University prescription

Our view : To heal wounds of a walkout by University of Maryland Medical System board members, governor needs to find experienced leaders with a collaborative sensibility

August 31, 2008

The troubles at the University of Maryland Medical System started long before one-third of the board, including its chairman, resigned a week and a half ago. And it predates the dispute over how to replace outgoing Chief Executive Officer Edmond F. Notebaert, who announced his retirement in July.

Tensions at the medical system have been building for years, and critics who now lambaste Gov. Martin O'Malley for intervening in the matter have it exactly wrong. The problem is not that the governor took recent action but that he did not step in much earlier when it was clear that UMMS leadership had become dysfunctional.

Admittedly, there were few outward signs of trouble. UMMS has prospered over the last two decades, replacing aging facilities with gleaming new towers, attracting top-flight medical talent and expanding to include community hospitals from across the state. Today, it's a $2 billion enterprise and one of the region's largest employers. That success was possible, in large measure, because of the organization's unique structure. Since its spin-off from state control 25 years ago, UMMS has been a private nonprofit with strong ties to state government and to the University of Maryland. Thus, it has been freed of much government red tape, can borrow money in the private market, has strong state support (including $200 million to underwrite capital improvements) and maintains a community-focused mission.

At its heart, UMMS is two things: a hospital and a medical school. Those two purposes are often complimentary - the hospital is among the nation's finest, and the school, also consistently judged among the best of its kind, provides well-trained physicians to staff it.

But sometimes those missions are in conflict, and in recent years, the physicians and those involved with the medical school felt they had been treated poorly and lost faith in management. The feud escalated, causing an important hospital expansion project to be shelved and a call for new leadership. The recent attempt to appoint an interim CEO opposed by the doctors, the university's board of regents and the governor was a final straw.

Make no mistake, the departure of so many board members with as much expertise and experience as outgoing Chairman John C. Erickson is a sizable loss for the system. Mr. O'Malley needs to find replacements of similar talents, stature and knowledge and not just draw from personal or political relationships, as politicians are sometimes prone to do in such circumstances.

Acting CEO Robert A. Chrencik, the system's affable and well-regarded chief financial officer, appears to be well on his way to restoring the institution's reputation in the academic community and mending fences. State House Speaker Michael E. Busch, one of the legislature's leading voices on health care, is also a strong choice as the board's acting chairman.

But they can't do it alone. While Mr. O'Malley may be worried about further conflict at UMMS, it would be a huge mistake to trade a conflicted but high-achieving board for a collegial but undistinguished one. The governor needs to find the right people for this important institution and then steer clear and let the medical system thrive by returning its attention to what it does best, healing the state's sickest patients and training our next generation of doctors.

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