The University of Toledo announced Monday plans to pursue an academic affiliation between its College of Medicine and Life Sciences and ProMedica, as the UT Board of Trustees approved a resolution asking the administration to sign a letter of intent to begin negotiations on a long-term deal with the Toledo-based health system.
“This is a transformational day for UT medical and health science students, faculty at UT, physicians at ProMedica, and the long-term health of the community,” said Dr. Christopher Cooper, dean of the College of Medicine and Life Sciences. “This affiliation will provide our learners additional clinical learning experiences that are more varied and more local. The result will be more caregivers and more care options for northwest Ohio.”
In addition to clinical teaching, the affiliation will advance clinical and basic sciences research, said Cooper, who also serves as UT senior vice president for clinical affairs, noting that teaching and research form the core of the academic mission of UT’s academic medical center.
In their presentation to trustees, Cooper and Dave Morlock, CEO of the UT Medical Center, emphasized that the affiliation was with the College of Medicine only.
“UT will continue to independently own and operate the UT Medical Center, and UTMC plays no part in this agreement,” Morlock said. “UT has no plans to close or sell the hospital, and our priorities are unchanged: We will continue to focus on driving out hospital-acquired infections, improving the patient experience, and expanding ambulatory operations.”
Cooper said the letter of intent UT and ProMedica officials sign in the coming days will outline the framework for negotiating the final agreement, a process expected to take between three to six months.
Other elements of the affiliation the partners have agreement on include:
• A 50-year durable affiliation with limited abilities for either party to terminate the agreement;
• The UT Physicians practice group will remain a separate legal entity and interface with ProMedica in a clinically integrated network;
• Residency slots will be aggregated into ProMedica facilities, but the UT College of Medicine will maintain ownership of the residency programs from an accreditation perspective;
• ProMedica will accommodate substantially all UT Health Science Campus learners at ProMedica sites in northwest Ohio;
• Affiliation would be governed by an Academic Affiliation Operations Council, chaired by the dean of UT’s College of Medicine;
• UT and ProMedica will collaborate in the selection of clinical service chiefs at ProMedica, clinical department chairs at UT, and residency program directors;
• Subject to regulatory approval, ProMedica gets right of first refusal on certain transactions involving UTMC in future years;
• UT will have non-voting representation on the Toledo Hospital Board, and ProMedica will have non-voting representation on the UT Board of Trustees Academic Affairs Committee;
• ProMedica will provide $250 million in capital to rebuild the UT College of Medicine, in a location to be mutually agreed upon at a later date;
• ProMedica will provide at least $50 million per year in academic support payments;
• ProMedica will provide access to an electronic medical record; and
• ProMedica will provide access to clinic and office space.
Cooper said the affiliation would ensure for the next 50 years the continuation of the mission the College of Medicine’s founders envisioned when the former Medical College of Ohio was founded more than half a century ago.
“MCO’s founders wanted a medical school and an academic medical center in Toledo to ensure a healthy community,” he said. “By affiliating with ProMedica, UT’s learners, faculty and researchers will be able to learn, teach and conduct research in a premier health-care institution with the scale to accommodate UT’s medical, nursing, pharmacy, and health sciences students.”
The path to affiliation
In their presentation, Cooper and Morlock walked through the 18-month process they had followed to get to a letter of intent and in sight of the definitive agreements.
Reiterating comments from past board meetings and presentations across the University, the leaders reminded the audience of the vulnerability created by the mismatch between the size of UT’s College of Medicine and the size of its academic medical center.
The reason UTMC exists, Morlock explained, is to provide learning opportunities for UT health sciences students, research material for faculty and students, and capital for the academic mission.
UT’s College of Medicine, at 170 students per class, ranks in the 70th percentile nationwide while UTMC ranks in the 2nd percentile. The result is a hospital without enough patient volume or revenue to alone create long-term sustainability for the college.
With other industry trends, including the Affordable Care Act, the result, Morlock said, is that UTMC is financially strained today trying to provide capital for the College of Medicine and its own physical and equipment reinvestments simultaneously. And that tension would only be exacerbated over time, he said.
“Our learners are the overarching issue and as UT leaders, we have an obligation to them and to this community to ensure that in the decades to come, Toledo’s only medical school is adequately positioned to meet this region’s needs,” Morlock said.
“By affiliating UT’s College of Medicine with ProMedica, Toledo will become a net importer of medical talent and create a legacy we can all be proud of.”