Leaders of five Hartford-area hospitals have offered their support, in varying degrees, for the latest plan for the UConn Health Center, the Hartford Courant reports. The plan calls for $332 million in construction and renovation at UConn's John Dempsey Hospital and $20 million in teaching and research initiatives involving other area hospitals. Since Gov. M. Jodi Rell announced it last week, the proposal has not faced many of the obstacles that stymied previous plans, including opposition from other hospitals, the Courant reports.
The chief executive of Blue Cross and Blue Shield of Massachusetts abruptly resigned just weeks after he was replaced as chairman of the board. Cleve L. Killingsworth, 57, who helped lead Blue Cross for six years, departed shortly after the company posted a $149 million loss and reported it lost 89,000 subscribers last year. Former chief executive William C. Van Faasen, 61, who ran Blue Cross for 13 years and handpicked Killingsworth as his successor, will run the insurance giant without taking a salary until a permanent replacement is found.
The process and decision to terminate a resident for academic reasons weighs heavily on most residency program directors' minds.
"A lot of program directors wrestle with these decisions and feel guilty," says Forrest G. Read IV, Esq., academic medicine and employment attorney at Tobin, O'Connor & Ewing in Washington, DC.
Despite this guilt, most program directors take their obligation to protect the public seriously. After giving the resident a chance to remediate and documenting his or her inability to perform at the required academic standards, program directors have no other choice but to terminate residents who are performing below those standards.
However, the directors' guilt can still lead to decisions that can land the hospital in legal trouble. Because directors feel badly about such a harsh consequence for the resident, they often resort to a "compromise" option. They dismiss the resident but allow him or her to finish and get credit for the current academic year, Read says.
Program directors sometimes also opt to keep a resident on until June 30, the end of the academic year, to avoid disrupting call schedules or because one fewer resident will adversely affect patient coverage.
"This may be the less harsh and punitive way to go for the program director, but it may subject the institution to having to deal with a resentful resident and consequent lawsuit," Read explains.
Not promoting residents to the next academic year but allowing them to finish the current one often backfires because it sends a confusing message. The residents think, "If I'm so bad, why am I not being terminated now?"
"It arouses some suspicion in the resident that there was something amiss in the program director's decision," Read says, adding that it can also cause the resident to feel bitter about the termination.
These two factors often make the resident more likely to initiate a lawsuit. The resident may conclude, for example, that the adverse decision is because of an unlawful, discriminatory reason.
"We've had cases where residents have done just that," Read says. "This is a very real and practical situation we advise program directors on all the time."
Additionally, giving residents the opportunity to finish the year can hurt patient care and the functionality of the program. Residents in limbo often lose their motivation and stop performing activities, such as:
Responding to calls
Completing charts and other paperwork in a timely manner
Working congenially with colleagues
Following department or institution policies and procedures
Program directors should consult administrators in the graduation medical education office and hospital legal counsel to discuss the terms of the termination, including the date the resident will be fired.
Every case is different, but it's generally a better move to make the tough decision and not allow the resident to finish the year, Read says.
The benefits of a swift, informed decision often outweigh the risks of a limbo period for the resident and the program.
Michael Trainer, CPA, has been named CFO/treasurer of Akron Children's Hospital. Trainer has served as Akron Children's interim CFO for the past five months. He joined the hospital system in 2008 as a vice president. Before joining Akron Children's, Trainer was vice president of regional services and strategic initiatives at the Cleveland Clinic. He has also held financial positions with Summa Health System and Deaconess Hospital of Cleveland.
Vince Pryor has been named senior vice president of finance/CFO for Edward Hospital & Health Services. Pryor comes from Ingalls Health System, where he worked the past eight years as senior vice president of finance/CFO. Previously, Pryor served as CFO/vice president of finance at Provena Hospitals and vice president of managed care/COO of management services organization for LaPorte (IN) Hospital.
Clarence J. Silvia has been named president/CEO of The Hospital of Central Connecticut and president of the Central Connecticut Health Alliance, the hospital's parent organization, effective immediately. Silvia, 54, most recently was senior vice president/COO for CCHA and the hospital. Before this, Silvia was president/CEO of Bradley Memorial Hospital, a post he assumed in 1993 after serving as the hospital's executive vice president for seven years.