In the celebration over UTMB’s success in winning funding from the Texas Legislature, no one should miss an important point. The institution was broken before Hurricane Ike, and it’s broken now. The University of Texas Medical Branch’s future still is in doubt.
To move forward successfully, the University of Texas must focus on three things:
1. Clarifying UTMB’s fundamental mission and the University of Texas’s commitment to that mission;
2. Better preparation for disasters like Hurricane Ike; and
3. Improvement in patient care, access and basic services.
The question of UTMB’s mission is by far the biggest piece in this puzzle. First, however, the school’s leaders should think hard about both preparedness and patient services, about finally getting the basics right.
Not many businesses seemed as ill prepared for a hurricane last Sept. 13 as UTMB. That’s baffling.
Why was the basic design of the campus so susceptible to storm damage?
Why was there so little advance planning to immediately restart lifesaving services, such as the emergency room, still closed today after more than nine months?
Galveston businesses that sold soda and gasoline did more to get back in business quickly than the one business charged with saving human life. Why?
Before Hurricane Ike,
UTMB’s attention to the basic details of patient service was haphazard and unfocused. It was hard to get a timely appointment in a UTMB clinic. Most patients simply suffered from that or learned to game the system, bypassing the established systems for making appointments.
Even for patients who had insurance, the billing system was a mess.
UTMB, in fact, seemed a huge, drifting ship with scores of uncoordinated component parts.
There’s reason to believe some of those problems finally are on the institution’s radar and perhaps, at long last, improvement is coming.
By far the biggest and most important question is the one related to mission and to long-term commitment by the University of Texas.
Is the University of Texas truly committed to providing medical education and top-quality patient care even in the face of hurricanes? Will it hold to that commitment despite an economically challenged community and despite competition for funding from wealthier and more politically powerful communities?
Or, next time there’s a storm, will UT leaders have to stop and think before restoring emergency medical care? Will everyone have to endure another costly, meaningless consultant’s study?
It was this confusion about mission that caused UTMB to lose its way so badly in the weeks after Hurricane Ike when UT hastily fired more than 2,000 employees and seemed intent upon downsizing the institution into oblivion. The cuts remain a major roadblock to restoring medical care in Galveston County.
“At that time, a month or two after the storm, we didn’t know what our fate was going to be; we didn’t know what was physically possible, how quickly we could get the clinical facility up and running or if we were going to have the support,” Karen Sexton, executive vice president and CEO of the medical branch’s health systems, said on March 15.
“There was so much uncertainty. If we knew then what we know now ... Monday morning quarterbacking is easy to do.”
Precisely. That confusion came from UT’s own ambivalence about UTMB’s future, its lack of commitment. The staff cuts, planned poorly and made in haste, were indefensibly misguided. All who depend on UTMB will pay a price for that. It also has made the political fight to provide more local funding for UTMB much more difficult.
In his remarks last week, UTMB president David Callender quoted a UT leader who, after the devastating 1900 hurricane, wrote resolutely: “UTMB stops for no storm.” In 2008, ironically, there were many UT leaders who seemed entirely willing for UTMB to stop for a storm, and Callender was their point man.
While the University of Texas mulled and dawdled, its patients suffered and some died, and the fate of Galveston hung in the balance. That crippling uncertainty and lack of direction must never, ever happen again.
The work of ensuring UTMB’s survival has to start at the top within the University of Texas System, and it has to start at the top on the Galveston campus.
