After the controversial split earlier this year (previous posts here) with longtime partner Baylor College of Medicine, The Methodist Hospital has been announcing a series of bold moves as it attempts to define its post-Baylor research and teaching role in Houston’s famed Texas Medical Center. Yesterday, Methodist announced its boldest move yet — a 30 year primary affiliation agreement with Cornell University’s Weill Medical School in New York City.
No one can of another teaching hospital-medical school partnership in which such a vast distance separated the from its medical school. According to the Chronicle article on the deal, Methodist President Dr. Ron Girotto downplayed the mileage separating the hospital from Cornell, saying “distance is not an obstacle. Technology today makes anything possible — the sharing of information, quality data and collaboration on research and patient care.”
Cornell’s Weill Medical College’s primary teaching hospital has long been New York-Presbyterian Hospital which is one of the largest hospitals in the country. That affiliation will not change, as Methodist’s deal with the medical school includes a Methodist affiliation with New York-Presbyterian, also.
Still unclear from Wednesday’s announcement is how the affiliation deal will work in practice. Given the distance between Houston and New York, the relationship would appear to limit the typical type of faculty-student relationships that a teaching hospital typically enjoys with a medical school. Under the agreement, Methodist physicians can choose to have faculty appointments at Cornell, which Methodist believes will be a lure in recruiting. Methodist also contends that the affiliation will accelerate the development of the hospital’s new research institute, which it recently announced.
Notably, the affiliation with Cornell and New York-Presbyterian is not an exclusive arrangement, and Methodist will continue to search for other medical school partners. Methodist forsees having multiple affiliations and are open to other ones in Texas. In that connection, talks are still ongoing between Methodist and the University of Texas Health Science Center at Houston, the other medical school in the Medical Center.

Following on this post of earlier this week regarding the brewing divisions in the Texas Medical Center resulting from the decision of Baylor College of Medicine to terminate its 50 year relationship with the Methodist Hospital, this Chronicle story reports on Dr. Charles Brunicardi‘s resignation as the Methodist Hospital’s chief of surgery, which is the first key defection from Methodist in the battle between Methodist and Baylor to retain staff members.
Dr. Brunicardi did not resign from Methodist’s medical staff and will continue treating patients and performing surgical procedures at Methodist.
Dr. Brunicardi is a heavyweight in the Medical Center, and his defection is a blow to Methodist. Stay tuned as the battle for doctors between Baylor and Methodist heats up.

This earlier post reported on the controversial decision of Baylor College of Medicine earlier this year to sever its long ties with The Methodist Hospital and switch its teaching hospital relationship to St. Luke’s Episcopal Hospital. That news rocked the medical community in and around Houston’s famed Texas Medical Center.
Well, it looks like Methodist is upping the ante on Baylor. This Chronicle story reports on Methodist’s move to create a special corporation that will employ doctors effective July 1. The corporation may force Medical Center doctors to decide between Baylor and Methodist, which — as noted earlier here — has been a major issue since Baylor ended their historic relationship.
Apparently, that difficult choice has already been put to Baylor doctors who are Methodist division chiefs. The physicians have been asked to stay and told they cannot maintain practices at St. Luke’s or a new clinic that Baylor plans to build.
In creating the new physicians’ organization along with a previously announced research institute, Methodist will allow be able to hire physicians and scientists on the condition that they do not work for Baylor. Texas hospitals typically create such physician organizations because of the state law that forbids hospitals from employing doctors in order to lessen the pressure that a hospital’s financial conditoin would impair doctors’ medical decisions.
Methodist’s new organizations turn up the heat on the festering issue that has loomed since the breakup of the historic partnership — that is, whether Baylor faculty members will elect to remain at Methodist rather than relocate to St. Luke’s. As noted here, a group of Baylor faculty publicly opposed Baylor’s decision to split from Methodist on those grounds. More than 1,000 doctors currently practice at Methodist and approximately 300 of them are currently Baylor faculty members.
H’mm. Any bets as to when the first “tortious interference with contractual relations-type” lawsuit will emerge from this brewing controversy?

This Chronicle story does a nice job reporting on Dr. Billy Cohn, one of newer wave of cardiovascular surgeons who are fulfilling the legacy of great heart surgeons at Houston’s famed Texas Medical Center that Drs. Michael DeBakey and Denton Cooley began.
Dr. Cohn, 43, has already improved the relatively new method of operating on a heart that is still beating by inventing a cardiac stabilizer that secures the part of the organ that needs surgical attention while the rest of the heart continues to pump blood. Moreover, Dr. Cohn is one of the leaders in a movement within cardiovascular surgery that is attempting to make heart surgery less costly and burdensome to the patient. Eventually, this movement among heart surgeons believes that open-heart surgery will be done without cutting into a patient’s chest.
Dr. Cohn grew up in Houston, attended Memorial High School, and has recently returned to Houston from Boston to practice at St. Luke’s Episcopal Hospital and the Texas Heart Institute. The entire article is well worth reading and provides a good summary of developments in heart surgery in the Medical Center.
As an aside, whenever I see an article about a doctor such as this one, I cannot help but recall noted medical academician Dr. Walter M. Kirkendall‘s (my late father) standard observation about such articles:
“Good advertising.”

This Chronicle story reports on a recent letter from seven Baylor College of Medicine faculty members to the Baylor Board of Trustees that predicted “a crisis of major proportions” if the Baylor Board followed through with its decision to sever Baylor’s 50 year relationship with Methodist Hospital. The Baylor Board announced the decision to sever its ties with Methodist and commence a relationship with St. Luke’s Episcopal Hospital on April 21, as reported earlier here.
Apparently, a group of prominent Baylor physicians tried to prevent last week’s breakup between the medical school and Methodist by warning of “a crisis of major proportions” that could cause the school to “implode financially.” On April 18, seven Baylor faculty members — who are apparently either department chairs or division chiefs — wrote the letter to the Baylor Board and the Methodist Board pleading that their affiliation not be terminated. The Chronicle reports that the letter says the following in part:

“If the St. Luke’s affiliation proposal is adopted, a crisis of major proportions for Baylor will develop, and we will struggle to avoid devastating consequences. With (St. Luke’s), the college will be burdened by more debt and, in fact, may implode financially.”

The letter went on to say that Baylor had never “faced such an alarming crisis over its future.” The letter also predicted that many Baylor’s faculty members would “undoubtedly” keep their clinical practices at Methodist because Baylor and Methodist over the years have established so-called “centers of excellence” in various medical fields, including cardiovascular surgery, neurosurgery, psychiatry, ophthalmology and gene therapy. The letter contends that St. Luke’s does not have the financial ability or facilities to build such programs in the near future, and also does not have sufficient operating rooms or bed space to meet Baylor’s needs.
Finally, the letter predicts that some Baylor faculty members would become “voluntary faculty” to avoid moving to St. Luke’s and that others would “leave Baylor and Methodist altogether.” Replacing these faculty members, states the letter, would be costly and a blow to Baylor’s academic prestige.
Dr. Richard Stasney, a long-time ear, nose and throat specialist at Methodist and a Baylor faculty member, was quoted in the Chronicle as saying: “It’s very upsetting that a 50-year marriage ended. It’s going to hurt Baylor a lot more than Methodist.” Dr. Stasney was not one of the seven faculty members who signed the April 18 letter.
Read the entire article. More than a few ears are going to be burning in the Medical Center over this public disclosure.

One of the most well-known stories of Houston lore — yet not discussed publicly much — is the long-time rift that has existed between two giants of cardiovascular surgery and of Houston’s amazing Texas Medical Center, Dr. Michael DeBakey of the DeBakey Heart Institute and the Baylor College of Medicine, and Dr. Denton Cooley of the Texas Heart Institute at St. Luke’s Episcopal Hospital. That rift has resulted in Dr. DeBakey and Dr. Cooley rarely speaking to each other over the past 40 years.
As a result of the major announcement of this past Wednesday that Baylor College of Medicine is changing its primary teaching facility from Methodist Hospital to St. Luke’s, Dr. DeBakey (of Baylor) and Dr. Cooley (or St. Luke’s) are being forced to speak to each other again, at least to a limited extent. As this Chronicle artice reports, the first meeting occurred yesterday when both Dr. DeBakey and Dr. Cooley attended a meeting in which the historic agreement linking Baylor and St. Luke’s was consummated. Cooley, 83, and DeBakey, 95, shook hands and greeted each other, then sat down at a table where institutional leaders signed contracts making St. Luke’s the primary teaching hospital for Baylor. As the Chronicle report notes:

The pair’s relationship dates back to 1951, when DeBakey offered Cooley a job at Baylor, allowing the Houston native to return home after completing his training at Johns Hopkins University School of Medicine in Baltimore. For the next decade the two would collaborate closely.
Cooley left in 1962 to found the Texas Heart Institute, acknowledging that directly competing with DeBakey in the same hospital became problematic. The two remained friends and were both still on the Baylor faculty, but no longer operated together.
In 1965, DeBakey participated in a federally funded program to design an artificial heart. Within a few years he had a device that some physicians felt was ready for human trials, but DeBakey believed it needed more work.
Then, to international acclaim in 1969, Cooley performed the first artificial heart implant in the chest of 47-year-old Haskell Karp, a dying heart surgery patient. Karp lived with the heart in his chest 65 hours before dying shortly after a heart transplant.
But Cooley’s notoriety was quickly tarnished after DeBakey said the heart was identical to one under development in the Baylor labs, and that Cooley had used it without permission.
Cooley said he and Dr. Domingo Liotta, who also designed artificial hearts in DeBakey’s lab, had built the heart privately, and that he had no choice but to use the heart because the patient’s life was in jeopardy.
In a 2004 interview, Methodist heart surgeon Mike Reardon said the episode “stole DeBakey’s shot at a Nobel Prize. What Mike needed was one crowning event to make him a candidate. And that was going to be the artificial heart.”
After the incident the American College of Surgeons voted to censure Cooley and, amid a dispute with the trustees of Baylor, Cooley resigned from the institution. DeBakey changed his focus and decided funds would be better spent developing pumps to assist failing hearts. Such devices became the mainstream treatment for patients with failing hearts.

In a move that has been expected for over a year but nevertheless shakes the foundation of Houston’s huge Texas Medical Center community, Baylor College of Medicine announced yesterday that it is ending its 50 year primary affiliation with Methodist Hospital as its main teaching hospital and entering into an agreement to make St. Luke’s Episcopal Hospital its primary teaching hospital.
Baylor (which has no affiliation with Baylor University in Waco) is one of two medical schools in the Medical Center (the University of Texas Health Science Center is the other) and the older of the two. In addition to the financial considerations that induced Baylor to make the move, the affiliation with St. Luke’s now gives Baylor a direct relationship with two of the Medical Center’s best hospitals, St. Luke’s and its world-renowned affiliate, Texas Children’s Hospital.
Although the severing of the Baylor-Methodist relationship is unfortunate in several respects, it may turn out to be a good thing for the Medical Center as a whole if Methodist and UT agree that Methodist would become UT’s main teaching facility in the Medical Center. Such a relationship would give Methodist a direct relationship with another of the Medical Center’s world recognized hospitals — UT’s M.D. Anderson Cancer Center and would either supplement or replace UT’s existing relationship with the Memorial Hermann Hospital System. UT’s relationship with Memorial Hermann has always been hindered by Memorial Hermann’s relatively limited presence in the Medical Center, where its only hospital is Hermann Hospital, which is much smaller than either Methodist or St. Luke’s.

One of Houston’s elite group of doctors who were integral to the development of the Texas Medical Center as one of the world’s finest medical institutions has died.
Dr. William Fields, a long-time professor of neurology at both Baylor Medical School and the University of Texas Medical School in the Medical Center, died Sunday at his Houston home at the age of 90. Dr. Fields was a pioneer in medical research and testing of the role of aspirin in the treatment and prevention of strokes. In the late 1970’s, Dr. Fields directed a major research project at 10 medical centers that established that aspirin may reduce minor stroke symptoms and also the likelihood of catastrophic strokes. Dr. Fields also was the first to assess the clinical value of carotid endarterectomy, which is the surgical removal of the lining of diseased or blocked arteries.
Dr. Fields was a colleague and dear friend of my late father, Dr. Walter Kirkendall, with whom he collaborated on many research projects. Through this friendship with my father, I had the privilege of knowing Dr. Fields, who was a wonderful and engaging man. Dr. Fields and my father were members of a generation of American doctors who revolutionized the purpose of medicine and health care in our society, and we all should pause and contemplate the magnificent contributions that this generation of doctors has given to each of us.

The Texas Heart Institute and the DeBakey Heart Center in Houston’s Texas Medical Center are two of the best cardiovascular surgical care facilities in the world. Yesterday, the Texas Heart Institute announced that the 12th and only living recipient of an experimental, self-contained mechanical heart called the AbioCor replacement heart underwent surgery to implant the device on Feb. 20 at its facility in Houston. The recipient of the AbioCor replacement heart is in critical but stable condition. This is the fifth patient to receive the device at Texas Heart Institute under the care of Dr. O.H. Frazier, chief of cardiopulmonary transplantation and director of surgical research at the Texas Heart Institute and chief of transplant services at St. Luke’s Episcopal Hospital. The AbioCor clinical trial began in July 2001.
In this related Chronicle article, several of Houston’s leading cardiologists discuss the merits of the increasingly popular “off-bump” heart bypass procedure in which the operation is done “off-pump” — i.e., without circulating the blood of the patient through a heart-lung machine. While some Houston doctors believe that the benefits of minimizing a patient’s recovery time are so great that they use the procedure almost exclusively, other surgeons are skeptical about the procedure’s ability to reduce the risk of stroke and other side effects.