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August 2008 1400 AM WAMC - Host: Dr August 2008 1400 AM WAMC - Host: Dr. Alan Chartock Albany Medical Center President and CEO James Barba discusses the history of Albany Medical Center. Alan Chartock: Hi, Alan Chartock here. Joining me today is James Barba, President and CEO of Albany Medical Center. Albany Medical Center is the region's only academic health sciences, and is nationally recognized for excellence in education, research, and its patient care programs. James Barba has served as President and CEO for more than a decade. He led the way in combining Albany Medical College with the hospital, creating the unified medical center that exists today. James Barba, welcome and thanks for being here. James Barba: Thank you, Alan. It's great to be with you today. Alan Chartock: So I see a wonderful book in front of me called The History and Formation of Albany Medical Center. Now when your wonderful colleague Greg McGarry sent it to me, I said to myself, "You know we share this common history. It's WAMC." And a lot of people slap themselves on the side of the head when I tell them, "WAMC stands for Albany Medical College", or it did in the old days before you guys were kind enough to allow us to separate out and go on our own way. James Barba: Are you telling me it doesn't still stand for Albany Medical College, Alan? Alan Chartock: We have always been grateful for that opportunity. And it really, really mean that. So as soon as I say this I said, "You know, we really ought to have an hour with Jim Barba and have a discussion of how all of this came about. Because it's a fascinating thing. What you've done is just miraculous, what's become of this little hospital. Maybe you could just start us off by giving us a little bit of a history lesson in how all of this happened James Barba: Certainly. To begin at the beginning, in 1839 Dr. Alden March, who was a local practicing physician, managed to convince the New York State Legislature to charter a medical college here in Albany. Interestingly, he began that process about 15 years earlier, in 1824. And every year he'd go back to the legislature saying I assume, "Please give us a charter this year. Please give us a charter this year." So I guess the more things change, the more they stay the same in Albany, Alan. But finally 15 years later, in 1839, he got his charter. And he began a medical college. Began teaching students. Ten years after that, in 1849, he actually opened a very, very small hospital. It was in a house. And the house is still standing. It's on the southwest corner or Madison and Dove. And you can drive by that and see a very unimposing red brick building, I think three stories tall. That was the original Albany Hospital. In any event, these two institutions, the college and then the hospital were founded by Dr. Alden March. Fast forward to about the year 1900 when the commissioners of Washington Park gave the hospital the plot of land on New Scotland Avenue on which it has sat ever since. Alan Chartock: Had that been Washington Park? James Barba: It was part of Washington Park at the time, yes. So they gave them this plot of land. The hospital moved to New Scotland Avenue. And I believe it was two decades later the college, which was down on the old part of Lancaster Street in Albany, a part that doesn't exist anymore ... the Empire State Plaza took all that away ... moved from its spot on Lancaster Street up to the New Scotland Avenue campus, physically next to the hospital. And actually they build their building so that they adjoined and integrated. You could go from one building to the other without going outside. And there they sat for the better part of 60 years. Alan Chartock: Are any of those buildings still there? James Barba: Oh, yes. Oh, yes. The main, the original building of the hospital we call the main building or the end building. That's where the pillars are, the famous pillars of Albany Medical Center. And if you were to go around ... If you're facing the pillars and go around to the left side of the building, you'd see the original entrance to the Albany Medical College, which was actually transported from Lancaster Street to the building that was being built for the college and put in place there. So the buildings are still all there. We rarely take anything down. We just keep adding and adding and adding more buildings. In any event, there they sat, two completely independent organizations but dependent on one another for the delivery of missions. And there grew up over those 60 or so years very, very complicated inter-institutional agreements with respect to who did what, and who owed what, the money for doing what, and so forth. Finally in 1970, a couple of members of the hospital board, a couple of members of the college board began conversations about possible merging the two institutions in some fashion. That conversation occurred over the succeeding 12 years, from 1970 to 1982. And it had many, many ups and downs. I actually happened to be a party to it for the last three years. I went on the college board in 1979. But during the 70s at two separate times it looked like an agreement was at hand when at the very last minute, literally, the college would pull back. And there was always a great fear ... and I know this first hand ... There was always a great fear on the part of the college that the hospital, which was a bigger organization and had a different mission ... It had a service mentality as opposed to an academic mentality or milieu ... that the hospital would overreach in any such combined organization and steal the college's endowment, as pitiful as the college's endowment was in those days. So they kept backing away. But the times were very difficult, and I can recall when I came on the college board in '79 the college faced a one million dollar deficit that year. Barba James J - History of Albany Med - 2008 Page 2 of 19 A million dollars is still a lot of money today but 30 years ago it was a tremendous amount of money, especially for a college that was very, very poorly endowed, that had no natural source of revenue to go to. Alan Chartock: And how was the hospital doing financially at that time? James Barba: The hospital was doing okay at that time, in the late 70s, early 80s. It wasn't doing tremendously well. It would face its own difficulties financially during the 1980s. Alan Chartock: So in '79 they had a million dollar deficit? James Barba: Yes. Alan Chartock: And that's when WAMC certainly got born. James Barba: Yes, indeed. You are a product of those difficult days. Alan Chartock: Of that time. Okay. So that's real interesting. And then you became a sort of instrumental figure in making this happen, didn't you? James Barba: Well, I wouldn't say so at that point in time. I mean I was a young kind of wet behind the ears, a third tier trustee on the college board. Alan Chartock: As well as a first rate lawyer, I may add. James Barba: Well I guess that's open to some discussion, but ... So I participated in what became the final debate, the debate that finally concluded that we would in fact create an organization. We couldn't really legally merge the hospital and the college because they exist under separate state laws and the college had to be a degree granting institution, the hospital had to be chartered under Article 28 of the Health Law. It's more complicated than I'm making it. So what the boards decided to do, with some expert help from the outside, was to create a parent holding company that would sit on top of these two institutions and would have all the powers and all the authorities to do whatever it needed to do, and to control all the money. And that seemed to satisfy, to the extent necessary to get an affirmative vote, the governors of the hospital and the trustees of the college. So we said yes. In 1982, we said yes. We all sat back and congratulated ourselves that, after this long 12 year debate on again off again, we finally had done it. We had created the Albany Medical Center and from then on everything was going to be hunky dory. There was going to be the recognition of economies of scale. It was going to be combinations of departments, so one finance function, one human resource function, etc. And we expected it would happen. And it didn't. It didn't. Because there was no real buy in on the part of the managers of the hospital and the managers of the college. Barba James J - History of Albany Med - 2008 Page 3 of 19 There was some, but there wasn't the type of buy in that was going to be necessary to truly actualize what these directors thought they had created. So we had this parent holding company. And it had very, very small board, a couple of hospital directors, a couple of college trustees. And it hired its first CEO, Dr.
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