Task Force Will Review King/Drew

Los Angeles County supervisors agreed Tuesday to form an expert task force led by former Surgeon Gen. David Satcher to review physician training programs and recommend reforms at the county’s troubled Martin Luther King Jr./Drew Medical Center.

On the same day, a state legislative panel held a nearly four-hour hearing in Los Angeles, at which speakers alternated between pleading to preserve the hospital’s mission and assigning blame for its problems.

“We must restore the level of respect and dignity that the people who work here, who are served by this institution, deserve,” said Assemblyman Mark Ridley-Thomas (D-Los Angeles).

The two public meetings occurred as King/Drew, founded in one of the county’s most underserved areas in the wake of the 1965 Watts riots, struggles for its survival as a teaching institution and community resource.

“The county is committed to do whatever it can to address those problems,” county Supervisor Yvonne Braithwaite Burke told the Assembly Select Committee on King/Drew Medical Center. “I want to assure you that we work on this night and day.”

Burke proposed the task force, which was later approved unanimously at the Board of Supervisors’ weekly meeting. Within 60 days, the outside experts will examine obligations as a teaching hospital, how other hospitals have responded under similar circumstances, and how to strengthen recruitment and retention of faculty.

King/Drew faces a crisis because six of its 18 training programs have received sanctions or warnings from national reviewers in the past two years. The hospital’s radiology training program will be shut down in June 2004, and its surgery residency faces a proposed revocation. The hospital plans to ask the reviewers at the Accreditation Council for Graduate Medical Education to reconsider their decision on the surgery program; a final decision could come next month.

The 337-bed hospital in Willowbrook, just south of Watts, received an overall unfavorable rating for oversight of its residencies three years ago. And now its ability to train physicians is on the line, pending the results of a recent review by the accreditation council. King/Drew relies heavily on medical residents to treat its largely impoverished, minority clientele.

Assemblyman Mervyn Dymally (D-Compton) called for the Assembly probe to assess the causes of the hospitals’ woes and recommend solutions. The review is ongoing, and additional hearings are anticipated.

“We are not here to investigate anyone or anything in an adversarial manner,” he said at the introduction of Tuesday’s session, “only to look for constructive responses.”

But his words did not keep other speakers from pointing fingers. Hospital workers blamed Los Angeles County, which runs the hospital, for providing inadequate resources. Faculty leaders faulted the administration of Charles R. Drew University of Medicine and Science, which runs the teaching programs at the hospital. And county officials attributed Drew’s woes to its relative youth, saying the 37-year-old school hasn’t yet built the endowment and reputation needed to attract the best faculty.

Many speakers touched on the recent troubles in King/Drew’s surgery department. Officials with Drew and Los Angeles County have blamed the former surgery chairman, Dr. Arthur Fleming, for the accrediting agency’s proposal to strip the department of its ability to train residents. They have said Fleming allowed the program to enroll 40 residents even though he was told repeatedly by the accrediting body not to train any more than 38. That violation occurred while the program already was on probation for other educational deficiencies.

Speaking for the first time publicly Tuesday, Fleming said he did not disobey the accrediting council. He testified that he believes he was following the council’s wishes when he allowed two residents to continue in the program after he held them back a year for academic reasons.

“A red flag was never raised to me regarding maintenance of these two residents in the program,” Fleming told the legislators.

Even with those two residents, Fleming said during his 90-slide presentation, the program never exceeded the 38 slots it was allowed by the accrediting council. His position on the enrollment number conflicts with what reviewers told county officials.

Fleming said the proposed loss of accreditation “took me greatly by surprise.” He said an official of the accreditation council made an “absolutely false statement” by saying Fleming had been warned not to increase enrollment.

Some lawmakers and community members at the Assembly hearing blamed the health department for the hospital’s shortcomings, saying it should not have cut more than 400 positions at King/Drew this summer. The county contends that the hospital is less efficient than other county facilities, and that the cuts won’t lead to a reduction in services.

Assemblywoman Jackie Goldberg (D-Los Angeles) said some cuts clearly would affect patient care. “Would you consider no pediatrician on duty [overnight] a cut in service or an efficiency?” she asked Dr. Thomas Garthwaite, director of the county Department of Health Services. He promised to reexamine any cuts that caused a loss of services.

Alejandro Stephens, president of the labor union representing King/Drew workers, said nurses at the hospital are “dangerously overextended.”

Several speakers said officials should not lose sight of King/Drew’s mission: to care for underserved patients and train minority doctors.

Assemblywoman Judy Chu (D-Monterey Park) said the hospital is a “story of how good can come from despair and how communities can triumph when their needs have been ignored for so long.”