UT College of Medicine Academic Affiliation

Partnership Frequently Asked Questions

Sections: Affiliation LogisticsGovernance, Teaching and ResearchUTMC and UT Clinics


How is this partnership different from the partnership in 2010 with ProMedica?
The current affiliation agreement is more comprehensive in that it aims to move the primary academic teaching functions to ProMedica. Ultimately, the durability of the 50-year agreement will provide the College of Medicine, ProMedica, and the community with a degree of stability it’s never before seen.

By having all UT learners covered by a single affiliation agreement, Northwest Ohio will have a greater pipeline for healthcare providers plus students are guaranteed a broader array of medical cases to enhance their education.

The investment of $250 million in capital to College of Medicine facilities will transform UT’s education and research efforts and the annual $50 million payments to the college will help propel the affiliation to a new tier on the national level.

Has there been appropriate, full exploration and discussion about this partnership?
The value of a partnership has been discussed within the former Medical College of Ohio and The University of Toledo for decades. The current conversations have taken place for the better part of the year. Now that a letter of intent has been signed, we are seeking engagement from across the institution and in the community to provide feedback from stakeholders about how to effectively implement the affiliation

Did you talk with other potential partners? If yes, with whom?
We had conversations with several healthcare organizations in the Midwest. In assessing our priorities and the proposal terms from various potential partners, we were confident that ProMedica was the best match.

Is ProMedica buying UTMC? Is it buying the College of Medicine?
No. We can say that after the affiliation agreement is finalized, each organization will retain ownership and control of all the assets it brings to the partnership.

How will this partnership impact jobs at UTMC?
The affiliation is with the College of Medicine, not UTMC. UTMC will continue to operate solely under UT’s control in competition with other local and regional healthcare providers.

Is this affiliation happening because of UTMC’s finances?
UTMC provides a significant amount of financial support to the College of Medicine every year. It’s no secret that UTMC has been under financial pressure just like other academic medical centers that are not part of larger health systems. This academic affiliation between the College of Medicine and ProMedica will relieve UTMC of some of the financial responsibility for supporting the College of Medicine.

How will the UT Physicians Group be connected to ProMedica?
Under the new affiliation, UT Physicians Group (UTP) members will remain UTP employees. UTP will collaborate with the ProMedica Physicians Group (PPG) to create a clinically integrated network, the specific parameters of which will be designed and agreed upon throughout the transition process, and will involve physician leaders from both UTP and PPG.

If I’m a member of the UT faculty in the College of Medicine, who do I report to under the new partnership?
UT faculty members will continue to report to the Dean of the College of Medicine. It will take a few months for us to resolve the other terms of the affiliation. We recognize that uncertainty may create some anxiety. We will keep everyone informed as we go through this process to the extent we are able given the confidential nature of negotiations.

Who will decide who leads a clinical area?
The affiliation will have oversight from our Academic Affiliation Operations Council that will be chaired by the Dean of the College of Medicine. Leadership decisions will be jointly approved by UT and ProMedica.

When will this affiliation be official? When will it be implemented?
The UT Board of Trustees approved the signing of a letter of intent. In the coming months, UT and ProMedica will work on preparing a final agreement. Implementation will be a deliberate process that will take months to years depending on the area. Much of the implementation process will be driven by consultation with different stakeholders, including faculty, students and staff as well as stakeholders at ProMedica.


Affiliation Logistics

ProMedica is giving the College of Medicine a lot of money. What will it get from the affiliation?
ProMedica benefits in several ways. First, there will be a physician shortage over the next two decades and Toledo already sends more medical students elsewhere for residencies than it attracts. Through this affiliation, the College of Medicine and ProMedica hope to recruit more residents and physicians to Toledo who will stay in Northwest Ohio. Second, ProMedica wants Toledo Hospital, its flagship hospital, to be an academic medical center. There’s prestige in being an academic medical center because of the clinical and biomedical research that happens in universities and affiliated medical centers. In addition, an academic medical center will enable the recruitment of additional, high-quality faculty to the region.

Will ProMedica provide the College of Medicine with $250 million in one lump payment or will that be paid out over several years?
ProMedica will pay the College of Medicine $50 million per year for 50 years. We have not yet worked out the details of how the $250 million will be paid.

How were the figures of $250 million and $50 million determined?
We considered how much it would cost to renovate the existing College of Medicine and how much it would cost to build an entirely new facility. If the entire $250 million is not spent for College of Medicine buildings (classrooms, labs etc.), the remainder will be paid to the College of Medicine to be used in other ways, such as housing for residents.

Why is the affiliation for 50 years?
We wanted a long-term agreement that would outlive any of the current people involved in negotiating the agreement. The long duration also provides stability, not only for UT and ProMedica, but for the community that will need a steady pipeline of health care providers in the decades to come.

Now that the Letter of Intent has been signed, what’s next?
We will work with ProMedica to establish work groups to help identify matters that need to be addressed in the final affiliation agreement document. Work group leaders will solicit ideas from the broader groups they represent. Please continue to ask questions, raise issues and stay engaged in this process.

What is the timeline for the academic affiliation?
We will negotiate the terms of the agreement over the next several months. Once the agreement is signed, it will be in effect for 50 years. We anticipate it will take several years to complete the implementation of the Affiliation. Some benefits of the affiliation will be recognized sooner than others.

Will residency slots shift and when?
Our residents are spread across multiple hospitals. About 45 percent of them are at UTMC; 30 percent at ProMedica hospitals; 10 percent at Mercy hospitals; and 15 percent at other hospitals like Henry Ford Health System’s. Eventually, the vast majority of College of Medicine residents will be at ProMedica hospitals. We don’t yet have a precise timeline for when changes will occur, but residents will continue in their current slots for the 2015-16 academic year.

Will the College of Medicine be relocated closer to Toledo Hospital or Toledo Children’s Hospital?
At this point, no decisions about the location of the College of Medicine have been made. We will engage in discussions throughout this process towards developing a joint campus development plan for the CoM. We will begin to have conversations about that over the coming months. This affiliation will take several years to unfold, and there will be short-term steps and longer-term steps.

When organizations become larger and scale up they tend to lose their culture. Are you concerned about this?
We are, of course concerned, but we recognize that the affiliation may prompt some changes to the cultures of both organizations. We think that academic environments tend to be more interactive, collaborative and collegial, and that both organizations’ cultures will adapt and evolve. Our goal is preserve the benefits of our academic culture and to identify ways in which our culture can be enriched by the affiliation.

Has UT’s new president been engaged in this process?
Dr. Gaber is fully aware and in full support of the academic affiliation between the College of Medicine and ProMedica.

How was the state involved in this affiliation?
As a public University, the Ohio Attorney General is the attorney for The University of Toledo, and we involved his office during these discussions.

Do you think people will try to prevent this affiliation from happening?
There are many people at the College of Medicine and ProMedica who recognize the importance of this affiliation. We also know that there will be people who may be uncomfortable with this affiliation. We spent many hours reviewing past partnership attempts and are trying to better engage stakeholders this time as well as avoid past pitfalls. As such, while there may be some detractors, we are confident in our ability to successfully complete the affiliation.

What would happen if the College of Medicine and ProMedica did not affiliate?
We prefer to focus on negotiating an affiliation that will happen.


Governance, Teaching and Research

Does this affiliation affect just the College of Medicine or the other life sciences too?
Although the affiliation will be with the College of Medicine, this is an agreement that we intend to cover substantially all of our health sciences learners at both the undergraduate and graduate level. This would include all learners in the Colleges of Nursing, Pharmacy, and Health Sciences that require clinical experiences as part of their curriculum.

Will this affiliation help the College of Medicine grow its class size?
The College of Medicine currently has approximately 170 residents and students. We want to ensure we’re providing them with the best learning and research opportunities before we begin exploring whether to change the size of our academic programs.

How will this affiliation affect our PhD and master’s candidates, and where will the basic sciences programs be located?
We would like to improve the funding for current and future faculty and doctoral candidates. We have a lot of planning still to do as we negotiate and then implement the affiliation.

How will clinical chiefs and department chairs be determined?
The College of Medicine Dean’s Office and faculty will continue to identify our department chairs although ProMedica may want to have a voice in those decisions just as the College of Medicine may want to have some input into who serves as ProMedica’s clinical chiefs. For LCME (Liaison Committee on Medical Education) accreditation purposes, academic decision making will remain in the College of Medicine.

There are several College of Medicine departments with open or interim chairs. Will you continue to search for new leaders?
Yes. It will take many months to negotiate the affiliation agreement between the College of Medicine and ProMedica. In the meantime, we need to continue to run the College of Medicine, and that includes filling our department chairs. We think this affiliation will help us to recruit additional, high-quality candidates because it provides an opportunity for a chair to grow a department.

How will you address some of the College of Medicine’s short-term issues, like low faculty numbers?
Short-term planning will not stop. We will continue to engage associate deans and department chairs in helping us to address ongoing college concerns.

What kind of research expansions do you foresee?
The University of Toledo receives approximately $45 million in externally funded research dollars annually, and there’s been a steady decline in the research dollars we — as well as research institutions across the country — have received for the last five years. We would like to expand the number of faculty members conducting research as well as the amount of research dollars we’re bringing to Toledo. We envision Toledo evolving into a biomedical hub where research plays an integral role in discovery, patient treatment and regional economic development.

At which ProMedica facilities will UT residents do their work?
UT learners primarily will do their residencies at Toledo Hospital and Toledo Children’s Hospital. The agreement will provide UT the flexibility to ensure students receive the type of individualized experiences they need in their specific disciplines. For example, pharmacy students may still receive some of their experience in a retail setting, such as a CVS, Rite Aid or Walmart.

Will some ProMedica physicians be interested in teaching?
That is certainly anticipated and hoped for. There’s a lot of prestige in being affiliated with a university, and we think few ProMedica physicians would opt out of an opportunity to help train future physicians or other healthcare professionals.

Who will ProMedica physicians report to?
There are some details that need to be resolved as we work on an affiliation agreement. There will be some clinical integration for teaching purposes, but we believe physicians in an academic environment need to report to the College of Medicine’s dean. ProMedica may have some voice in how physicians are selected to teach just as the UT College of Medicine may have a voice in the chairs of clinical departments. The agreement will help us determine the process through which decisions are made and who has final authority.

Meanwhile, the University of Toledo Physicians group and the ProMedica Physician Group will continue to be owned and operated independently.


UTMC and UT Clinics

What will happen to UTMC?
The University of Toledo will continue to own and operate UTMC as an independent, free-standing hospital. Many of the patient cases at UTMC are from the Zip Codes in the surrounding neighborhoods. We will continue to perform community healthcare needs assessments to ensure that the services we provide at UTMC appropriately match the community’s needs. We will continue to work to drive down hospital-acquired infections, to focus on improving patient satisfaction and care quality, and to improve our ambulatory care delivery at UTMC and in our clinics across the community.

Will UTMC and ProMedica be able to engage in joint contracting to obtain better costs for medical supplies?
The affiliation is between the College of Medicine and ProMedica, and one of the primary purposes of this academic affiliation is to expand clinical learning and biomedical research opportunities for our learners. For legal reasons, we will need to closely review whether UTMC can legally engage in any joint contracting with ProMedica to obtain better pricing. For general purchasing purposes, we’re already part of UHC, a national organization that helps us to negotiate better pricing.

Will the affiliation affect third party payer contracts?
No. That’s an area in which we cannot work with ProMedica because it has the potential to create anti-trust concerns.

Since ProMedica is providing so much financial support to the College of Medicine, will the University of Toledo withdraw some of its funding for the college or for UTMC?
The budgets for the University of Toledo, the College of Medicine and UTMC have additional strain on them, but that’s due to unrelated factors. UTMC currently provides the College of Medicine with approximately $35 million in direct and indirect funding. The details of any changes to this current funds flow arrangement are still to be determined.

I work at UTMC. I’m concerned about whether I’ll have a job. What should I do?
We intend to continue to own and operate UTMC. We have no plans to close or sell the hospital. You should focus on providing safe, quality care and service to our patients and visitors.

Will UTMC jobs be outsourced?
We have no plans to outsource UTMC jobs because of this affiliation.

What will happen to UTMC when ProMedica completes the new tower at Toledo Hospital?
We will continue to own and operate a hospital at 3000 Arlington Avenue.

If the College of Medicine is affiliating with ProMedica, will UTMC continue to be an academic medical center?
It’s too soon to say. UTMC plays an important role in South Toledo, and we intend to continue to own and operate UTMC so the community’s healthcare needs are met.

If the College of Medicine affiliates with ProMedica, aren’t you leaving UTMC on its own?
No. UTMC will continue to be owned and operated by the University of Toledo.

At what point will residents leave UTMC?
We don’t know, but nothing will change for many months, and a transition will likely take a number of years to complete.

Why didn’t ProMedica want to affiliate with UTMC?
The affiliation is between the UT College of Medicine and ProMedica. A deal involving UTMC was not considered by the University.

Will UTMC change its name as a result of the affiliation?
No. This is an affiliation between the College of Medicine and ProMedica.

How will the affiliation affect UTMC’s relationship with Northwest Ohio’s independent hospitals?
Eight independent Northwest Ohio hospitals joined together to create Vantage Healthcare of Ohio to pool resources to improve quality and purchasing power. (The hospitals include Wood County Hospital in Bowling Green; Bellevue Hospital, Blanchard Valley Health System in Findlay; Fulton County Health Center in Wauseon; Henry County Hospital in Napoleon; Magruder Memorial Hospital in Port Clinton; Fisher-Titus Medical Center in Norwalk; and Community Hospitals and Wellness Centers in Archbold, Bryan and Montpelier.) We have notified them of the affiliation, and we will determine how to continue working with them.

What will happen to our relationship with Mercy?
We recently renewed our relationship with Mercy St. Vincent Medical Center for our residents. Mercy currently provides opportunities for about 10 percent of our residents. We expect that Mercy will continue to honor our relationship for the 2015-16 academic year and beyond as is necessary.

What will happen with our accountable care organization (ACO)?
The joint venture between the Toledo Clinic and University of Toledo Physicians is up for renewal later in 2015. We have not determined next steps at this point.

Will UTMC or the UT Physicians be switching EMR systems as a result of the affiliation?
ProMedica is installing Epic, one of the best electronic medical systems. The EMR system in our clinics sunsets in 2018. Eventually, we would like to be on a more robust EMR system, but we have not discussed a switch at this point.

Will we continue to run our physician clinics?
Yes. We fully intend to continue operating our clinics independent of ProMedica under their current UTMC and University of Toledo Physicians branding.

 

Last Updated: 7/5/16