Friday, August 06, 2010

Stories from the Clippings

Fight at the OK'd Corral

So, last week we learned that in 1954, there was much ado among the Oregon State Medical Society, the Multnomah County Medical Society and the State Board of Higher Education. The altercations, concerning the policies of the UOMS teaching hospital being erected on Marquam Hill, were heating up. Nothing new here, issues among the medical profession had been only moderately held in check for several years.

The policy of the hospital in question was OK'd by the Board in September of 1954, with the school slated to open in April of 1956. The hospital would be operated as a unit of the medical school and would augment the school's mission of teaching, research and healthcare. Patients would be chosen by the medical school staff and must be diagnosed with conditions that would contribute to the mission of the school. Indigents would be admitted and if patients were able to pay, they would be charged. But here's the rub: none of the fees would go to the attending physicians but would go to supplement the state's budget for the hospital. No physician, not on the hospital staff, would be able to treat a patient at the hospital.

The Oregon State Medical Society endorsed the policy with the provision that the hospital only admit the indigent. The Multnomah County Medical Society had no provision and embraced the policy wholeheartedly.

Besides other issues, the big issue at stake here was that the hospital could not afford to pay full-time faculty for full-time service, so needed to allow faculty at the school to conduct private practice. The opposition's point of view was that salaries should be enough for full-time faculty, so that they would not have to continue in private practice; the school, they argued, could and should be able to recruit for and demand full-time status for instructors. But it was that salary inequities existed. It was true that some physicians on staff had highly successful practices that provided a much larger income. Would it be, they offered, that in order to maintain that kind of income, those physicians would opt to attend to their private practice patients and possibly neglect their academic duties. And, remember from last week's blog post, that some physicians were also in favor of on-site private practice at the medical school hospital.

The controversy was so great and arguments so heated that, apparently, there was even a fist fight between two of the medical school faculty.

The Oregon Medical Society asserted that the board had asked them to form a committee to study this policy and to report their findings to the board. But the committee had not had time to formulate a report when they were informed that the policy had already received the rubber stamp of approval. The society fumed that the decision was not and could not be acceptable under these conditions and was deemed incredible, unbelievable and premature. But Dr. R. E. Kleinsorge, president of the board claimed that, "The board never asked the medical society to make studies. We asked them to appoint a committee to meet with us, and after a delay of three months with no appointment of a committee we went ahead and adopted our policy." Furthermore, the board stated that, "No policy is permanent. All policies are subject to change. We welcome any assistance anybody can give, but we cannot delay establishing policy forever, waiting for studies to be made which are only a repetition of those which we have."

Ouch!

So, the Oregon State Medical Society, the liaison group between the medical school and the state's private physicians, called a closed meeting at the Benson Hotel to discuss the complaints against the policy. But underlying the main purpose of the meeting was the widening chasm between the medical school and private practitioners.

Stay tuned, more to come…

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