USF's desire for a teaching hospital reveals tensions with Tampa General Hospital

TAMPA — The ambitious proposal to build a hospital on the University of South Florida campus has stalled, but not before exposing tensions between USF and its primary teaching hospital, Tampa General.

Leaders at the two institutions have different views on their relationship and their obligations to each other. A national consulting group is coming in to help the two work on how their relationship should be structured.

Ask Ron Hytoff, president and chief executive at Tampa General, about how the hospital treats USF's medical school and he'll talk about how much the hospital does to help USF. Last year, Tampa General poured more than $37-million into support of USF, he said.

"We're very proud of our relationship, and we're looking forward to continuing to work closely with USF," Hytoff said Friday, the first time he has talked publicly about USF since it proposed the hospital.

But ask Dr. Stephen Klasko, dean of the USF medical school, and he'll say that the hospital's support comes mostly in payments to residents and faculty doctors for services they provide. If that money didn't go to USF, Klasko said, Tampa General would have to hire other health care workers.

"The issue is how much is invested in research and the academic enterprise, as opposed to service," Klasko said this week.

Klasko says the medical school has been hemmed in, unable to place faculty members at community hospitals, where doctors don't welcome potential competitors. Tensions between medical school and hospital, for example, contributed to the collapse of USF's anesthesiology training program for graduate medical students in 2006.

They even disagree on terms. Klasko wants Tampa to have an academic medical center. Hytoff says it already does.

"I think every academic medical center has a dialogue with their medical school partner, and it's unpleasant when it gets into the media," Hytoff said.

He decided to talk about the issue after Klasko said Tampa isn't the best place for health care. As Klasko pushed for a USF hospital, he said people diagnosed with serious illnesses often leave the state for care.

"I really believe the quality of patient care in Tampa Bay is superior," Hytoff said. "We have excellent physicians and excellent staff working to provide excellent care."

Hytoff said he was puzzled by some of Klasko's remarks. Still, he said Klasko is "doing the very best he can" and that he expects USF and Tampa General to continue to have a strong relationship.

This week, Klasko called Tampa General "a great hospital" and said he wants the two to have closer ties. His intent wasn't to knock health care in Tampa, he said, but to encourage ambition.

"Do we want to be a place that's okay, or do we want to be the kind of place that people talk about nationally?" he said. "I'm saying that we can do better & The places that get it are where the medical school and the hospital are truly together in a true strategic alliance."

A few weeks ago, Klasko had pointed out that Tampa Bay hasn't scored well in rankings by one national rating group, HealthGrades, and that Tampa General scored poorly in the group's ratings on hip and knee replacement.

Hytoff took issue with that. He criticized the HealthGrades rating and noted that U.S. News & World Report ranks Tampa General as one of the nation's best in orthopedics.

That difference also shows the difficulty for consumers in using rankings to make choices about hospital quality, said Dr. Rachel Werner, an assistant professor of medicine at the University of Pennsylvania School of Medicine.

"No single quality measure captures everything about the quality of care at a single hospital," she said.

Rankings that look at mortality rates, for example, may be more interesting to consumers. But they also might be skewed by other factors, such as whether sicker patients are referred to that hospital. Other types of rankings may measure things more accurately — how many heart patients got aspirin, for example — but not seem as important.

Lisa Greene can be reached at greene@sptimes.com or
(813) 226-3322.

>>Fast facts

Different ratings, opposite results

HealthGrades: Tampa General Hospital rated one star, or "poor," for hip replacement, knee replacement.

U.S. News & World Report: Tampa General Hospital rated No. 24 in the United States for orthopedics.

USF's desire for a teaching hospital reveals tensions with Tampa General Hospital 03/26/08 [Last modified: Friday, March 28, 2008 1:25pm]

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