King/Drew’s Ties to Medical School Grow More Uncertain

As Los Angeles County officials struggle to solve the problems of Martin Luther King Jr./Drew Medical Center, the hospital’s affiliated medical school is under increasing pressure and is losing the support of some longtime backers.

County supervisors directed their health department chief this week to recommend by May 10 whether the county should cut long-standing ties to Charles R. Drew University of Medicine and Science.

County officials have linked many of the persistent problems in King/Drew patients’ care, including several recent deaths, to doctor trainees who have not received proper oversight from Drew University faculty.

As a result, the school’s future is uncertain as county officials and consultants try to overhaul the public hospital.

The university’s supporters say it is a vital institution in the community and the only historically black medical school west of the Mississippi. Its critics, including several members of the county Board of Supervisors, have been openly skeptical of the university’s ability to improve after years of broken promises.

The county pays Drew about $12 million a year to oversee the training of doctors and provide some clinical care to patients at the hospital in Willowbrook, just south of Watts.

Drew’s is the only medical teaching program in the nation to have received the lowest possible rating in its last two reviews by the Accreditation Council for Graduate Medical Education. The school faces another review in October, and if it doesn’t improve, it could lose all of its training programs.

As that deadline looms, the medical school has other serious internal challenges. Its president was ousted in January 2004 after a national task force criticized his leadership, and the Drew board of trustees is still searching for a replacement.

Many physicians who head clinical departments at King/Drew have criticized Drew’s medical school dean, Dr. Marcelle Willock, but have stopped short of formally calling for her removal.

And at Tuesday’s meeting of the county Board of Supervisors, some black community activists encouraged board members to cut ties with Drew.

“It kind of pains me to be here today, because of what I have to say,” said Celes King IV, vice chairman of the California Congress of Racial Equality. “We have come to the conclusion that Charles R. Drew University does not function in a manner that is sufficient to be able to maintain a quality of care that is necessary at the hospital.”

Ernie Smith, a former Drew professor, said the university had abandoned its mission by moving away from the African American community. Of the school’s 97 medical students in fall 2004, 31 were black, including both African Americans and Africans, according to school statistics.

“It is not a historically black college,” said Smith, a frequent critic of Drew’s leaders. “It is a white shell game that is being played on the black community. End it now! End it now!”

In September, after a spirited debate about whether the school could be trusted, the Board of Supervisors renewed its contract with Drew for 21 months.

Several supervisors have been openly dismissive of the university.

“I am terrified of what I’ve been hearing from past residents who are now docs in different areas,” Supervisor Gloria Molina said at Tuesday’s meeting. She added that senior Drew doctors left the physician trainees “sometimes with nobody to attend them, with three residents looking at each other trying to sort out what to do.”

At one point, she snapped at Drew Chairman Bart Williams, “I think you need to talk to your own residents.”

“I have,” he replied.

“Why can residents not go to you?” Molina asked. “When there are three residents in the operating room and there is no physician, why can’t they come to you” to report a problem?

Supervisor Mike Antonovich sponsored the motion calling for the rapid review of the county’s ties to Drew.

“I currently do not have confidence that Drew University will be able to meet the county’s standards,” he wrote in a letter Monday to the county’s chief administrative officer.

The county has several options if it jettisons Drew. It could operate King/Drew as a community hospital without training programs, or it could seek to link up with another medical school. Officials at both UCLA and USC, however, have said they are not interested in taking over King/Drew’s residency programs.

In an interview, Williams said the university was headed in the right direction. The Drew board has been working to reform itself by paring its membership and recruiting national leaders in healthcare and public policy as trustees.

“The board is more knowledgeable, working harder and is more cohesive than it has ever been, at least in my opinion, in the six years I have been on the board,” he said.

Supervisor Yvonne Brathwaite Burke, whose district includes King/Drew, said she wasn’t ready to break off the contract.

She said she did not know how the hospital could survive without its nearly 300 doctors in training.

“Losing 300 residents, to me, would be absolutely detrimental, devastating,” Burke said. “All of these things are great in terms of throwing out ideas, but when you stop and evaluate them, you have some difficulty.”

Dr. Thomas Garthwaite, director of the county Department of Health Services, also said he did not believe Drew’s contract should be severed.

“From the community’s standpoint, Drew has great potential and great opportunity,” he said. “But if it doesn’t change, it can’t succeed.”

Like Drew, Garthwaite was scolded Tuesday by the supervisors. They ordered him to physically move his office from the department’s downtown Los Angeles headquarters to King/Drew to focus exclusively on its problems.

On Wednesday, he complied, arriving at King/Drew about 7 a.m. and finding an office on the fourth floor. His support staff will join him there.

He made rounds with doctors, met with department chairmen and made a surprise visit to the operating room.

Garthwaite said he planned to “take the pulse of the organization personally. I’ve gotten a lot of reports and a lot of test results in the past, but I’m here with a lot of my personal time and investment.”