Across the street from Martin Luther King Jr. General Hospital is a new medical school that was founded in hopes of providing King with the brainpower, research opportunities and high academic standards critical to any public teaching hospital.
But despite a promising beginning, the Charles R. Drew University of Medicine and Science in Watts has more recently struggled with fiscal problems and has had troubles recruiting top-flight doctors as faculty members.
The medical director at King, Dr. James G. Haughton III, has complained that the Drew school--far from helping the hospital--has become its “albatross.”
In particular, he blamed the school for problems in recruiting and retaining top doctors.
Serious Financial Problems
University President Dr. Walter Leavell denied that the school is an albatross. He acknowledged serious financial problems in the past, but said they have been resolved.
Last year, a wrenching financial crisis and looming $2.5-million deficit at Drew forced the layoffs of more than 50 employees. Since then, the faculty has been hit by wholesale salary cuts and suspension of payments to the employee retirement fund.
Independent auditors who examined the university’s books from the recent past noted that school officials had failed to consistently obtain bids for purchases, employees were given monetary advances without supporting documents and received loans from school funds without a repayment schedule. Bank accounts had not been reconciled for two years, wire transfers were not recorded, bounced checks were not followed up, petty cash accounts were replenished without proper authorization and vacation hours taken by faculty members could not be verified.
‘Light at the End of the Tunnel’
Since then, school officials have struggled hard to put the university on a steady course, and as a result, Leavell said, “We can now see the light at the end of the tunnel and know that it is not another train.”
Founded in the early 1970s, the university was named in honor of a famous black doctor and scholar renowned for his research on blood plasma. The school was established with the help of doctors and officials from the UCLA and USC schools of medicine, which continue to have representatives on Drew’s Board of Directors.
The university as a whole is unaccredited, but the medical school, which began accepting students in 1980, is accredited through its affiliation with UCLA. Drew medical students spend most of their first two years in study at UCLA.
At the outset, Drew attracted a host of top doctors dedicated to the mission of creating a medical school that would train minority medical professionals and serve the surrounding community.
But problems begans surfacing more recently, and the last 18 months have proven to be a tumultuous time at Drew, whose $25-million annual budget is derived mostly from county, state and federal funding.
* Doctors doing research at Drew have complained that important research has ground to a virtual halt. They have complained that they could not get access to their grant money to buy even mundane supplies--including food for laboratory animals.
* The Los Angeles County sheriff’s forgery-fraud unit has launched an investigation into the alleged theft by school employees of about $130,000 in payroll funds.
* Collection agencies and unpaid vendors have hounded school officials for overdue bills. In one example, the school received a final notice from the electrical company threatening to shut off service unless an overdue bill for $12,521 was paid immediately.
* The school’s personnel director reported last fall that “it takes months to obtain routine office supplies because we have not paid our vendors.” The IRS, she reported, had assessed “severe delinquent penalties” against the school for late payment of payroll taxes, and the school is “consistently behind (two or three months) in processing premium payments for health insurance because of cash-flow problems.”
* In May, the chairman of the department of neuroscience, Dr. George Locke, complained that “monumental problems that exist in Drew’s accounts payable and procurement sections” were bringing research to a halt at his nationally recognized epilepsy center. “Promises have been made to me by every official in the school that bills would be paid and that everything would be done to assist me in the research program and invariably these promises have not been kept,” he stated.
Leavell said the school has had problems but added emphatically that laboratory animals have never starved and that fiscal controls have been put into place to ensure that bills are paid promptly. He said he has made a “sincere effort and significant progress” in implementing sound fiscal practices. But even so, he said of the school’s financial plight: “It hasn’t turned around as fast as I would have liked.”
Educational, Research Arm
The Drew medical school serves as the educational and research arm of King--in much the same way that USC and UCLA serve the two other county-owned major acute-care hospitals. By and large, the medical school faculty serves as the senior doctors of the hospital, ultimately responsible for patient care.
The 130 senior doctors at King are dependent upon Drew for important research and academic opportunities as well as supplemental stipends to boost their hospital salaries. Indeed, the doctors at King are recruited, hired and promoted jointly by officials at King and Drew.
As one indication of the overall quality of the school’s faculty, 48% of Drew’s faculty members are certified specialists in their fields of medicine, compared to more than 80% at County-USC and Harbor-General.
Over the years, the turnover among faculty members has left some gaping holes at Drew. Three key medical services--orthopedics, emergency services and medicine--have long lacked full-time permanent chairmen.
Lacks Established History
Part of the problem, according to a 1987 management review of King, is that the Drew medical school “lacks an established history to which highly qualified potential faculty may be attracted.” The medical center “has not yet established a longstanding reputation for excellence as a teaching institution,” the report said.
Dr. Marshall Morgan, chief of emergency medicine at UCLA who served on a search committee several years ago to recruit candidates for a key vacancy, recalled: “No qualified candidate was willing to come forward and take the job. People felt it was not a good career opportunity.”
Drew’s financial problems have not made recruiting any easier, even though Leavell said that recruiting top faculty and students is his “highest priority.”
Haughton, King’s medical director, complained that Drew officials have set up search committees but provided no budget.
He said, for example, that the university set up a search committee a year and a half ago to recruit a chairman for the department of emergency medicine--a post that has been vacant for more than seven years. But Haughton said the committee “did nothing for a full year” because it had no budget to reimburse candidates for their travel expenses.
‘Superior Candidates Were Lost’
In another case, Haughton pointed out that during the search for a chairman of the department of internal medicine “two superior candidates were lost because more than six months after their visit, their travel expenses had not been reimbursed.”
They were both excellent candidates, Haughton said, but they figured, “ ‘Why get involved with a place like this?’ ”
Leavell countered: “I do not believe that is why we lost the candidates.” He added that the school has earmarked funds for recruiting but conceded that he does not know whether the search committees have actually “accessed the budget.”
Doctors have complained that Drew’s failure to reimburse its visitors had proven embarrassing.
“We are constantly being ‘dunned’ by people who have visited Drew in the last six months and have not been reimbursed for out-of-the-pocket expenses. This includes candidates for department chair positions, visiting professors and faculty being recruited,” the doctors declared in a March, 1988, memorandum.
Given the school’s significant cash-flow problems at the time, Leavell said, “That could have happened.”
It is the school’s administration of research funds that has prompted the angriest complaints from some doctors and researchers. They say that after complaining for more than a year, the problems are still largely unresolved.
Mamdooh Ghoneum, a researcher at Drew with a grant to study cancer immunology, said in an interview that “very elementary supplies” he ordered for his experiments the first week in December still had not arrived five months later. “I’ve got a $30,000 to $40,000 grant,” he said, “But we are doing the very minimum level of work, borrowing (supplies) from here and begging from there, doing everything I can, even paying for things out of my own pocket.”
In March of 1988, Dr. Clarence Grim, an authority on hypertension at Drew, convened a meeting of concerned researchers, declaring that “it has become clear that the ability to carry out funded grant goals and objectives at Drew has virtually stopped because of the school’s administrative problems with grants management.”
In an interview, Leavell dismissed the complainers as an unrepresentative minority of all the researchers. He said they exaggerated a few minor problems, which have mostly been resolved. “I’m not aware of anyone’s research coming to a halt,” Leavell said.
But Grim complained in letters to top school officials that researchers could not readily purchase supplies because the school took “weeks to months” to process purchase orders and suppliers took equally long to ship items. “This stems from many suppliers no longer accepting Drew’s credit and refusing to ship to us,” Grim said.
Food for laboratory animals had run out “in the middle of critical experiments,” Grim asserted, and doctors had been forced to dip into their own pockets to buy food to prevent the animals from starving.
Furthermore, a special school committee, responsible under federal law for reviewing the use of human subjects in research grant proposals, had virtually ceased to function since its secretary was laid off, Grim charged.
Secretary on Loan
Haughton said he loaned the committee a secretary after doctors complained that their grant applications were jeopardized by the hamstrung committee.
“I can’t let all the research in the hospital stop because there’s nobody to take the minutes of a committee meeting,” he declared.
Leavell said, “Secretarial help was not denied from the school. . . . I even offered it out of this office . . . but no one took me up on it. . . . We don’t have a lot of secretaries, but that’s an . . . extremely important function. We have a moral and a legal obligation for that function to go forward.”
The frustration level among some researchers reached the point last year where they threatened to demand their grants funds be turned over to some other institution for better handling and safeguarding. They also threatened to report alleged irregularities to funding authorities.
But Grim said the doctors backed off from filing a formal complaint because “we were essentially threatened with being dismissed if we complained about this.”
Leavell denied any such threats, but said that some of the statements made by the school’s dean at the time could have been misinterpreted.
He said in an interview in March that virtually all complaints involving research money had been resolved and that he has set up a process to expedite research grant applications and procurement of supplies needed in experiments.
But in a letter to school officials in May, Locke, chairman of neuroscience, complained of recurrent problems that had seriously undermined his multimillion-dollar epilepsy research at Drew. He stated that it was his “moral and scientific” responsibility to alert authorities at the National Institute of Health, which has funded his research. A formal complaint was filed with NIH in July.
Meanwhile, Drew’s attorney, Joe Duff, acknowledged that a different funding agency--the U.S. Agency for International Development--has subpoenaed documents from Drew pertaining to research money awarded the school’s former president, Dr. M. Alfred Haynes. Duff said he has provided federal investigators with batches of credit card receipts relating to Haynes’ travel expenditures.
Haynes left Drew in 1987, at a time when the school’s financial problems were mounting.
About a year later, Leavell implemented severe cuts to head off financial disaster.
In explaining the cuts to faculty members at a meeting Jan. 12, 1988, Leavell said:
“You are familiar as I am with the shortcomings that have existed for some period of time in our fiscal systems and the credibility of those systems. I think your lack of confidence was justified, because those systems were not solid, sound and not as responsive as they should have been.”
But now, Leavell said he believes that the school is being properly managed. “We have rebounded from significant fiscal crisis,” he said.