Tampa General Hospital president Bruce Siegel will unveil a plan today that at its core has angered the poor, delighted university leaders and intrigued a community that has a 70-year attachment to its beleaguered public hospital.
Can Siegel, the 36-year-old administrator who breezed into town only in July, convince skeptics from Tallahassee to College Hill that his plan will save the hospital, protect care for the poor and maintain elite services like the burn unit?
Siegel is expected to unveil plans at 8:30 a.m. today in the hospital's cafeteria to create a medical health science center that would consolidate research and medical specialists at a new building near the University of South Florida campus and that would offer primary health services in a series of expanded satellite clinics.
During the next five years, operations would shut down at the Davis Islands hospital. At the crux of his plan is a measure to turn Tampa General into a private, not-for-profit corporation.
"It's a bold proposal," said James Kickman, vice president of the Robert Wood Johnson Foundation for health care research in New Jersey. "When all this managed care shakes out, consumers are going to be interested in quality and service, and a research mission is going to give you that credibility. It's not a bad strategy to say "I want to wrap myself in quality.' "
Siegel and Dr. Martin Silbiger, the USF medical school dean, have discussed building the new medical center on a vacant parcel of state-owned land at Bruce B. Downs Boulevard and Fowler Avenue, university officials said Tuesday. The land is leased from the state to the Tampa Bay Area Research and Development Authority.
"It could present some very promising opportunities for USF," said USF President Betty Castor. She said Siegel and hospital board chairman H. L. Culbreath began to focus on a plan over the past month that would provide a more strategic role for the university and open "a new frontier in research."
Former Tampa General president David Bussone exiled university researchers from the public hospital in 1994, saying a fourth-floor fire that shut down part of the hospital had caused a space shortage. The measure was viewed by some at the time as part of a covert effort to fracture a tenuous affiliation agreement with the university.
USF doctors obtained $44-million in grants in the last fiscal year for health science research, said spokesman Michael Hoad. Hospital officials said little of that money came to Tampa General. By comparison, the prestigious Mayo Clinic in Rochester, Minn., which has been described as one of the models for Siegel's plan, took in about $120-million in research grants last year.
This isn't the first time such a plan has been suggested. Former hospital president Fred Karl talked last year of turning Tampa General into a "giant intensive care unit" surrounded by strategically located medical malls. He said Siegel's proposal looks good.
Dr. Richard Hoffmann, the former director of the USF physician's practice plan, also began developing a plan two years ago to reduce the number of specialists on the USF staff and bolster the number of primary care doctors. At the time, many surgeons were forced to take pay cuts of up to 20 percent in part because of a shortage of patients. Hoffmann said Tuesday that he is developing a community health enterprise project that he called compatible with Siegel's vision. While Hoffmann said his project is still in the "think tank" stage, he is continuing to develop a primary and specialty care system for USF's doctors.
Siegel's plan, if approved, could have a ripple effect on the number and type of medical residents accepted at USF, university officials said.
Meanwhile, other hospital administrators will be watching Siegel closely. Among the plans he has discussed with elected officials is an eventual partnership with the Baycare Health Network, which includes St. Joseph's Hospital and University Community Hospital.
"I guess anything's possible," said Charles Scott, St. Joseph's president. He said Tampa General would become a more attractive partner if it goes private. "Most of the hospitals that are private institutions are very reluctant to enter into a sensitive or controversial arrangement with a partner if they know all of the discussions along the way will be subject to public scrutiny. . . . We're not used to dealing with that kind of environment."
Scott said plans for a private research center would not conflict with the business of hospitals already situated near the university, such as University Community. But any plan to open an inpatient acute care facility could create controversy.
"Spending money on bricks and mortar is no longer the focus of where money should be spent on health care," Scott said.
At a glance
Tampa General Hospital president Bruce Siegel is expected to unveil a proposal at 8:30 a.m. today that will:
Turn TGH into a private, not-for-profit corporation
Phase out operations over the next five years at the Davis Islands hospital.
Construct a new research hospital near the University of South Florida.
Enter into partnership agreements with a community-wide network of primary care physicians.