An Open Letter to Mayor Michael Bloomberg, Comptroller JohnLiu, Chairman Michael Stocker, President Alan Aviles, and theDirectors of the New York City Health and Hospitals Corporation

4/12/2011, 5:32 p.m.

We also have nothing but sincere thanks for Mayor Bloomberg, who allocated $350 million to the Health and Hospitals Corporation to help offset its $1 billion operating deficit during the current fiscal year.

However, we have nothing but disdain for decisions that deny the citizens of Harlem timely access to neurosurgery and rehabilitation medicine services-- decisions that directly threaten the trauma center and stroke center designations awarded to Harlem Hospital, centers that treat the very conditions that occur in greatest number in our community. We also decry the shortsighted financial decisions to limit support for graduate medical education--since it will cost the Health and Hospitals Corporation nearly $500,000 to replace each resident trainee with far less comprehensively trained physician extenders.

Last, we find it nothing less than a disgrace that public officials are determined to disregard irrefutable evidence that medical services rendered by Columbia doctors at Harlem Hospital were indeed provided, and to deny that repeated requests to fill vacant positions in our Division of Cardiology were made, yet went unheeded, year after year, resulting in the large backlog of unread echocardiograms sensationally reported in the press--decisions we believe could only have been made for the purpose of terminating the relationship between the Health and Hospitals Corporation and Columbia University, despite nearly sixty years of honorable service to the community, and vast improvements in the health of its residents.

In Columbia's place, we are told, a nonacademic affiliate will be retained to provide patient care at less cost. But for how long? The leadership of the Health and Hospitals Corporation cannot really believe that a physician group representing as many as 2,000 physicians across seven of its eleven acute care hospitals will.

not be in a much stronger position than its current affiliates when it enters into collective bargaining. It also cannot truly think that a small physician group with an untested track record can take on such added responsibility within as short a time as a year, as is currently planned. Surely, it cannot justify retaining two other academic institutions--the New York University and Mount Sinai Schools of Medicine--to provide medical services at Bellevue, Woodhull, Elmhurst, and Queens Hospital Centers, when its stated reason for terminating its Columbia affiliation is that academic affiliations are too costly.

If the Health and Hospitals Corporation were seriously interested in developing viable accountable care organizations in its facilities, logic dictates that it would turn to recognized experts in medicine, nursing, public health, law, and business to help it achieve this goal. Few institutions in New York City can provide such a depth and breadth of expertise across so many disciplines--Columbia University is one of them. We must therefore ask: what sense does it make for the Health and Hospitals Corporation to entrust the future of its medical operations to a small, inexperienced physician group, rather than an institution with the resources, and multiple levels of expertise, to find the best way forward--particularly when that institution has been part of the very fabric of the City it serves for over two hundred fifty years?

It makes no sense at all. Thus we ask, in the name of the people of Harlem--those who will surely suffer most from the irrational decision to end the relationship between the Health and Hospitals Corporation and Columbia University--that you reverse this unwise decision before it is too late. Do not take us back to the past. We have already been there. It has taken very many years of hard work by the Health and Hospitals Corporation and its medical school partners to engineer the remarkable success that recently has been realized. Do not destroy the very engines of that success--the partnerships that make it work.

Respectfully yours,

Medical/Dental Board of

Harlem Hospital Center