We don't do obstetrics. He did obstetrics at Hahnemann and gynecology at MCP. As an OB/GYN, I would not practice in a place where I had patients in labor in one place and surgery in the other place. 85 2/12/04 - COMMERCE - RES. 040046 Somebody could call me and say "The baby is about to delivery," I'd have to get in a car and travel --
In an effort to keep this short, it seems to me -- no 7 disrespect -- that was a bad decision on your part to think it would work.
It wasn't a bad decision on our part. The physician wanted to come to MCP.
That doesn't make any sense to me. If you know something is not going to work, somebody should have said to them, "This isn't going to work. You're a great guy. Go some place else." Thank you, Mr. Chairman.
Dr. Klasko, you get approval from the doctor from South Philadelphia, but then you said that you couldn't get approval on the Chestnut Hill practice, which I think is a little closer. Why? 86 2/12/04 - COMMERCE - RES. 040046
Let me go back to Councilman Rizzo's question. Who made the decision to say no on the Chestnut Hill practice?
On that one, the things that the doctors needed in order to make it work, Tenet could not do. Some of these are timing issues. At the same period of time that we were building new ORs and increasing neurosurgery and increasing minimally invasive surgery and we've made commitments to people, then you bring in another group that says, "I will come here if you promise me three rooms, three days a week." And it might be something like that where they said, "Right now, we can't promise you three rooms, three days a week." For example, in the Dr. Simeone's case, when we negotiated with him, he said, "I'm going to bring a thousand cases and I will need X amount of rooms, X amount of days per week." We literally had to spend hundreds of hours to 87 2/12/04 - COMMERCE - RES. 040046 make sure everybody else would be taken care of while we accommodated him. So for that period of time, if somebody else wanted to move their whole practice, it was difficult to do. That goes on every place, in every hospital in a period of growth.
Well, let's go back. You said you were informed about the decision the day before. Now, you laid out, and you tried to be as responsive as you could, that you submitted a business plan, you've hired people to work there, you're committed to MCP, you're the dean of the medical school. You're seemingly living, breathing, dying this place. You responded to Councilman Goode by saying that as a part of a formal or informal meeting -- it sounds like a routine weekly meeting. And I guess maybe fortunately for you it happened to be on Wednesday. It sounds like if your routine meeting or weekly meeting was on Friday, you would have gotten the newspaper version of the announcement. How is it possible that the dean of 88 2/12/04 - COMMERCE - RES. 040046 the medical school has a business plan for the hospital -- you're on the Board of Governors of MCP, you make decisions or at least recommendations, some are accepted some are not, in terms of services and practices at the hospital. Your goal is to grow the hospital. How is it possible that you would only get a day's before notice, or not have other information available at your disposal, either as a member of the Board of Managers or in your capacity as dean to not know that this is imminent? How is that possible?
The way that it had been presented to us is that the decision would be made external to Philadelphia and that literally up until very close to the time of the announcement, we were encouraged by, at least the signals we were getting from the CEO, that whoever makes the decisions was leaning toward investing in the hospital.
But going into this, you're under the impression that the hospital is not only going to stay open, but more investment is going to be made; that's 89 2/12/04 - COMMERCE - RES. 040046 your testimony?
As Mr. Schaengold said, there was a business plan put forward by the CEO of the hospital to invest significantly in the hospital.
What was your participation in the consultant study in the fall of last year?
Did they talk to anyone on your staff? You had an hour-and-a-half interview about the financial condition and proposed future of MCP hospital?
Mr. Schaengold said that they were going to bring in an external consulting group to help determine what would be necessary to move MCP toward a more optimistic future. We made our entire staff and entire faculty open for those interviews. They asked to interview me for an hour and a 90 2/12/04 - COMMERCE - RES. 040046 half. I was not part of the choosing of the group. I was not part of the discussions about the consulting arrangement. I actually never saw the actual report.
Up to and including today you have not seen the report? I'll be glad to give you a copy. I have a copy of the report. What I'd like to ask you for, though, is actually an exchange of information. I'd like to have a copy of your business plan from 2002 and any other business plans that you've developed since 2002 for MCP. What I don't understand -- and I guess I'm still somewhat perplexed -- you had an hour and a half with the consultant. You were informed that a decision would be made external to Philadelphia about the hospital. You're the dean of the medical school and 91 2/12/04 - COMMERCE - RES. 040046 you're on the Board of Managers of MCP. What is the nature of the agreement between Tenet and Drexel, and what rights or responsibilities or input do you get to have over the hospital that you care a great deal about, that you have to send medical students to get their training and ensure that they have a place to go? How many med students are up there, or were up there?
What is the nature of the agreement and who is responsible for what? And how can a facility be closed without your input or any amount of notice? How is that possible?
The affiliation agreement -- they operate the hospitals. There's a requirement --
You can't operate a hospital without any doctors, and 92 2/12/04 - COMMERCE - RES. 040046 you've got the doctors.
Understood. There's a requirement, a notice requirement of approximately two years in the affiliation agreement. Obviously, they didn't keep that. They gave us a couple hours' notice. That agreement requires them, if they don't give us adequate notice, that they have to cover certain of the wind-down costs that we're going to incur because we did not get the notice in time.
Let's talk about that, because I think Senator Hughes was in that area and I'd like to go back to that area. Now, you're saying that there are only 45 students up there? I thought there were many more than that.
There are more than that that go through MCP throughout their career. The easiest way to look at it is for clerkships for third year, which is where the predominance of the clinical activity is, There are 250 students that need clerkships. That's, 93 2/12/04 - COMMERCE - RES. 040046 you know, medicine, surgery, OB/GYN. Forty-five percent of them are at Tenet hospitals; Hahnemann, MCP.
There are 250 students that need clerkships; 45 percent of them are at Tenet hospitals, so we're down to 60.
We're down to 125 or something. Of those 125, about a third or so at any one time are at MCP. So that's where I came up with that 45 number.
So let's talk about, you didn't get your two years' notice. Maybe you got about 12 hours. What happens to all these medical school students? What are the wind-down costs? Who pays for them and what happens to their education?
I'll talk about the education piece and then Mr. Archibald can talk about the finances. On the education piece, once it became clear -- and this actually became clear 94 2/12/04 - COMMERCE - RES. 040046 once the hospital census went down as part of the nurses' strike -- that the educational quality for our students would not be up to the Drexel par, we started to move some of the students out to other hospitals in the State. We are currently looking at how we handle the post-July numbers. We have all students placed up through and including June 30th in other hospitals throughout the State. Other affiliates have come forward and said, "Gosh, we know you're in a crisis, Drexel. We used to take three students, now we'll take six."
Who covers the cost of the relocation of these students?
Tenet does. We cover the cost and then Tenet reimburses us because of the two-year notice.
Ballpark. You made the relocations. You know where they are. You must have some idea of what the cost 95 2/12/04 - COMMERCE - RES. 040046 is.
Right now as of this moment, most of those folks from now through July have been able to be outplaced in other places that we have in the system.
We don't know yet. That's what we're working on now. The reality is, there might be housing costs. There might be food costs. There might be airplane costs for the students. And literally, that's part of that affiliation agreement.
What do you mean by, that's part of the affiliation agreement?
If I have to send a student to California to do a rotation because MCP closed without giving me two years' notice, then whatever the direct cost to that student would be or to us would be covered.
Tenet is going 96 2/12/04 - COMMERCE - RES. 040046 to pay the cost of basically helping that student to finish their education, and if you have to send them, fly them around the country to do it, they're going to pay for it?
You made reference to some wind-down costs. What would you estimate these wind-down costs to be?
Wind-down costs through June 30th, '04, should be approximately $20 million.
So you'll take in $20 million of expense and then charge it back to Tenet --
It's for salaries, fringes, and malpractice. That's what the agreement requires Tenet to pay us back, for salaries, fringes, and malpractice associated with the closure because they did not give us two years' notice. 97 2/12/04 - COMMERCE - RES. 040046
Is this on a fiscal year basis? Is it a two-year period from December 17th --
We have to honor all of our contractual agreements with our faculty and our staff. And that will obligate Tenet to honor whatever costs through June 30, '05, that we incur associated with individuals who are currently working at MCP. We are reimbursed for our direct salary, fringes, and malpractice. It's a reimbursement for cost because they did not give us due notice.
I understand that. The $20 million through June 30, 2004, is that primarily covering the period from December 18, 2003 through June 30, 2004?
What would you estimate the cost to be from July 1, 2004 through June 30, 2005?
Hopefully, it's a 98 2/12/04 - COMMERCE - RES. 040046 reimbursement for cost. When somebody decides to leave and get a job, when they get the job, it's no longer our cost. We don't get reimbursed for it. If nobody got a job through June 30th of '05, I would expect that to cost somewhere in the range of another $30 million.
So you're in the neighborhood of about $50 million in wind-down costs as a result of a precipitous closure of the hospital and a violation of a two-year notice agreement?
Dr. Klasko, when you were informed of the closure, what steps did Drexel take in response to that?
Well, I couldn't talk to anybody that day. So that was very difficult.
I understand that. 99 2/12/04 - COMMERCE - RES. 040046
Starting the next day, we went into a -- I guess I call it a SWAT team approach. I met with all our faculty and all our staff and all our residents and all our students and did what anyone would do if half of their body had just been cut off. We looked at what would have to happen for each of those areas. We created a student team, a resident team. I want to give you one example because you asked me. We lost in the middle of recruiting 240 of our 580 resident slots because they were assigned to MCP. So I've had to go through every single program and decide how many residents in the middle of a recruiting year I'm going to recruit. In medicine, for example, we had 160 residents. As of today we have 102. That was between December 18th and now. That's just residents. Students, we had to look at all the student rotations. Faculty, obviously, I was meeting almost on a daily basis with the faculty because they wanted to know what it meant to 100 2/12/04 - COMMERCE - RES. 040046 them, they wanted to know what it meant to their patients, they wanted to know what was happening with the hospital, so what you would do in a similar situation if half of what you did immediately went away.
Was there a presentation or a slide show that afternoon laying out Drexel's next steps in this situation?
We had a faculty meeting -- and I don't remember if it was exactly that afternoon and I don't remember exactly what I presented. But we did, obviously, have a meeting with the faculty at some point within a couple days of that, and we did basically talk about the areas that I just mentioned; students, residents, faculty. I don't remember a slide show. I might have had one.
I guess what I was trying to understand is that either on the 17th or the 18th, it's my understanding that there was a presentation with regard to Drexel's next steps, and I was trying to 101 2/12/04 - COMMERCE - RES. 040046 understand how such a presentation could be put together if you were only notified on the 17th or even on the 18th. It takes a little while to put a slide show presentation together of next steps. I know there are very smart people out at Drexel, but how do you do that?
The only thing I can think -- and this might make me not seem quite as smart to you -- but on the 16th or 15th, two days before, I did a slide show on what we hoped to do over the next year toward growing the business. So that did take me a while to put together, and that was consistent with the business plan that the CEO of the hospital had sent to Atlanta. And frankly, when I did meet with the staff after the announcement, I had to explain to them, as I'm probably going to have to explain to you, how I could give a slide show about what we're going to do next year and then three days later have the hospital close. That is the reality. No, we did not have well laid out steps by the 18th, 19th or 102 2/12/04 - COMMERCE - RES. 040046 20th or, frankly, in some cases even today of exactly what we're going to do with the hospital closure.
What happened with the financing of the properties with regard to Hahnemann and MCP last year? Did that go through?
At the time, some of the underlying assumptions were no longer playing out. A lot of assumptions about what was going to occur and those things were not --
When was the decision made not to pursue the financing?
I'm not exactly certain when that was made, but I think it was probably somewhere in the October time frame. Some of those items occurred 103 2/12/04 - COMMERCE - RES. 040046 pursuant to that financing, but they happened differently. Interest rates move around, and some of the terms for getting that transaction carried forward required us to acquire some insurance on the bonds. That was a $6 million cost to us. It didn't make sense to have to pay and insure $6 million when we could go out in the marketplace and acquire some of those assets that we were acquiring. Many of the things that were going to be paid for by the bond proceeds were dealt with financially differently than a bond.
Well, ultimately it's your decision. All I can tell you is that it was very aggressively pursued by the highest level Drexel representatives, including the Chair of the medical school, very aggressively pursued, helping to ensure that Councilman Clarke and I put that bill forward and got it approved before we left, my recollection is, on our summer recess. So it's a little surprising to hear that after all of that pursuit and agitation and anxiety about that particular financing, it was ultimately decided in October 104 2/12/04 - COMMERCE - RES. 040046 that you wouldn't pursue it.
I was just wondering whether some people were starting to read the tea leaves a little bit.
It was about the economics of the transaction. And paying $6 million for having the bonds insured meant that we could -- it was less expensive to go out and get a mortgage.
Dr. Klasko, can you forward to us through the Chair a copy of the -- I think you referred to it as an affiliation agreement, between Drexel University and Tenet?
There's a confidentiality clause in there and we have to work it out with Tenet when they come back. So there is a confidentiality clause in there. And I'm not a lawyer, but I think we have to honor the terms of the agreement unless both parties are willing to pass it up.
Is that a two-way 105 2/12/04 - COMMERCE - RES. 040046 confidentiality clause? Does it go both ways or can Tenet release you?
Thank you, Mr. Chairman. That agreement dates back to 1998?
If it's not confidential, what rights do you have? We've talked about the two-year notice issue. You put forward ideas and proposals, at least in the MCP case, maybe others, that you think will make the hospital work or work better. Someone says no. What is your right under the agreement to somehow influence or exercise your judgment on how to make healthcare service better? And if you have no rights, again, how do you make this partnership work?
The affiliation 106 2/12/04 - COMMERCE - RES. 040046 agreement doesn't speak per se to the rights of either party with respect to making capital investments. They make proposals to us. We make proposals to them. Their proposals require them to make a capital investment and our proposals also obligate us to make investments in the people that we're hiring. They may want to enter into a different line of business and we say no. They're not the only ones that say no. We say no. They say no. So whatever their internal processes are, we're not privy to.
We're trying to say no to this. Everybody is saying no. 16 (Applause.)
We're not in front of their committees and they're not in front of our committees.
Senator Hughes asked you earlier about what I referred to as the ripple effect of this. Could you put a number on the anticipated layoffs as a result 107 2/12/04 - COMMERCE - RES. 040046 of the loss of $35 million in revenue? How many people will you have to lay off?
It's expected that we'll be laying off approximately 115 faculty and -- I am sorry. I think it's 131 faculty, and staff of approximately 110.
131 faculty and 110 staff as a result of the proposed closure of this hospital?
And what happens to all of those people? Do they just get laid off? Do they get a severance package?
There are established policies, and whatever the policy is, based on your length of time and service, we're going to honor the policy.
Has Drexel taken any steps to try to participate in any alternative plans, a turnaround plan? Again, Senator Hughes asked what are you prepared to do to try to save the hospital? I mean, Drexel is certainly not without allies. It is not without friends in 108 2/12/04 - COMMERCE - RES. 040046 fairly high places. What discussions and conversations has Drexel had -- if as Dr. Klasko said, kind of half of your body gets taken away, I think self preservation being one of the fundamental laws of existence, I think you pretty much try to do anything you can to save yourself at that point. So what has Drexel been doing since the morning of December 18th to try to either prevent the closure or turn the situation around just for your own safety and security?
I have an affiliation agreement, and they put me on notice that they are shutting it down. Our operational time has been what to do with the students, the residents during the shutdown period. We're prepared to respond to anybody who decides that they want to operate the hospital as a hospital. We still have all of our employees and all of our faculty.
Mr. Archibald, I'm asking proactive. You're talking about reactive.
If other things have 109 2/12/04 - COMMERCE - RES. 040046 occurred at Drexel with respect to whoever these connections are that you're referring to, we're not privy to that.
I understand that. I'm asking what outreach have you done, who have you talked to? If half of your operation is being so devastated -- and I understand your first responsibility is to the students, to get them wherever you need to get them and you call up people and say, "You only took three before, but we're in desperate straits, but will you take six," and all of that. But doesn't this action also have a potentially serious impact on your ability to run an accredited medical school?
The answer is that our ability to run an accredited medical school is not in doubt. We will be able to run an accredited medical school. That doesn't mean that we're not passionate or don't want to do something for that site. When you talk about Drexel, half the people that you brought up here in the beginning part of this City Council hearing 110 2/12/04 - COMMERCE - RES. 040046 are my faculty. Dr. Wagner is my Chair of emergency medicine. He's been out every day trying to find principle. (Applause.)
Exactly. You make my point. The point is he's a doctor desperately trying to figure out how to turn the situation around. But he's one individual; you are an entire institution in West Philadelphia, highly respected, great reputation, have a great Board. You've got a medical school. You've got a university. You have friends that you can talk to to work with us about this situation. So I'm not exactly excited when people say, "Well", under the affiliation agreement, we've got to do this. We've got to do that." It's like a person gets shot in the head and they're trying to figure out are their shoes shined. I think you might want to check on the head wound a little bit. What are you doing in a proactive fashion to say, "Hey, we've got a problem, We're dealing with our students, We're going to put them in upstate Pennsylvania or down in 111 2/12/04 - COMMERCE - RES. 040046 Virginia or whatever the case may be. But we also want to lend our support to trying to help this particular situation." Because you had a lot of friends working with you when this started back in 1998. My recollection is you were approached to take over the medical school, a certain amount money was put forward or offered or suggested, It was rejected. And then another meeting was held and then another amount of money was put on the table because you had the juice and the will to make other things happen. And then a deal was constructed and, as they say, then life went on and the rest is history. I'm asking you to join us. Don't be distracted from taking care of your students. You have an obligation to them. But work with us, the people who are getting the trickle down effect here, 200 people on your campus and a thousand up at that place and the devastation to healthcare in that particular community, and use some of the power and authority that you have to force this situation to a point where everyone is 112 2/12/04 - COMMERCE - RES. 040046 actually working together, not just taking care of their own backyard. (Applause.)
Councilman, I will expend as much energy I can individually to help make that happen. I think the issue is, an organization is the sum of its parts and the individuals that have been working hard to look at what can we do for emergency services for that area, which include the Dr. Wagners and the Dr. Needs (ph), are part of my organization, and I'm proud of that. And my job is to spend not only hours a day being 15 reactive and proactive for the medical school, 16 but looking at ways that we can make sure that 17 both the community is taken care and that 18 something positive happens to that site. 19 We're not a hospital operator, but I 20 invited myself to the meeting that Governor Rendell and Senator Specter had with some of the different CEOs of different hospitals because I wanted to be there and I wanted to be a part of it. We are not dispassionate and we are not at all sort of standing on the 113 2/12/04 - COMMERCE - RES. 040046 sidelines. We are absolutely ready, willing, and able to help something happen at that site.
Dr. Klasko, Councilman Rizzo has some follow-up questions, but I have a couple very quick ones. Under the affiliation agreement, you say you're entitled until June 30th of this year to approximately $20 million in reimbursement?
Because that's what the affiliation agreement requires them to do. Is that the only reason you have that expectation?
Yes. So you have no agreement with Tenet -- 114 2/12/04 - COMMERCE - RES. 040046
It's in the affiliation agreement. It's within the affiliation agreement?
Right. Beyond the affiliation agreement, do have any other agreement in writing or informally about how much Tenet will reimburse you?
That exactly was my question. Great minds think alike. You've gotten no signal from Tenet that they are going to honor what you believe the affiliation agreement means? I heard another number of $50 million. Maybe you can restate that. The wind-down charges, is that brought in? Does that $30 million have anything to do with the affiliation agreement, or is that another agreement, the wind-down.
No. Everything I've 115 2/12/04 - COMMERCE - RES. 040046 spoken about with respect to reimbursement is pursuant to the terms of affiliation agreement.
So you're not talking $20 million, you're talking $50 million?
In the worst case scenario, it would be approximately $50 million. They reimburse us for direct incurred cost. If I don't incur the cost, they don't reimburse me. But you have not --
I don't know at what rate these people would go out and find other jobs.
If every one of our faculty found another job right after they were non-reappointed, they would owe us nothing for faculty.
Is that likely or unlikely. I think it's unlikely that it will be none and it's unlikely that it will be all. I think the place was announced that it was going to close on December 18th. We have other systems literally talking to our faculty 116 2/12/04 - COMMERCE - RES. 040046 on a daily basis.
It's hard for me to sit here and listen to both of you say that you believe that Tenet is going to pay you $20 million and no one has a face-to-face with Tenet yet and said, "Are you going to honor this affiliation agreement?" I just can't imagine that you're just accepting a piece of paper that you don't know whether it's going to be challenged or you don't know whether it's going to be argued.
You say it's a piece of paper. It's a 20-year agreement. We made that commitment a long time ago. They're our partner for years. 18
I'd be curious 19 today -- and I hope that the Chair will ask 20 Tenet the question -- if they're going to honor the affiliation agreement, because I've never heard of such an assumption in my life. Thank you. Thank you, Mr. Chairman. (Applause.) 117 2/12/04 - COMMERCE - RES. 040046
Mr. Archibald, in that same area, when you spend the money that you're going to spend and then get the anticipated reimbursement, whose money are you spending up front? Is that Drexel money? Is that Commonwealth of Pennsylvania money? Is it federal government money?
So if you make the outlay and for whatever reason -- and I'm sure we'll get to that when the Tenet panel comes back 118 2/12/04 - COMMERCE - RES. 040046 up -- if you make the outlay and somehow you don't get the reimbursement, who's on the hook?
I'm assuming you've had the appropriate discussions about being on the hook.
They're keenly aware of the terms of the affiliation agreement.
Let me ask one last question about the whole doctor issue. Now, help us again to understand. There are doctors who, I guess, are your faculty?
At MCP. And it's true at Hahnemann also, there are the medical staff. The medical staff of the hospital is made up of doctors that are employed by Drexel University.
Stop right there. The medical staff of the hospital 119 2/12/04 - COMMERCE - RES. 040046 which is owned by Tenet is on the payroll of Drexel?
No, no. The medical staff of any hospital is made up of doctors. And some are single doctors and some are parts of big groups. The medical staff of MCP is made up of some physicians that are a part of Drexel University physicians.
That's where I'm confused. What does Drexel University physicians mean?
They're our full-time employed university physicians, our professors, our full-time professors.
Right. But not all of them. There are other physicians that are associated with Philadelphia College of Osteopathy, and then there are other physicians that are private physicians, two or three-person 120 2/12/04 - COMMERCE - RES. 040046 practices, five-person practices, 10-person practices. They're what we call volunteer faculty. In essence, they have a clinical associate professor title, don't get paid at all by us. We have nothing to do with their clinical practices. But in order to be part of the medical staff at MCP --
Yes. You have to have a faculty appointment. That has no economic value.
How many doctors are we talking about? And give me a breakdown in terms of who's on the Drexel payroll, who's doing the private practice thing and whatever the other categories are.
I think the MCP medical staff is about 200. And I believe that about 130 or so were Drexel University physicians.
150. Now, the testimony last week was that the doctors somehow would wake up one morning and decide, I don't want to work at MCP anymore because now I want to work at Hahnemann or St. Chris or somewhere else in the system; is that correct? Can they do that?
Yes. Doctors can decide tomorrow that I was operating at MCP and now I've gone and talked to Roxborough or Chestnut Hill, and starting next week I'm going to start doing my operations at Chestnut Hill. Yes, they can do that. They have to get staff privileges. Many of the physicians have staff privileges at other hospitals, especially the private doctors.
I understand that. You've got 200 doctors at MCP, 150 of whom are paid by Drexel?
If one of those doctors says, I don't want to be at MCP anymore, I want to be at Hahnemann, do they have to ask anyone's permission?
Then they would either stay at MCP or leave Drexel and go someplace else.
Suppose you said, "I don't think that's good for MCP for Dr. So-and-so to leave," do they still get to go?
If the chair wanted them to go, is that what you're asking? If the chair said, "Yeah, I want them to go 123 2/12/04 - COMMERCE - RES. 040046 someplace else"?
In my current role, I would win because I'm the dean. In my former role, which was to be the MCP campus cheerleader and dean, we would have a discussion and it would go to the dean.
So the flow of the doctors back and forth is controlled, to some extent, by the Chairs of the departments and ultimately by the Dean?
Right. I'll be happy to give you the actual statistics. The amount of people that leave MCP and go to Hahnemann or vice versa over that two-year period was relatively small. Very small. The reality is that a lot of the numbers that would go down in an individual department had nothing to do with the doctors that were faculty there. It had to do with referring physicians who would decide, "You know what, I was sending you to MCP, but either I'm mad at MCP or I'm mad at you or I got a better 124 2/12/04 - COMMERCE - RES. 040046 deal sending to some group down over at Abington," and that's where we do lose significant amounts of patients. That's where we often do that. Then it's our job, it's the doctors' job, to go and get new referral sources.
Let me ask you this question. This could actually be my last question for you -- That's actually not true. What was your evaluation, in your professional capacity as Dean of the medical school, of the overall management in operations of MCP?
I think that I would call it, from my perception, average. I don't think it was exceptionally creative. But I think that generally the people that were there running that hospital understood the nuts and bolts of running a hospital. I've been at places where there was significantly more creative management than at MCP.
And do you think, given a wide variety of circumstances, whether we're talking about patient mix and all of the other factors and reimbursements and all of these 125 2/12/04 - COMMERCE - RES. 040046 issues that have been discussed, do you think a hospital like MCP can make it with, in your perspective, average management?
In my perspective, I don't think anybody over the last seven years has proven than MCP can make it with any kind of management. I think that the reality is that the metrics of that hospital as they currently exist, from what I understand, even before Allegheny, just weren't very positive. There was a period of time where Tenet was able to make it, and that was mostly financial.
Let me try to understand this. From what vantage point do you feel, I guess, confident to make that kind of statement? You became the Vice Dean in January '02.
Where were you prior to being Vice Dean in January of '02? 126 2/12/04 - COMMERCE - RES. 040046
I was the Senior Associate Dean for Clinical Affairs at Drexel University.