Tensions at the Maryland Shock Trauma Center boiled anew as University of Maryland officials yesterday accused 34 doctors of pocketing $2.5 million in patient-care fees and threatened legal action unless the money is returned by Friday.
Dr. Errol L. Reese, president of the University of Maryland at Baltimore, said that the university had received "over 50 percent" of the money as of noon and that he was confident that the remainder will appear by the end of the week.
But he said that Attorney General J. Joseph Curran Jr. is prepared to take individual doctors or their fee-collecting corporation -- Shock Trauma Associates Professional Association (STAPA) -- to court if the deadline isn't met.
Dr. Reese said that individual doctors had collected amounts ranging from "several thousand dollars to $200,000." In a related action, university officials said they had retained the accounting firm of Coopers & Lybrand to review STAPA's books to look for any irregularities.
"This is not a witch hunt," said Dr. Stephen C. Schimpff, executive vice president of the University of Maryland Medical System. "It is to satisfy [state trauma director] Kimball Maull and the Board of Regents that nothing else has happened."
Two longtime trauma doctors who asked not to be identified defended the payouts, saying the $2.5 million had accumulated in a reserve fund established eight years ago to handle potential malpractice judgments and settlements at a time when many insurance companies appeared on the brink of collapse in the face of rising malpractice judgments.
Several years later STAPA directors voted to continue the account as a "rainy day fund" to handle unforeseen problems, the doctors said. The STAPA board voted to disburse the money last month. In one doctor's words, doctors saw "the handwriting on the wall" that Dr. Maull and Dr. Reese intended to exercise "autocratic" control over the fund.
STAPA, a private corporation, collects patient fees and distributes the proceeds to various sources. It pays doctors' salaries -- including a portion of Dr. Maull's -- and allocates money for equipment, training, research and other institutional needs.
While the doctors claim the $2.5 million came out of their own professional fees, university officials said the money was siphoned off before Shock Trauma had a chance to get its fair share. The officials contend at least half of the amount paid to the doctors should have gone to support the institution.
Reese and University of Maryland of Maryland Chancellor Donald N. Langenberg, said the payments violated rules that require university approval of all doctor compensation.
In a letter to the STAPA board, Dr. Langenberg said that the payments raise "serious questions" about the group's tax-exempt status, "the loss of which could have devastating financial impact" on the corporation and its member doctors.
The dispute is the latest chapter in a growing controversy between trauma doctors and the University of Maryland leadership, which has sought to end the autonomy that Shock Trauma has enjoyed for many years and to make it more accountable to the university.
Seeds for this latest feud were planted on May 1, when the university's Board of Regents approved a "practice plan" that gave Dr. Maull and Dr. Reese the authority to approve all expenditures of STAPA funds. The STAPA board voted a day earlier to formalize the reserve fund as a "deferred compensation" pool to be disbursed at some later date.
mid-August, the STAPA board voted to divide $2.5 million in different shares among 34 doctors, according to Dr. Reese.
Dr. Maull is a member of the board that approved the payouts. But he said he wasn't present at the April or the August meetings, and was never told about the disbursements until a doctor told him last week that he had received a substantial check.