The UConn Health Center: Whither or Wither?

Copyright 2009 Robert S. Rosson. All rights reserved.

On November 21, 2009 it was announced that the University of Connecticut had rejected a proposal by Hartford Hospital to merge with the UConn Health Center to form a first rate medical school-hospital complex. Under this plan, supported by a state-sanctioned commission, the state would build a new hospital in Farmington to be owned and operated by Hartford Hospital. The result would be a new University Hospital with campuses both in Farmington and Hartford. The Hartford Healthcare Corporation would assume financial responsibility for the new hospital except for $13 million in labor costs to be born by the state. The other community hospitals in Greater Hartford would continue to participate in the teaching and research activities of the medical school.

Now the situation will revert to that of 18 months ago; the Dempsey Hospital will remain too small to be financially profitable, and the state will continue to be responsible for an annual deficit of about $20 million. Moreover, the 32 year-old hospital is said to be in need of major renovations. No alternative plan has been proposed by UConn or the Legislature. The question is where we go from here with this unsustainable situation.

In the Hartford Courant of Sunday, December 6, 2009, Connecticut State Representatives David Baram and Timothy Larson, suggest that the VA partner with UConn as a way to solve the problem. They make no mention of the Newington VA Hospital; which already has an affiliation with the Health Center. In recent years that hospital was reduced to an outpatient facility and its inpatients transferred to the West Haven VA, which is a major affiliate of Yale Medical School. At one time a suggestion was made that the VA build a hospital on the Farmington site, but nothing came of it. While the VA does provide salaries and space for residents and faculty at many medical schools, I do not know whether it can provide operating expenses for university hospitals or funds to build new non-VA hospitals.

I would suggest, as others have, that UConn revisit the idea of the “Harvard Model.” This system is one in which the university medical school has no hospital of its own, but rather utilizes the hospitals within its geographic area for teaching students, residents and fellows, and for care of patients and research by its faculty.

In this regard I suggest the following:

1. The Legislature and UConn should appoint a joint commission to study this possibility. Representatives should visit Harvard Medical School to learn in detail how the system works.
2. UConn should engage a consultant with intimate knowledge of the Harvard Model to determine the efficacy and implementation of such a system in Greater Hartford.
3. Under this proposal, the John Dempsey Hospital would close its inpatient services.
4. The hospital would be re-fitted to include research laboratories, outpatient clinics, outpatient surgical centers, a walk-in center, and a triage emergency center. Patients needing admission could be rapidly transferred to one of the cooperating community hospitals by helicopter or ambulance.
5. The participating hospitals, Central Connecticut, St. Francis, and Hartford Hospitals, and others, would provide laboratory and office space and designated hospital beds to the university physicians. Consultations between the university and community physicians would work to the benefit of both groups and their patients. Each group would contribute significantly to the education of medical students, residents and fellows, who would continue to rotate among the hospitals as they do now.

Obviously many financial and administrative problems would have to be worked out before such a plan could go into effect. With, however, strong, enlightened leadership and open-minded good will among the various players, the University of Connecticut-Greater Hartford Medical Center could become the first rate system of education and medical care the citizens of Connecticut deserve. If we can become first class in basketball and football, we ought to be able to do it in medical education, research and patient care.

Note: The writer is a graduate of Harvard Medical School and Clinical Professor of Medicine at the UConn School of Medicine. The views expressed herein are strictly his own and do not necessarily reflect those of either institution or YJHM.

Published originally in YJHM December 9, 2009