The Houston professional community and the Medical Center was abuzz yesterday with Baylor College of Medicine’s announcement late this week that the school will construct a new teaching hospital in the Texas Medical Center and end its recent affiliation with St. Luke’s Episcopal Hospital as its primary teaching hospital. This move comes only a couple of years after Baylor (which has no affiliation with Baylor University in Waco) terminated its longstanding with the Methodist Hospital as its primary teaching facility (previous posts here), a relationship that was as storied as the Medical Center itself. As usual, the Chronicle’s Todd Ackerman — who has done a superlative job in covering the Baylor-Methodist split and the changing nature of Baylor within the Medical Center — has this excellent report on the development.
Baylor’s new hospital will resolve Baylor’s increasing concern over being the nation’s only top-20 medical school that does not own a hospital or whose department chairs do not head the key medical departments at an affiliated teaching hospital. The announcement is really not a surprise as there have been rumors for the past six months or so that Baylor-St. Luke’s partnership was on the rocks. Although the two institutions entered into merger negotiations shortly after they entered into the teaching hospital affiliation, those negotiations didn’t go anywhere as St. Luke’s staked a vision of providing medical services in new hospitals throughout the far-flung Houston metropolitan area. The straw that broke the camel’s back was St. Luke’s dragging its feet in making Baylor department chairs the head of the hospital’s parallel medical departments.
The demise of Baylor’s relationships with both Methodist and St. Luke’s is a reflection of the difficulties involved in sustaining long-term business and professional relationships in the face of the fast-changing world of American health care finance. When those pressures overwhelm a productive relationship such as the one that Baylor and Methodist long-enjoyed, the risk increases that a decline in the quality of medical care will be the ultimate result, which is a risk that should concern all of us. On the other hand, Baylor is presenting an ambitious plan for maintaining its position as one of the top medical schools in the country, and more competition between outstanding hospital facilities in one of the nation’s top medical centers could well generate even better medical care and research. How it turns out will reflect much in regard to the direction of the American health-care finance system and the challenges of training physicians within that changing system.