A yearlong contract dispute between Wayne State University and the Detroit Medical Center has threatened 68 separate residency programs that train more than 1,000 physicians, jeopardizing the students’ education as well as future medical services for thousands of patients at the hospital system.
The impasse over reimbursement and exclusivity arrangements reached the crisis point earlier this month, triggering the intervention of Gov. Jennifer Granholm, who named former Cabinet member David Fink as a mediator in a last-ditch effort to resolve the dispute.
While the high-level mediation continues, the Chicago-based Accreditation Council for Graduate Medical Education, which oversees the nation’s training programs for future doctors, has also stepped in. The group sent officials to Detroit last week to evaluate the explosive situation between the medical school and the DMC, an integrated, nine-hospital system that ranks as the No. 1 provider of medical care in southeast Michigan.
Mediated negotiations were expected to continue late last week, but spokespeople for both sides were not optimistic of a quick resolution.
In the meantime, the Michigan State Medical Society announced late last week it had declared a "state of emergency" in the wake of the stalled negotiations. In a news release, the society’s president, Paul Farr, a physician, said, "healthcare in our state will be devastated" if the impasse forces the ACGME to suddenly yank accreditation for the programs.
Among the sticking points, sources said, is the medical center’s insistence on maintaining an exclusive arrangement with Wayne State, which has sought to develop graduate-level affiliations with other hospitals. Wayne State also has reportedly complained that reimbursements for these medical students have not increased since 1998.
Julie Jacob, a spokeswoman for the ACGME, said the organization does not "comment on reviews or accreditation actions." While stripping residency programs of accreditation is a fairly rare and time-consuming process, she did say that the ACGME can fast track such a drastic action through an "expedited withdrawal of accreditation" if a program suffers a "catastrophic" loss of resources, including faculty, facilities or funding. In 2004-05, the ACGME involuntarily withdrew accreditation from 20 programs, Jacob said.
In April, the first casualties of the battle in Detroit were 24 students in the orthopedic residency program who were forced to transfer to new hospitals to complete their education.The first meeting over the dispute was held earlier this month at the urging of Mary Kramer, publisher of Crain’s Detroit Business. Keith Crain, chairman of Crain Communications, parent of Crain’s Detroit Business and Modern Healthcare, is a member of the Detroit Medical Center’s board of directors.
This article initially appeared in the Nov. 20 edition of Modern Healthcare magazine.