Strife eroded UMMS goals

New leaders say they're working to move ahead

August 22, 2008|By Laura Smitherman | Laura Smitherman,Sun reporter

The University of Maryland Medical System started planning a $350 million ambulatory care center in Baltimore more than two years ago to treat patients on an outpatient basis, but disputes and infighting at the organization have helped to stymie the project.

A parking lot has been erected at the site but nothing else.

That kind of gridlock among leadership of the medical system is one of the factors that led to the resignation this week of one-third of its board - including the chairman and vice chairman. The system, which oversees hospitals in Baltimore and throughout the state, has been beset by a number of competing agendas that have not only stalled progress but left a wake of distrust, current and former board members said.

Doctors had become frustrated with what they felt was a more bottom-line approach at the not-for-profit medical system. A power struggle had led to sour feelings on the board, where former Chairman John C. Erickson said the university was asserting its interests over other stakeholders. And recently, Gov. Martin O'Malley intervened by making a number of appointments to the board without its input, prompting accusations of political interference.

The result was a very public airing of the disputes at the normally staid and secretive medical system. At stake is the stability of a $2 billion-a-year enterprise that not only provides care through a network of hospitals and medical centers but also trains most of the doctors that set up practice in Maryland and undertakes ground-breaking research, including cancer studies done by Dr. Kevin J. Cullen, who is highly regarded in his field.

"The medical system and university are losers in this battle in the sense that it's going to take a long time to get everyone back together," said Dr. Stephen Schimpff, the retired chief executive officer of the University of Maryland Medical Center, who had written to the board this month urging cohesion. "But they've got people in place now to see that that happens."

While directors on the reconstituted board say they want to leave the rancor in the past, they face the daunting task of trying to patch together relations between the disparate and powerful stakeholders - from the doctors and a network of community hospitals to the State House, which during the past five years has provided about $350 million in funding. At the same time, the system must attract permanent leaders.

Erickson, Vice Chairman James F. Pitts and eight board members left the 27-person board Wednesday during a meeting that attendees have described as a respectful exchange that ended with the realization that they could not overcome their differences. Erickson had spent nine years on the board and acknowledged insinuations that he had become too controversial.

The remaining board members chose as their interim chairman House of Delegates Speaker Michael E. Busch, who was on the board and has developed a reputation in Annapolis for his ability to corral strong coalitions in his 141-member legislative chamber. They also had to choose an interim chief executive officer after Edmond F. Notebaert retired a few weeks ago.

They picked Robert A. Chrencik, the medical system's chief financial officer, who has worked there since 1983. Under Maryland law, Chrencik also had to be approved by the University System of Maryland Board of Regents to serve as a vice president. The regents board voted unanimously yesterday for his appointment.

"There's a strong feeling that he has just the right kind of personality and skills that we need to build a strong relationship between the medical school and community hospitals," said University System of Maryland Chancellor William E. Kirwan.

O'Malley has made seven appointments to the board in rapid succession during the past month, including some nominees who had not been recommended by the board. Erickson said the direct appointments without board input jeopardized the body's independence, while others have raised questions about whether political cronies were installed.

Among the nominees was Stephen A. Burch, former president of Comcast Corp.'s Mid-Atlantic Division and an O'Malley donor, though he also has supported Republicans. O'Malley also nominated John P. Coale, an attorney who lent O'Malley $500,000 in the final days of last year's gubernatorial campaign. But the board had put, or planned to put, both on its preferred list of nominees, according to people familiar with the matter.

The medical system is the creation of legislation passed by the General Assembly 25 years ago to privatize the then-financially troubled university hospital. The idea was that a private institution would be free of bureaucratic restraints and therefore more efficient. Since then, several community hospitals have been added to the system.

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