UCSF-STANFORD: Divorce with Little Heartache
Last week's announcement that Stanford University and the University of California-San Francisco are dissolving their health care merger elicited few tears from those at either institution. Calling the merger a "halfhearted effort" that was "doomed at the start," San Francisco Chronicle news analyst Sabin Russell reports, "There will be no rush to buy flowers and no run on sympathy cards ... Like an arranged marriage between rival kingdoms, the combination was a passionless union. Its justification was purely economic. It was forced upon often unwilling participants by decree" (10/30). Columnist Mark Simon agrees in a piece Saturday, noting that the merger "was like a marriage in which the bride and groom refuse to give up their separate apartments. This marriage could not be saved." According to Simon, the intense rivalry between the two institutions "appears to extend far beyond the football field and is more deep seated within the distinct cultures of each university. There has always been the assertion by Cal alumni that Stanford is arrogant and overfed. Among Stanford alumni, Cal is populated by rabble. The exaggerations of those notions ... appear to find their own more subdued manifestations in the classrooms and the hospital hallways" (San Francisco Chronicle, 10/30). Dr. Warren Gold, president of the UCSF faculty association, admits, "We've got myths about (Stanford doctors) and they've got myths about us." But he blames the merger's failure on administrators, who did not solicit support from physicians and faculty, ignoring them throughout out the entire merger process. "They haven't talked to us since the first day they dreamed up this thing. It is supposed to be shared governance here. That's the way a university works. ... The management just laid this on us. If it failed, it's their own fault," he said (Krieger, San Jose Mercury News, 11/1). "Gleeful" over the split, Gold said the decision "gives us an opportunity to save our university" (Russell/Schevitz/Fagan, San Francisco Chronicle, 10/29). While UCSF workers rejoiced by "dancing in the hallways," the consensus at Stanford Hospital was a "general sigh of relief ... [and] the notion that the merger was a noble experiment that failed." Said Jeanne Kennedy, director of community and patient relations at Stanford, "I can understand why [UCSF workers] feel that way. They love UC as much as I love Stanford." She added that the merger was a "grand concept, and it's sad it didn't work. But that doesn't mean we shouldn't have tried it" (San Francisco Chronicle, 10/30).
Second Chance for Mount Zion?
An editorial in today's San Francisco Chronicle laments the merger's failure but points out that the "end of the union may offer opportunities" to reevaluate recent decisions, particularly plans to close Mount Zion hospital. "New circumstances do change the equation ... especially since Gov. Gray Davis balked at the idea of a two-year state program of 'bridge financing' to keep the hospital going for the specific reason that it was no longer owned by the public," the editors write (11/1).
Officials at UC Davis Medical Center were "saddened" by the news but took "some security in knowing a similar situation likely won't happen here -- mainly because Sacramento hospitals aren't likely to pursue mergers in the first place," the Sacramento Bee reports. Area medical centers have preferred to collaborate on care but have "stopp[ed] short of sharing finances, business plans and missions," which often fails to "improve financial pressure[s]," according Peter Bolan, a Berkeley-based health care consultant. "Mergers are at least as technically difficult as heart transplants, I'd say, but with significantly lower success rates. In general, I don't see that (mergers) make good business sense, especially when there are so many other ways (hospitals) might work together that are less messy. (For USCF and Stanford) to go for all 100 yards was probably pretty foolish" (Fisher, 10/30).