WHAT IS GOING ON AT OHSU? Is Oregon’s Premier Academic Medical Center in Turmoil?

Oregon Health & Science University is the state’s premier academic medical center, but recently it has been beset with troubling departures, closures, lawsuits and apparent turmoil. On many fronts.

That should concern anyone in the state who may require, at some point or another, diagnosis or treatment at the facility. And even though OHSU is not really a state university, it divorced the state in 1995 to become an “independent corporation,” taxpayers still pay 1.3% of the institution’s $3 billion annual budget.

Recently, in Reddit’s large medical community (www.reddit.com/r/medicine) a physician user asked “What is going on at OHSU?” A current intern (whom I will not identify) at the facility answered: “I’m a (self-identification removed) and have a few observations:

• Coming from a large academic medical school, OHSU by comparison, does not seem like a very highly functional organization
• - There are wards here that should be locked which aren’t that patients regularly elope from
• - Mock codes just started being run in the last couple of years
• - There was recently a power outage that lasted for hours that resulted in patients rooms getting hotter than 75, some 80
• - There was a huge HIPAA violation a few years ago that resulted in millions of dollars of settlements. Prior to this, there was no office/department addressing HIPAA compliance.”

So what’s up? Let me explain the HIPAA issue with this quote:

Oregon Health & Science University (OHSU) has agreed to settle potential violations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy and Security Rules following an investigation by the U.S. Department of Health and Human Services Office for Civil Rights (OCR) that found widespread and diverse problems at OHSU… (source)

But that’s not all. OHSU shut down it’s heart transplant cardiology program last September, after the program’s four senior physicians left the facility. Initial press reports indicated the physicians left for family or personal reasons, but shortly thereafter, it was revealed that the program’s mortality rates had spiked and hit “alarming levels”.

In 2017, the year before every cardiologist in the OHSU Hospital heart transplant program quit, the program experienced an alarming number of patient deaths, eventually losing twice the number of people analysts expected. “…people who received a heart transplant at OHSU Hospital in the last two years are at 67% higher risk to die in the first year after the operation than patients at comparable programs.”(source)

One of the female cardiologists who left has since filed a sexual discrimination lawsuit alleging OHSU “…perpetuates a toxic environment of sexual harassment.”

So far in 2019, the academic medical center is facing four such lawsuits. Hospital administration admitted the problem exists in 2017 when David Robinson, PhD, executive vice provost, said: “We do have harassment and discrimination going on, and it’s something we need to deal with…”

Making matters worse, in July 2018, the chair of OHSU’s anesthesiology was “forced to resign” in yet another blow to the facility.

In another shocker, in May, 2019, OHSU’s head of Emergency Medicine resigned after a tenure of 12 years that was marked, according to reports, by unrest in the department and claims of harassment and poor treatment. There is an obvious trend here, and it’s not a good one.

In addition to discrimination lawsuits, a number of current or former medical malpractice lawsuits have drawn negative attention; including:

• A liver transplant candidate bleeding to death after 12 of his teeth were extracted by OHSU maxillofacial dental surgeons as a pre-transplant precaution
• A $25 million lawsuit resulting from brain damage to a newborn infant
• A $22 million lawsuit that claims a surgeon dropped a tool twice on a man’s spinal cord leaving him paralyzed.

And these lawsuits are nothing new. Records indicate that malpractice claims are an ongoing problem at OHSU.

“Though hospital officials contend that OHSU has an exemplary record of patient safety, the institution and its staff were sued 232 times for malpractice, negligence or wrongful death allegations between 1995 and 2005.” (source)

Full disclosure: this writer has had his own problems with the institution; including a botched EGD exam conducted by a resident, and, an interview with a bone marrow transplant physician who fell asleep on his hands during our conversation. Nevertheless, he suggested a need for the dangerous, high-risk procedure. A trip to Stanford Medical Center to see the world’s leading authority on blood cancer proved otherwise.

The university is also under fire for its treatment of about 5,000 monkeys at its animal research center. OHSU has been cited with 12 violations of the federal Animal Welfare Act since 2017. And now, PETA has filed yet another suit alleging mistreatment of animals at the research center. (source)

One can only speculate about the origins of such alarming problems, but the genesis appears to be related to a lot of internal politics; a possibly toxic environment where senior doctors reportedly denigrate colleagues and harass female professionals, the independent and opaque management of the institution, and a lack of proper governance and oversight. After its divorce from the state in 1995, the institution was no longer governed by the laws and regulations that apply to state agencies. In these circumstances, strong leadership must fill the void, and that may have never happened.

As an “independent public corporation,” OHSU is also free of the oversight that is usual and expected by state agencies. Its board has zero elected officials, rather a number of industry sorts from sectors like accounting, law, lumber and pharmaceutical consulting. There is one board member representing labor and a number of physicians or MD candidates.

One of the former female staff physicians suing the institution summed up the problem this way:

(There is a) “…glass ceiling and old-boys’ network that has broken OHSU, led to the departure of great physicians, and hurt an entire region that needs a strong and well-functioning academic medical center.” (source)

Edit: Recently, Providence Health Care System Portland announced that, with a $75 million grant from the Knight Foundation, they will be opening their own heart transplant program. OHSU has announced plans to re-open their heart transplant program, perhaps in August, 2019, but details are scarce. Here is what they say they’ve learned from the unfortunate 2018 experience.

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By: Charles McHenry, co-founder of Trilobyte Games, former Oregon Telecommunications Forum Councilor (appointed by the governor), former Registered Nurse (RN) and former director on the board of directors at La Clinica (FQHC) health systems.

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