UCI Medical School, CHOC to Reaffiliate After Two-Year Split

After a two-year rift that both sides likened to a divorce, Childrens Hospital of Orange County has decided to reaffiliate with UC Irvine’s College of Medicine.

The preliminary agreement provides that UCI again will send residents to train in pediatrics at the hospital. In addition, the hospital’s 15 staff pediatricians are expected to join the UCI medical school faculty, according to Dr. Jerry Weinstein, the former acting dean of the UCI medical school who played a key role in negotiating the tentative agreement.

Lawyers for the hospital and the University of California still have to agree on the details of what UCI officials described Friday as a “draft of principles.”

UCI Chancellor Jack Peltason said: “We were once affiliated with CHOC. We hope to reaffiliate, and they’ve been reporting to me they’ve made considerable progress.”

Peltason added that he hoped a final agreement could be sent to the UC Board of Regents for approval by next spring.

Leaders of both UCI and the 202-bed hospital heralded the tentative agreement as a boon to county pediatric care.

In a prepared statement, Dr. Edward J. Quilligan, the new dean of UCI’s College of Medicine who was also instrumental in negotiating the tentative agreement, said: “The combined forces of these two fine institutions would result in a level of care, teaching and research that is unsurpassed. We’re extremely excited about the possibilities.”

Dr. L. Rex Ehling, the county’s public health director, said he was pleased that the two sides appeared to have buried their disagreements.

“It’s very good for perinatal medicine” in the county, Ehling said, adding: “Yeah, it’s about time. . . . When we don’t have that coordination, things haven’t worked as well--perinatal planning for high-risk infants and for care of crippled children--all of those things.”

Before the rift, UCI and the hospital had been affiliated for 17 years. But in mid-1985, leaders of the two institutions exchanged insults after CHOC declined to renew its agreement with UCI to train residents there.

Some CHOC leaders said bitterly that they thought UCI was trying to take over their facility, while some UCI officials called hospital leaders “capricious” for their decision not to accept residents from the university.

But starting in January, 1986, the hospital’s chief executive officer, Harold W. Wade, and Weinstein, then acting dean of the medical school, began to meet and seek rapprochement.

Thursday morning, the hours of negotiations began to pay off when the 10-member CHOC board of directors approved a memorandum of understanding with UCI.

Though details of the pact must still be approved by both institutions, Weinstein said the tentative agreement covers these points:

- UCI pediatrics faculty members and CHOC physicians will jointly select new medical school graduates who will work at the hospital.

- About 20 or more physicians from UCI’s department of pediatrics will work at the hospital, and 15 staff physicians at the hospital will be invited to join the UCI medical school faculty.

- Most of the UCI Medical Center pediatrics department, now at the university’s 493-bed hospital in Orange, will be relocated to CHOC, also in Orange. However, neonatology and pediatric intensive care will remain at the medical center.

- Quilligan will become a member of CHOC’s board of directors, either as a full member or an ex-officio member.

Financial arrangements between the two institutions must still be worked out, Weinstein said, but he noted that CHOC would pay residents’ salaries directly.

Ehling said the rift between the hospital and the school was a result of problems that were typical of what happens when “a medical school and a city hospital get together and have a divorce.”

It was in July, 1985, that hospital officials declined to renew a longstanding agreement to allow UCI medical graduates to train as residents at their nonprofit institution. When the contract then in effect expired--on June 30, 1986--Childrens Hospital no longer would train residents, its board decided.

While UCI medical school officials called that decision capricious, Childrens Hospital board member Kenneth Heuler argued in September, 1985, when the dispute became public, that the university had been trying to take over the hospital.

Some of the allegations centered on UCI’s insistence on having representation on the hospital’s board of directors.

“They wanted to run Childrens Hospital, and we didn’t want them to,” Heuler said at the time.

UCI officials insisted that there had been no bid to take over the hospital and that they had wanted three seats on the hospital’s board of trustees, which then had 16 members, only to ensure that the university’s residency program at Childrens Hospital would be protected.

At the time, UCI was providing the hospital with some 20 residents, five medical students and five fellows a year. The hospital was paying the university about $1 million a year for the residents’ services.

In addition to the hospital officials’ complaints about UCI’s demand for board membership, concerns were voiced over talks between UCI Medical Center and a for-profit hospital corporation, American Medical International of Beverly Hills.

At the time, the corporation was seeking to take over operations of the debt-plagued UCI Medical Center, while planning to open its own for-profit hospital, with a pediatrics unit, in Irvine.

Childrens Hospital officials said they were concerned that a UCI affiliation with the private hospital in Irvine might result in patients being diverted away from their institution. Heuler called UCI’s potential agreement with American Medical International “a threat to our program.”

Eventually, however, the UC Board of Regents rejected American Medical International’s bid to operate the medical center.

Since June, 1986, UCI residents have trained in other hospitals, including Miller Children’s Hospital, part of Memorial Medical Center of Long Beach. But most became residents at UCI Medical Center, about two miles from Childrens Hospital of Orange County.

CHOC, meanwhile, established a medical group, Hospital Based Physicians, to provide the 24-hour care that UCI residents would have offered.