Hopkins medicine due for a shake-up Restructuring could curb authority of hospital president

February 03, 1996|By David Folkenflik | David Folkenflik,SUN STAFF

In response to a campaign by some medical faculty members to oust the president of the Johns Hopkins Hospital, university and hospital trustees are planning the third management shake-up in two years at the East Baltimore medical center.

George L. Bunting Jr., chairman of the hospital board of trustees, said that Dr. James A. Block would remain as president of the Johns Hopkins Hospital and Health System. But Dr. Block's authority could be diminished by the new management structure, which Mr. Bunting said will be announced in a few weeks.

Dr. Block said through a spokeswoman yesterday afternoon that he was not available for comment.

The university, which includes the medical school, and the hospital were created more than a century ago as separate nonprofit corporations, but trustees of the two institutions have taken steps in the past two years to combine their leadership structures.

The moves were taken to allow Hopkins medical center to act more like a corporation in the increasingly competitive medical marketplace. But officials said that they also were necessary to address major personal and cultural conflicts between the school and the hospital.

In interviews, Hopkins physicians said the clash has hurt the university's ability to select a new president 13 months after the resignation of William C. Richardson.

In recent weeks, some Hopkins physicians told trustees that those conflicts had not been resolved. In particular, the doctors said, they did not trust Dr. Block to protect the hospital's mission of cutting-edge research and patient care as he leads Hopkins into the new world of managed care.

"Some medical faculty, some who don't know Dr. Block very well, are concerned about him, particularly because he is such a strong and powerfully articulate person about the future," said Dr. Paul McHugh, chairman of the Hopkins psychiatry department. Dr. McHugh said he supports Dr. Block as a man who has financially stabilized the hospital.

The lobbying efforts by some faculty, Dr. McHugh said, "are generated by the great demoralization that the faculty has felt by the loss of the [university] president and the dean of the medical school and the dean's right hand man."

Acting University President Daniel Nathans, a Nobel Prize-winning Hopkins medical researcher, has declared that he will not be a candidate for the post, and trustees do not have a list of finalists.

Mr. Bunting acknowledged that a "leadership void" at the medical school was created by the announced departures of its two most senior officials last month, and that it had shaken many medical faculty members. Physicians familiar with the thinking of the two men -- Medical Dean Michael E. Johns, and Executive Vice Dean David Blake -- said the changes and the uncertainty at the medical center contributed to their decisions to leave.

"I've come out of the corporate world, so I don't believe in long-lasting debates," Mr. Bunting said. "It's important to get a clear message to the organization for what we're doing."

Professors at "the School of Medicine [are] very concerned about controlling their destiny, and they want to be at the table," Mr. Bunting said. "Jim Block is on the other side, and so he becomes the lightning rod. I'm very open to listening to everybody."

The revelations last month of the departures of Dr. Johns and Dr. Blake triggered a flurry of meetings between some basic research professors and clinical department chairmen with trustees. According to colleagues, some professors told trustees they were uncomfortable with the new management structure created two years ago, called Johns Hopkins Medicine, integrating the leadership of the medical school, the university and the hospital.

The panel sets strategic policy and decides management issues. Currently, Johns Hopkins Medicine includes several medical professors and hospital officials, the medical school dean and the hospital president. The university president is the panel's chairman, and is in charge of settling major conflicts between the two sides.

Yesterday, Mr. Bunting said that the structure of the upper levels of management at the medical center would change yet again.

But despite rumors that raced through the hospital's corridors this week, Mr. Bunting said that Dr. Block had not been fired. Three days ago, in response to those rumors, Mr. Bunting issued a memorandum to all employees affirming that Dr. Block still had his job.

But several professors said that Mr. Bunting's terse, two-sentence statement fell far short of assuring Dr. Block's job security.

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