WVU fires health adviser

Consulting firm had cited severe problems in report
June 14, 2008 12:00 am

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West Virginia University yesterday fired a Pittsburgh consulting firm that had cited severe medical and financial problems confronting the university's $1 billion health care enterprise.

Fred R. Butcher, interim vice president of WVU's Robert C. Byrd Health Sciences Center, said an interim report by R&V Associates contained "many errors of fact and understanding." The report was based on interviews with only 14 employees and Dr. Butcher said R&V never gave him a good answer why more doctors weren't interviewed.

R&V was founded in 2005 by former Children's Hospital of Pittsburgh President and chief executive officer Ron Violi and Vincent Deluzio, a UPMC director and former partner and director of Buchanan Ingersoll, a Pittsburgh law firm.

The report on the university, delivered May 16, cited "alarming deficiencies" in cardiovascular surgery; "serious leadership and productivity issues" in the anesthesia department, which will post an estimated loss of $12 million to $14 million this fiscal year; and an "alarming lack of surgeons." R&V told university officials they sought, but were unable to obtain, written reports regarding the deaths of two children involving pediatrics and anesthesiology.

Mr. Violi declined comment yesterday.

R&V is under contract to manage Wheeling Hospital through July 2010. Mr. Violi is CEO of the hospital, which has 276 beds and 230 physicians.

WVU's Health Sciences operation includes the schools of medicine, dentistry, nursing and pharmacy; WVU Hospitals, which operates Ruby Memorial Hospital and WVU Children's Hospital in Morgantown and five other facilities; and United Health Associates, a physician practice. It employs more than 7,000 in Morgantown and 11,000 statewide.

Dr. Butcher said he initiated the decision to discharge R&V and it was approved by university President Mike Garrison, who hired the Pittsburgh firm. R&V's six-month contract with the university was to have expired in August. The Charlestown (W.Va.) Gazette reported that WVU hired R&V in late Febuary to a contract that paid the firm $75,000 a month plus expenses.

The firm was dismissed yesterday because "I didn't see anything that suggested things were going to improve," Dr. Butcher said.

The action against R&V comes amid high anxiety at WVU's Health Sciences Center caused by a turnover in leadership and a pending reorganization ordered by Mr. Garrison. The dean of WVU's medical school, Dr. John E. Prescott, left suddenly in April and a search is under way for someone to fill the position Dr. Butcher has held on an interim basis since last year.

The role Mr. Garrison will play in reorganizing Health Sciences is not clear. Mr. Garrison announced last week that he will step aside Sept. 1 because of the furor sparked by the university's decision to award a degree to Mylan Inc. executive Heather Bresch that she did not earn. Ms. Bresch is the daughter of West Virginia Gov. Joe Manchin and a longtime friend of Mr. Garrison, who reported to her as a one-time lobbyist for Mylan.

Some staff members of the university's medical operations are convinced R&V was brought in by Mr. Manchin to recommend cost savings to justify eliminating a soft drink tax that generates about $15 million of the health sciences center's $70 million in annual state funding, Dr. Butcher said.

Mr. Manchin tried to get the tax eliminated last year but failed. His efforts were opposed by Dr. Robert D'Alessandri, Dr. Butcher's predecessor. Dr. D'Alessandri left last year to start Commonwealth Medical College in Scranton.

Dr. Butcher said he has not discussed the tax with Mr. Manchin.

"It's not illogical that he may still have it in his sights," Dr. Butcher said.

Word of R&V's dismissal was greeted with a standing ovation among health sciences employees who attended a briefing yesterday on the announcement, Dr. Butcher said. Staff members had criticized R&V's report and methodology. Last week, Dr. Jeffrey L. Neely, president of United Health Associates, told his staff in an e-mail that external criticism "may be unfair."

"It can be the result of a selective interpretation of data. It may reflect a narrow perspective or even a political agenda," Dr. Neely wrote.

Seven of the 14 WVU doctors R&V interviewed signed a May 1 letter supporting Mr. Garrison, who had been under severe pressure from faculty, alumni, donors and students to resign.

Supporters of Mr. Garrison who were interviewed by R&V included Dr. Julian Bailes, head of the medical school's neurosurgery department. Dr. Bailes, who has privileges at Wheeling Hospital predating R&V's arrival in 2006, organized the letter of support for Mr. Garrison. He also served on the 17-member search committee that led to Mr. Garrison's appointment as president last year.

Another of Mr. Garrison's supporters interviewed by R&V was Dr. Uma Sundaram, whose medical license was suspended by New York in November 2006 for two years. Dr. Sundaram was cited for gross negligence, ordering unwarranted tests and treatment, and failure to maintain accurate records. His employer, Strong Memorial Hospital of Rochester, paid a $492,000 fine to settle state and federal investigations of improper billing according to an August 2005 press release issued by then New York Attorney General Eliot Spitzer.

Dr. Butcher said he knew of the disciplinary action against Dr. Sundaram "only in the most general terms" and called him "an outstanding scientist." Dr. Sundaram is heading up a WVU initiative to qualify for additional funding from the National Institutes of Health.

R&V cited the lack of a "cohesive and unified leadership structure" at Health Sciences as "a serious concern." The university will probably seek help from a more experienced national consultant in streamlining the organization, Dr. Butcher said. R&V was supposed to do that, but "there wasn't guidance in that report that helped us," he said.

Len Boselovic can be reached at lboselovic@post-gazette.com or 412-263-1941.
First Published June 14, 2008 12:00 am

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