Doctors support merger of Kaleida, ECMC

By Henry L. Davis
News Medical Reporter
The Buffalo News
08/17/2007

The doctors at Kaleida Health System and Erie County Medical Center held their peace as the hospitals this year flirted with marriage. Now, they say it’s time to speak.

In a joint letter to Dr. Richard F. Daines, state health commissioner, the leaders of the organizations’ two medical staffs voiced support for a hospital consolidation, saying the region must embrace significant change to prevent its health care system from sliding into second-rate status.

We need great people working in great programs with great facilities, not old hospitals, outdated equipment and antiquated systems,” the medical staff officers wrote.

The doctors also urged Daines, as well as elected officials and hospital executives in Buffalo, to include physicians while redesigning the hospital system.

Doctors aren’t architects, planners or administrators, but they want to be part of the process,” Dr. Evan J. Evans, president of Kaleida’s medical-dental staff, said in an interview.

Past efforts to merge or reorganize hospitals in the region have been top-down affairs, with hospital directors and administrators unsuccessfully trying to sell reluctant medical staffs on proposals. In this case, the doctors are warning the hospitals, whose consolidation talks have been deadlocked for months, to get on with the business of reforming themselves but not to repeat the mistakes of the past.

We’re concerned that a realignment of the hospitals will be about bricks and mortar first, and doctors second,” said Dr. James T. Evans (no relation), president of the ECMC medical staff. “You need physician input, and we believe we can offer worthwhile ideas.”

ECMC and Kaleida have yet to agree on basic corporate issues, such as how to divvy up seats on a new board of directors and how the new entity should be structured.

But hospital officials welcomed the physicians’ message.

It’s a major breakthrough and shows the leadership on both sides,” said Michael Hughes, spokesman for Kaleida.

The points the physicians make are what we’ve tried to keep in the forefront of consolidation talks,” said Thomas Quatroche, ECMC spokesman.

In an effort to restructure the state’s inefficient health care system, the Commission on Health Care Facilities in the 21st Century, also known as the Berger Commission, last year recommended the closing of nine hospitals and seven nursing homes, and the restructuring of dozens of others.

The recommendations, now state law, require Kaleida and ECMC to combine into a new nonprofit corporation that includes the University at Buffalo medical school. The commission also called for closing Kaleida’s Millard Fillmore Hospital at Gates Circle and building a new center for heart and vascular procedures for the combined organization.

If the would-be partners can’t reach agreement by year’s end, the state Health Department was given the authority to close either ECMC or Kaleida’s Buffalo General Hospital. Failure to accomplish a deal also could jeopardize tens of millions of dollars in government funds to help the hospitals reengineer.

We’ve got too many hospital beds, duplication of high end services, trouble recruiting and keeping doctors, and out of- date buildings. There’s a consensus that something needs to happen to make health care better in this community,” Evan Evans said.

He said a consolidation must leave Buffalo with a higher-quality health-care system and will require substantial financial help if it’s to be done right.

The focus has to be on making the system better and not just on saving money by closing buildings,” he said.

The letter highlighted four priorities for physicians, many of whom work at both ECMC and Kaleida:

Make improvements to the system based on what’s best for patients and not to accommodate special interests in the medical community.

Leave the Buffalo area with a hospital system that is an engine for economic growth and not a financial burden.

Strengthen the hospitals to help them recruit specialists and improve the current fragmented training of new doctors.

Close unneeded hospitals and refurbish existing but out of- date buildings to bring them up to modern standards.

Movement on consolidation is expected soon.

Kaleida and ECMC recently filed separate applications with the state for funding related to Berger Commission’s recommendations, instead of seeking financial help for a unified plan.

The state is supposed to decide which projects to fund and to what extent by Sept. 30. Daines also is expected in the next few weeks to take the unusual step of naming members of a combined board of directors, said Claudia Hutton, spokeswoman for the agency.

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