Hospitals set on limiting school affiliations

In an attempt to "streamline" services at its 11 New York City hospitals, Health and Hospitals Corporation wants to take responsibility back from the prestigious universities it once sought help from, reports the New York Times.

Currently, HHC relies on schools such as Columbia and New York University to manage doctors in their hospitals. The schools wield hiring and firing authority, pay the doctors' salaries and heavily influence in how poor and working class patients are cared for, according to the newspaper. Furthermore, the schools help the hospitals to attain elite status.

HHC now believes, however, that the training wheels can come off, so to speak.

"If you go back 50 years, I think it was the notion that having a brand-name entity equated with quality and would be more attractive for physicians," HHC president Alan Aviles told the Times. "I think things have changed dramatically. We are not the system we were 50 years ago."

Not everyone is so excited about the prospect, however. Doctors at one department at Harlem Hospital, which currently is affiliated with Columbia University through the end of the year, have threatened to quit should the relationship end, amid worries about job security, university appointments and the overall quality of the hospital going into decline.

Dr. Lee Goldman, the dean of the College of Physicians and Surgeons at Columbia, however, isn't worried, maintaining that some sort of relationship would still exist, even if the two sides parted. "We don't use the name Columbia lightly, and a relationship is a relationship," he said.

Aviles told the Times that he foresees a restructuring that would create "specialized centers of excellence." In essence, each hospital would have a certain specialty, and patients would be sent to those facilities accordingly.

"Communities, even more than the affiliates, like the idea that their local hospital can do everything," he said. "But that's not the reality of the way healthcare is evolving."

To learn more:
- read this New York Times article

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