Troubling conflict stalls Hopkins' search New president must try to maintain prestige amid shrinking dollars

February 01, 1996|By David Folkenflik | David Folkenflik,SUN STAFF

The search for a new president at the Johns Hopkins University -- which passed its January deadline yesterday without completion -- has been complicated by the troubling financial issues facing academic medical research centers across the country, Hopkins officials said.

In years to come, major medical centers such as Hopkins will see a drop in revenue for treating patients from the government and private insurers, an issue that will demand considerable attention from the university's next president.

Formally, Johns Hopkins Hospital and the university are separate institutions, with the medical school under the university's wing. But the new university president will lead a new, powerful committee of medical school and hospital officials that has broad oversight over major policies.

Federal officials are predicting significant reductions in payments to hospitals for Medicare and Medicaid patients. And health maintenance organizations are shepherding clients away from more expensive academic hospitals to community hospitals, diverting money from research and education. In response, the Johns Hopkins Hospital and Health System has courted a new patient clientele based heavily on family practice.

But that strategy has created a clash between the hospital and the medical school, where many medical professors believe the culture that produced some of the world's greatest research is being debased. Some at Hopkins say that unresolved divide encouraged the recent resignation of two top medical school officials and has made it more difficult to find a new president by Hopkins' self- imposed deadline.

In recent weeks, some senior medical professors, including several department chairmen, have met privately with hospital trustees to lobby for major change in the management structure in the medical complex. So much attention has been focused on the status of Hopkins Hospital and Health System President James A. Block that the chairman of the hospital trustees, George L. Bunting Jr., issued this statement to hospital employees yesterday:

"It has been brought to my attention that inaccurate rumors are circulating regarding Dr. James Block's position at Hopkins. There has been no change in his status as president and CEO of the Johns Hopkins Health Systems Corporation and the Johns Hopkins Hospital."

The chairman of the university's board of trustees rejected the notion that conflict between administrators at the medical center had affected the presidential search. But Morris W. Offit acknowledged that changes in the medical center's administrative structure over the past year have led to what he termed understandable, but overblown worries.

The 19-member search committee has been engaged in talks with a handful of potential candidates in recent weeks, said Mr. Offit, who is leading the search. There is no short list, however, 13 months after the announcement of former President William C. Richardson's resignation. Acting President Daniel Nathans, a Nobel prize-winning molecular biologist, has ruled himself out as a candidate.

"The search could conclude in the next few weeks, it could conclude in the next few months," Mr. Offit said. "We'll have a president in place very shortly, and that will help to stabilize any person's uncertainty to the future."

The tensions at Hopkins are at heart driven by the new economic realities of medicine, Hopkins officials said. To make Hopkins more marketable to HMOs, Dr. Block, president of the hospital, has led a drive to bring the practices of primary-care physicians who are not faculty members under the Hopkins umbrella.

The move has angered senior professors, who believe that push could strip Hopkins of the pioneering patient care and research that earned it world renown.

"There is great concern that until [officials] get the medical center situation taken care of, they won't be able to attract anybody good" as president, said a doctor knowledgeable about Hopkins management. "Otherwise, that person will spend all his time on the East Baltimore campus.

"Hopkins exists because of a self-fulfilling mystique that it's excellent, and therefore it attracts excellent people," the doctor said. "[Hopkins] always will be very good. The question is whether it will be great. The esprit de corps is at risk of being fractured."

A recent pair of departures in the medical school surprised some at Hopkins. Medical Dean Michael E. Johns announced that he would leave this summer to become medical chancellor at Emory University in Atlanta. In mid-January, Executive Vice Dean David Blake, Dr. Johns' chief deputy, said he would become senior vice president of the Association of American Medical Colleges in Washington.

Neither Dr. Johns nor Dr. Blake cited the changed structure as their reason for departing, and few interviewed say that is the primary cause for their leaving. But both officials found the situation less appealing in recent months, say physicians knowledgeable about their departures.

Baltimore Sun Articles
|
|
|
Please note the green-lined linked article text has been applied commercially without any involvement from our newsroom editors, reporters or any other editorial staff.