Officials of the University of Maryland will soon implement a controversial plan to establish closer ties between the Maryland Shock Trauma Center and University Hospital despite the apparent absence of a formal vote by the state board of regents, a top official said yesterday.
The plan, which trauma doctors say chips away at the independence they have enjoyed for years, was discussed by the regents in a secret session that preceded their regular open meeting. The issue did not appear on the regents' agenda.
Physicians at Shock Trauma, who said last week they would resign if their independence were compromised, said yesterday they would seek other options before seeking other employment. These include legislation to preserve for them a large degree of autonomy from the affiliated University Hospital and medical school.
Meanwhile, news of the secret session angered Lt. Gov. Melvin A. Steinberg, who chairs an advisory committee overseeing the helicopters that ferry accident victims to Shock Trauma and other trauma centers throughout Maryland.
"It raises a perception -- I hope it's not true -- that someone wants to beat you to the punch and do something before anyone can do anything about it," Mr. Steinberg said. "If this is a power play by someone, I'd like to know who it is. It raises a lot of unanswered questions."
Mr. Steinberg said he planned to contact the regents today in hopes of finding out why the matter wasn't discussed publicly so the trauma doctors and other interested parties could present their viewpoints.
None of the regents could be reached for comment yesterday.
In April, the regents appointed one of their own -- attorney Richard O. Berndt -- to help resolve the long-standing tensions and rivalries between physicians at Shock Trauma and University Hospital. Both institutions fall under the umbrella of the University of Maryland Medical System.
Doctors working at Shock Trauma said they assumed that the regents voted to adopt Mr. Berndt's latest proposal in the secret session. But Dr. William J. Kinard, acting president of the University of Maryland at Baltimore, said the regents discussed but did not vote on the plan.
Nonetheless, he said officials of the university system left the meeting assuming that the plan was official policy. Dr. Kinnard said their main task now was to decide how and when to put the plan into effect.
"The document is not going to be changed," said Dr. Kinnard, who declined to discuss the plan in detail. "It is a good clean document. It's the implementation phase we are now in."
Earlier drafts of the proposal created a new clinical/academic director of Shock Trauma who would report to the dean of the medical school on issues related to the training of residents and fellows. It also gave the UMAB president, who has jurisdiction over the medical school, the power to appoint half the people serving on search committees for new trauma doctors.
Dr. Howard Belzberg, a Shock Trauma internist, said he and colleagues fear that closer ties with the medical school would mean that the center would begin to value research and academic accomplishments above skill in taking care of patients.
"That's absolutely not true," countered Dr. Kinnard. "Both sides in the process say they are not totally happy, and that's what happens when you try to bring people together. The plan has a base line of trying to preserve the clinical program and trying to build it."
But Dr. Philip Militello, Shock Trauma's clinical director, said the secret nature of the regents' proceedings simply adds to doctors' anxieties about a closer relationship with the hospital and medical school: "It seems like a lot of this falls into power plays behind closed doors. Officials just seem to know what's best for the campus and the university."