UTRGV President Guy Bailey has responded to statements made in letters by Doctors Hospital at Renaissance Health on the “quality of education” and “provisional” status of the UTRGV School of Medicine.
DHR “unilaterally” decided to end an affiliation agreement with UTRGV after six years, according to an Oct. 12 email sent by the Office of the President.
“Please know that we do not view this termination as problematic nor was it unexpected,” Bailey’s email reads. “This latest development is part of UTRGV’s natural evolution and undoubtedly reflects the fact that our healthcare mission no longer aligns with a for-profit, physician-owned health system like DHR Health.”
DHR took issue with part of the president’s email.
An Oct. 12 letter from Manish Singh, chief executive officer at DHR Health, to residents, fellows, faculty and staff explains DHR’s decision for the termination was not “financially motivated.”
“DHR Health has always put patients and quality in front of financial consideration,” Singh wrote. “On the contrary, DHR Health provides many specialties and service lines that others in the community will not due to their negative financial impact.”
Bailey told The Rider in a phone interview last Thursday that all the hospitals in the Rio Grande Valley are for profit.
“There are no nonprofit hospitals in the Rio Grande Valley,” Bailey said. “Anytime a medical school and hospital partner, [there are] issues that come up and this comes up all the time. I mean, when I had a medical school in Kansas City, we always had issues and it’s because the missions aren’t exactly the same. And, so, we’re a nonprofit medical school and they are a … for-profit hospital. And, so, our missions are just slightly different.”
He said he believes DHR is interested in training residents and the termination does not mean that UTRGV and DHR are not interested in expanding medical care in the Valley or training residents.
DHR paid UTRGV $1.5 million monthly to help compensate the residents, according to an email sent to The Rider last Thursday from Patrick Gonzales, UTRGV associate vice president for Marketing and Communications and university spokesman.
“In other words, we are the sponsor of the residencies,” Bailey said, “So those residents are our employees and so they get UTRGV checks every month. Since they are our employees, then DHR is using their labor.”
Singh’s Oct. 12 letter states that DHR Health’s decision to terminate the affiliation agreement was based on their requirements that residents and fellows receive the highest quality of education by the appropriate experienced faculty located on their campus.
Bailey said that DHR residents receive a “very high-quality education.”
“And it’s reflected in the fact that all of those residents end up getting very good jobs,” he said. “In fact, DHR has hired a number of our former residents who worked there, so they certainly had enough confidence to hire those residents. But the second thing is that the vast majority of the doctors at DHR, [who our residents are working with], are DHR doctors. So I don’t know how to interpret that. I don’t understand that statement, frankly.”
On Oct. 3, DHR Health also sent a letter to Texas Gov. Greg Abbott explaining how UTRGV’s approach of educating residents is no longer the vision DHR had for future physicians.
“The [School of Medicine] still remains [on] ‘Provisional’ status with the Accreditation Council for Graduate Medical Education (ACGME) after seven years of providing medical education in our community,” Singh wrote. “For these reasons we have come to the decision that a termination of our Affiliation Agreement is in the best interest of the residents and their continuing medical education.”
However, last Thursday, Gonzales provided The Rider with a letter from the ACGME to the UTRGV School of Medicine that states the ACGME Institutional Review Committee granted continuing accreditation to UTRGV effective Jan. 18, 2022.
The ACGME letter states, in part:
“The Institutional Review Committee (IRC), functioning in accordance with the policies and procedures of the Accreditation Council for Graduate Medical Education (ACGME), has reviewed the information submitted regarding the following institution: University of Texas Rio Grande Valley Harlingen, TX Institution: 8004801149 Based on the information available at its recent meeting, the Review Committee accredited the institution as follows: Status: Continued Accreditation Effective Date: 01/18/2022.”
Bailey told The Rider, “What that means is we were always accredited, fully accredited. There’s no provisional status at all. And the [DHR] letter was, I mean, it’s just false. I think [DHR has] since corrected that with the governor. I don’t know that for sure, but my understanding is that [DHR was] writing a letter to correct that.”
The Rider asked DHR for an interview, but Marcy Martinez, director of Public Relations and Corporate Communications at DHR Health, told the newspaper in an Oct. 20 email that DHR is not “currently giving any comments on the topic.”
The newspaper also tried to contact Dr. Michael Hocker, dean of the School of Medicine, for comment on the termination agreement. In an email to The Rider last Thursday, Saira Cabrera, internal communication content specialist for the School of Medicine, wrote, “Please accept our apologies that we were not able to meet your deadline. Unfortunately, Dean Hocker has previous commitments and is unavailable this week for interviews.”
The UTRGV School of Medicine currently has 241 residents overall and 119 at DHR, according to Gonzales.
Saul Ruvalcaba, a second-year resident of family medicine at DHR, said he decided to do his residency at DHR because there was a portion of the interview that asked more than just the typical questions.
“More than just ‘What’s your greatest strength? What’s your greatest weakness?’ and I felt that if they were really trying to look and get an idea of who the people were [going into their program] that sounded like they really cared about that, and that’s pretty much why I chose them,” Ruvalcaba said.
He said the termination affects the residency programs in different ways.
“The difference is in the timing,” Ruvalcaba said. “For instance, surgery and [obstetrics/gynecology], both of those are more than three years. OB/GYN is four, I believe, and surgery is five. So both of those programs, in that three-year wind-down period, at the end of that, there is no more UTRGV-DHR and so those people are left with one year of ‘Where I am going to go to school?’ … And, so, that’s a lost opportunity for them, as well.”
Bailey said it should not affect the residents’ training.
“I mean, you’re going to continue and finish your residency program and we will see where we guarantee, you know, that we will continue to support that,” he said. “Our residents will always be trained and they’ll have our support. And, you know, for a patient seeking health care, it shouldn’t affect your health care at all.”
Ruvalcaba said he believes UTRGV and DHR Health are trying to do what’s best for the community.
“It’s kind of tragic, you know, to see that UTRGV wants to be doing what is best for the community and help out people, and I believe that DHR wants to do that, too,” he said. “And, unfortunately, they can’t agree on how that’s done.”
Bailey said he does not know what the future will bring but hopes UTRGV and DHR will cooperate in the future.
“I mean, over time, agreements like this happen and then you’ll have an affiliation agreement,” he said. “You’ll end it. You’ll start it back. And if you look at these kinds of agreements over time, it’s just kind of normal process.”
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