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Detroit Children's Hospital Ousts Wayne State Pediatricians

— 25 doctors "squeezed in the middle" of administrative dispute

MedpageToday
A photo of the Detroit Medical Center’s Children’s Hospital of Michigan building

A group of Wayne State University pediatricians will not be able to practice at the Detroit Medical Center's Children's Hospital of Michigan, effective July 1.

The move is the latest in a years-long rift between WSU and a pediatricians group, University Pediatricians, which split from the school in 2018 to sign on with Central Michigan University. About 80 physicians joined University Pediatricians and 25, who stayed with WSU and formed will be affected by this latest ban, said WSU Medical School's chair of pediatrics, Herman Gray, MD.

"University Pediatricians, in partnership with Detroit Medical Center, states they have irrevocable exclusive rights to practice in the children's hospital, and therefore told their members, who were also our faculty at the time, if you join Wayne Pediatrics, you will not be able to practice in the hospital," Gray told 鶹ý. "For an academic pediatrician to not be able to practice in a children's hospital is a huge sacrifice and is very difficult to swallow."

The decision to sever ties with Wayne Pediatrics doctors came after the DMC, a for-profit health system owned by Tenet Healthcare, assured WSU that the children's hospital had an "open medical staff," that allowed them to practice at the hospital, said WSU School of Medicine Dean Mark Schweitzer, MD.

"The DMC is in the process of taking away the privileges of these 25 physicians who have had privileges at these hospitals for their entire careers to create a monopoly of pediatric care," Schweitzer told 鶹ý.

WSU initially created University Pediatricians as part of a practice plan that would allow academic providers to see patients at the DMC, Gray said. Over a couple of years, the group became increasingly independent and ultimately severed the relationship with WSU in 2018. Without a place for medical students to practice, WSU risked losing its accreditation, and created Wayne Pediatrics.

"The university would not have walked away if there were any other way to try and solve this, but we just could not find a way," Gray said. "We could not make them be a part of us and decided we would just have to separate."

However, University Pediatricians physicians services payments continued to go through the university, and the private group ended up owing the university about $25 million, Gray said. In April, a judge in which University Pediatricians alleged WSU took nearly $61 million in Medicaid funds.

In a University Pediatricians said the claim that WSU pediatricians had been banned from the Children's Hospital was "blatantly false," and that a "very small number of disgruntled pediatricians have decided to terminate their relationship with University Pediatrics and forego [sic] the benefits of our longstanding relationship with DMC Children's Hospital."

Children's Hospital of Michigan has had an exclusive arrangement in place with University Pediatricians for many years, and physicians who left to join Wayne Pediatrics will remain members of the staff, DMC told 鶹ý in a statement.

"DMC regrets that Wayne State chose to develop a competing pediatric group which has resulted in a potential separation in the pediatric community that has been a hallmark of excellence in Detroit and at Children's Hospital of Michigan for decades," it stated. "Wayne Pediatrics physicians can care for patients at Children's Hospital of Michigan for specialty services which are not part of the exclusive contract with University Pediatricians, and can care for their patients at all other DMC facilities."

Schweitzer does not expect the rift to affect medical students, he said.

However, the disputes are putting underserved patients at risk in one of the country's poorest cities, Schweitzer said. Some WSU pediatricians treat HIV, for example, and banning them from the children's hospital would prevent children with AIDS-related disorders from being admitted under their service, he said.

Schweitzer said this is "further evidence of Tenet's prioritization of profits over patients," and cited bylaws that do not tie a physician's employer to his or her medical staff privileges in a letter to medical school students and staff May 5.

"If you change employer, as long as you are in good standing as a physician, your privileges remain intact," he wrote. "To violate this norm is unprecedented and unconscionable, and far worse, it affects the health of children by separating them from their doctors."

Tenet Healthcare did not respond to request for comment Thursday.

Gray said providers who joined University Pediatricians were torn between continuing to see patients at the hospital or sacrificing their relationship with the university. Central Michigan University does not have the same infrastructure in place to support many WSU physicians' research -- not to mention it is 150 miles away from Detroit, Gray said.

"Most physicians who are in University Pediatricians wanted to stay with WSU," Gray said. "The vast majority of doctors got squeezed in the middle of this dispute."

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    Elizabeth Hlavinka covers clinical news, features, and investigative pieces for 鶹ý. She also produces episodes for the Anamnesis podcast.