
AAMC AAMC
the the
of of
collections collections
the the
from from Document Document
Information Submitted by: (Name) Lew_ W. Purinton MD
(Title) Vice President for Medical Education
Signature of Hospital's Chief Executive Officer: L Late221-4.7 ,11:
52 Document from the collections of the AAMC Not to be reproduced without permission St. Attachments operated Medical Sincerely Lew LWPmn Vice will and with The school of training their Trustees Obviously, this ical residents providing ment hospital ship but it ventures Joseph programs Wichita, Association Washington, those Dear One May letter Chairman, I it In trust medical seems is review W. medical has pathology. Dupont 13, President Center Joseph St. provide Doctor between in operated 3600 second requirements. PUrinton essentially from Medical Education this extended COTH. 1983 of for Francis of program. clear between involving in Affiliated to of the EAST Council education. Circle, 2 for anesthesiology center of St. support William D.C. adequate and the the The brief requirements training HARRY by Attached Center American that MD membership St. documents Joseph a third Regional program. psychiatric the University with the on 20036 St. controls family letter management basically N.W., of Joseph J. St. STREET, Teaching medical As The explanation medical Medical with site Joseph our years Medical Reals a Joseph Medical you Univers& Suite of Medical for practice, the result application, residents. participates in Exhibits for of the will WICHITA, explanation, operates center residency MD, in school; the Medical contract medical membership Hospitals Medical Center- 200 Kansas all psychiatry. residency Colleges id several find we Dean, and Council Center 53 of and are A psychiatry, KANSAS center's however, Center information the School through the program to Center, University In a dated, submitting the in Center and in School of along family the regards programs Mission first the 67218 medical the Teaching This of Wesley participates medical documents D each that January psychiatry Wichita, participation of with anesthesiology Medicine that Council practice year Medicine qualifying to of then Statement our in Medical hospital school is the the relate Kansas Hospitals. school. residents psychiatry, a application 1983, is of Kansas, including Medical attached - city-wide — pathology the residency residency in Wichita Teaching Wichita in from Center School to an St. recruits the in Department primary various The and cooperative equal and now residencies' Lew Joseph Master the anesthesiology, materials a Education of and medical for university residency, pathology. in W. most fulfills copy program, program Hospitals, WICHITA'S Board Vice Purinton, areas manner teaching the Medicine its HEALTH FOR St. member- Med- Agree- President of FAMILY of own CENTER CARE of M.D. of by the - Document from the collections of the AAMC Not to be reproduced without permission Washington, teaching learning Dear Chairman, will with and and May Association St. Center, cine This One Medicine, St. St. Suite a The I bcc: am broad 11, Dupont Joseph Joseph Joseph important University medical Doctor: this be letter pleased program 200 Dr. 1983 Wichita, happy variety experiences institution Medical Council Anesthesiology Lew sponsors Hospital Circle, Medical of D.C. students, is to and to institution Purinton of American written medical recommend College answer Kansas, contracts Kansas 20036 School on Center N.W. or has Teaching for within The of residents co-sponsors in Health any Medical specialties THE been University to to The School and St. is support in will the institute questions become Scienci Pathology. a University involved our UNIVERSITY Joseph Hospitals Main 600 (316) of Wichita, institution Colleges of and be 1001 Office educational Kansas (316) -bed of residency signed a Medicine N. and postgraduate 54 member 261-2600 the Medical of Kansas Minneapolis concerning 268 a in School community the training of sub 8221 Negotiations application medical Dean shortly Nrence al, OF 67214 -specialties. Kansas of of as began Kansas Center programs programs. Medicine KANSAS COTH. rotations site the hospital students education City operating School to -Wichita as and institution. of achieve for in are a Wichita St. in of Psychiatry, member offering our currently have It at Joseph our Medicine and is that Internal all a curriculum. is a of variety levels purpose. principal services in a Medical COTH -Wichita under Family valuable Medi- and since of way Document from the collections of the AAMC Not to be reproduced without permission for officials, ed medical to accomplished Center president and a following to patient Anesthesiology since ing ter Center ing long officials update participate medical staff reaffirmed has ihstitutions Medical The The St. 1958 provides history had education. care had reasons board Joseph the for for residency where an when education an of through Center through board medical better approved of - of that in approved a the Medical STATEMENT it applicable, for for 1977. final the commitment trustees developed The regularly Medical resources commitment training joint patient this resident the to education, care internship Medical review Center program set University solid OF efforts of of Center. as care, hospital SUPPORT to a programs: on our are St. participation, and and Pathology has a Center commitment the in graduate our full allocated patients from Joseph approval of and dedication Family been education of The accounting FOR 55 councel, administration, further voting encouragement Kansas 1941 Pediatrics involved board Medical GRADUATE residency medical Practice. are through of through to stimulation member of on School of has the personnel many, 1972. and Center physicians 12 with education trustees MEDICAL appointed educational staff - training controller an January of of of We but 1975; program graduate Since annual the and highly Medicine became officer, of membership. include, EDUCATION of Psychiatry programs. board our 1983. 1972, program. in its the St. directors, budgetary staff, qualified budget for graduate one medical medical -Wichita administration vice of Joseph and improvement the of trustees other president UKSM-W - The Medical the education and process training 1978; Medical vice physicians in graduate sponsor- Medical relat- nurs- the and of Cen- has Document from the collections of the AAMC Not to be reproduced without permission • officials developed medical supervision, ible program ing is dealt in Each individuals providing education, directors with and program by evaluation, hospital Medical in of our for and through the the contract teaching appropriate councel. Center's administrative Medical advancement its director staff with vice School faculty St. appointment president and staff (UKSM-W) cooperates Joseph dismissal with of for Medical cooperation the and and with medical Medical policies selected resident Center the education. of vice Center, are selection. residents residents appropriate delegated president the Due and respons- in Resident for train- UKSM-W process to was Document from the collections of the AAMC Not to be reproduced without permission .During 1, emphasis methods. intensity. "universsity-owned" Attention COTH The and and Salary The activities. and Suggestions discuss This In are Hospitals Annotated material. be May, made Department General time encouraged. the Medical publication Directory list o o the Survey; in the Survey 1980, on
is .to Five ,The should which Bibliography Describing in past The February, Hospitals: December, Teaching A Selected Hospitals,. this The Should education 'DEPARTMENT the following Operating appropriate Education and Description the It
Patient the Disease DRG publications of Housestaff. continues of questiOn mould three ACTIVITIES issues efforts observations appears.as area subject serve Educational Department University additional Case hospital Data Hospitals:
1982. 1982' costs is and A Case be years, October, Data items Costs of Staging on only .
OF Mix Technical for a will of a bf for to area helpful Paying diagnostic
Stipend's, Medical matter on TEACHING AND Mix, what a have of -Owned Teaching develop survey. in as as the a Plans not about of separate teaching studies Programs will 57 review, 'aSample
INITIATIVES A Case Small 1982 a Teaching possible May, Teaching useful if Department resulted Hospitals Technical be point which Report, Education remain Teaching are all HOSPITALS Mix and pursued the Benefits Sample case 1980' Hospital of of enclosure hospitals and departmental underway of requires Contributions of of the publish departmental Board Hospitals the
Hospitals
from mix December, high, departure Report, Teaching a Services; of Developments has Department's with Hospitals' Costs impact and Sample and Characteristics, would this Teaching focused the but to with attention.. be Funding the hospital in expand published encouraged? of.medical
effort:. of 1981 data COTH for review activities Executive same initiatives. Teaching this remain Financial particular discussion. Report; gathering Survey; project the agenda payment and to the
. o What specific questions should be pursued?
o Are there ways of making better use of the work that has already been completed?
o The current AAMC position is that graduate medical education is a legitimate patient care cost. With increasing price/cost competition, is a new examination of this issue in order?
The questions set forth under the heading, "Unresolved Issues and Unanswered Questions," (P. 791) in the article following
permission this agenda item are worth reviewing in this context.
2. Tracking the Financial Performance without of Teaching Hospitals
New payment systems involving contracting, discounting, and per case payments are rapidly being implemented. The impact of these payment systems on teaching hospitals is an reproduced area which has not received systematic attention. To monitor these changes
be and compare different subgroups to within the COTH membership, the AAMC could sponsor all of its non-federal members in the Financial Not Analysis Service (FAS) of the Healthcare Financial Management Association for a five year period. FAS uses audited financial statements to compute and display 29 standard financial ratios. AAMC A five year time series, 1982-1986, would permit comparisons the among COTH subgroups (university-owned, primary affiliate, of affiliated) and between COTH members and non-teaching hospitals.
3. Comparative Hospital Data collections Increasingly, executives in COTH hospitals are interested in the comparative data which could be used to assess their hospital's performance. When questioned about participation in the AHA's from Monitrend, most callers say its usefulness is limited by inconsistent data collection and reporting practices. To assist COTH member hospitals, at least three options are available.
Document A. Improved Monitrend Comparability
If the basic Monitrend reports are useful to the membership but the weakness is the data, AAMC staff could establish a joint project with AHA staff and participating COTH hospitals to help obtain more uniform input data. This could be supplemented by meetings of COTH subscribers where hospitals could explain atypical organizational and financial characteris- tics that underlie data differences. In addition, and depending upon member interest, Monitrend staff might be willing to develop special reports and comparison groups (university-owned, primary affiliate, affiliated) for COTH members.
58 B. Expanding the Yale-New Haven Hospital Study
Yale-New Haven Hospital is presently undertaking its second collection and analysis of case mix data in university-owned and primary affiliated hospitals. The first study assisted Yale-New Haven in a presentation to the Connecticut Cost Commission and provided participating hospitals with comparative data on length of stay by DRG. The current study uses the. new DRG's and additional cost information from the hospitals. Depending upon Yale-New Haven's interests, the AAMC could assist the hospital in establishing a center to gather and analyze comparative financial, data for university-owned and permission permission operational, and utilization primary affiliated hospitals. -
without without C. Commercial Teaching. Hospital Database
If a sufficient number of COTH members were interested and willing, the AAMC could forma joint venture with a commercial uniform database reproduced reproduced data processor to create and maintain Data included could be be be information on teaching hospitals. to to organized .at the specific patient level, the operational
departments, or both. Not Not
4. New Technology Clearinghouse AAMC AAMC As -C.0TH members introduce new technologies and services (e.g., the the NMR, PET scanners, bone marrow:transplants), the hospital often of of prepares an internal report for adopting and/or planning the .change. The AAMC could establish a clearinghouse on new projects/ services which member hospitals could share. If 'sufficient interest exists, the clearinghousecould be expanded to include
collections collections evaluation reports prepared by member hospitals for new services. the the
5. Insurance Access from from . As new payment and delivery arrangements develop, price sensitive insurers may be reluctant to provide beneficiaries with access to high cost teaching hospitals. The AAMC could identify services Document Document generally requiring care in major teaching hospitals, develop a directory of member hospitals performing minimum serVice thresholds in a specific service, and allow insurers to use a registered service mark on policies providing coverage for . specialized services in teaching hospitals listed in the directory.
6. Impacts of Clinical Research on Hospitals
In the recent AAMC report on 33 COTH hospitals and in the report describing teaching hospitals, no adequate information on research activity in teaching hospitals was found. As. a result, it is •
59 Document from the collections of the AAMC Not to be reproduced without permission Payment options indications face Secretary to expenses estimating data Medicare The The With issues altered. and payment. difficult hospitals hospitals. 7. I. F. H. G. E. D. C. develop B. A. Medicare changing AAMC years the on more The The The outliers; central second The The outliers; in in The The The inflation; and procedures; costs resident The of System, provide the the per the enactment is should payment extensiveness separation length definition method distinction definition rate rehabilitation In way concern The ahead. with to constrained could their measures for Payment of As in cost hospital; Medicare medical addition, describe -to in city 14 of substantial Congressional both no the management be use HCFA -bed of of for which case impacts pages cost and increase For to position and of paid payment stay System to AAMC research agencies of of of of education inpatient COTH must rate; adjustment; the example, impacts between payment the budgets, suburban the residents of estimate research research "marginal of the a by and patients, with of "distinct members: legislative address impacts 1983 future to discretion list and supervision Activities at research for urban research cost interest Part several system use this could in Social passthrough they services 60 components; of patients activity are thresholds used implementing when the cost cost" wage of A time mandated part" or may be and counted physician research or language following in in Security challenges and reporting indices adjusting developed. patient to -related has to dispute methodologies the transferred related implementing and unit third and which be provide been studies implementation when methods used on for the into those costs amendments, provide care regulatory which party old forms in are payment teaching costs. dramatically to computing Prospective in psychiatric either the their dollars. provides included allowed to define for physician data prospective paying individual payers the and a months A areas. for general project the some and J. The continued usefulness of input controls such as maximum allowable Costs for drugs, reasonable compensation equivalents for physicians, and access to subcontractor books and records.
Moreover, in the years ahead, HCFA must be prepared to address additional revisions of the.system, including:
A. The addition of case mix categories or systems more sensitive to severity of illness and intensity of care; permission permission B. A methodology for incorporating capital costs into •the per case payment; without without C. A means of paying for hospital-based ambulatory care, both outpatient and emergency, on a prospective basis;
D. A prospective payment system for physicians' services
reproduced reproduced provided to inpatients;, and be be to to E. Publicly available .methodologies for computing payment
Not Not adjustments for the indirect costs of medical education, national and regional referral centers, and hospitals
serving large number of indigent and Medicare patients. AAMC AAMC each of these issues the the The resources required to fully address
of of exceed those presently available to the .AAMC. Therefore, in recommending future activities for departmental action, the Administrative Board is requested to identify short and long term prospective payment issues Of greatest concern to the
collections collections Membership.
the the
from from Document Document
61