Tuesday, October 4, 2022

A question of patient care

University, community officials examine patient care, academic quality in light of College of Human Medicine’s evolving focus in Grand Rapids

October 10, 2011
Misty Holley, far right, of Fowlerville sits with her husband Larry, son Kristopher Brookens-Hillebrand, 14, and step-daughter Gabbie Holley, 13, as her daughter Dakota Brookens-Hillebrand, 12, laughs on the ground in their home Sunday night. Kristopher was using his nebulizer to help with his asthma. Lauren Wood/The State News
Misty Holley, far right, of Fowlerville sits with her husband Larry, son Kristopher Brookens-Hillebrand, 14, and step-daughter Gabbie Holley, 13, as her daughter Dakota Brookens-Hillebrand, 12, laughs on the ground in their home Sunday night. Kristopher was using his nebulizer to help with his asthma. Lauren Wood/The State News —
Photo by Lauren Wood | and Lauren Wood The State News

Editor’s note: This is part three of an ongoing series about the College of Human Medicine’s presence in Grand Rapids.

For Misty Holley, things add up.

Three kids with conditions including Down syndrome, cognitive impairment, tumors, epilepsy and a dozen MSU specialists to attend to their needs. One parent with hundreds of miles to drive, spending dozens of hours with doctors on a weekly basis.

It was time away from work that cost Holley her job. And her next job. And the next one. Thousands of dollars spent. One house lost.

And Holley is worried it’s about to get harder.

As the College of Human Medicine takes its headquarters 70 miles away to Grand Rapids, some East Lansing community leaders and CHM faculty wonder if the East Lansing campus can maintain specialists and, subsequently, quality patient care.

Said Omar, a neonatology subspecialist with MSU, said he does not want to leave the community, but he might have no choice.

“I love this community,” Omar said. “I don’t want to move, but at the same time I want to attain the highest level of academic achievement, and I cannot do it by myself.”

Mutually beneficial partnership
MSU’s partnership with Spectrum Health, a not-for-profit health system based in Grand Rapids, spans back more than a decade to former MSU president M. Peter McPherson, a Grand Rapids native. Dean of the CHM Marsha Rappley said Spectrum has given MSU $150 million to have the college’s headquarters in Grand Rapids and the relationship both strengthens the CHM and brings more research dollars to Spectrum.

As Grand Rapids gains CHM’s leadership, East Lansing loses academic credibility, said Stephen Guertin, Medical Director of the Sparrow Children’s Center.

This translates into difficulty attracting specialists to the area, he said.

But Rappley said the college has worked to keep the East Lansing campus strong.

“We have continued to build research programs and clinical programs,” Rappley said. “Education programs are in every one of our communities.”

But Guertin has seen a loss of several subspecialities in past years, particularly in the department of pediatrics.

“We have always relied on MSU to provide many of the subspecialties,” Guertin said. “No one is going to want to come work at a hospital that is not an academic center. That means MSU.”
A report from MSU University Relations shows MSU has created and filled 40 positions in East Lansing during the past five years and filled 25 positions from retirements.

“We have actually added positions in East Lansing,” Rappley said in an email. “We aren’t always able to recruit or retain the whole array of specialists at any one point in time.”

Farhan Bhatti, a medical student and Lansing resident, said concern about the CHM academics in East Lansing has reached students.

“There (are) a whole lot of teaching faculty at Sparrow who I look up to and admire who have voiced concern,” Bhatti said. “My concern, and a lot of other students’ concern, is not knowing what the future holds and wanting some assurance that what is in Lansing remains in place.”

Patient care
When Monica Goble began as an assistant professor and pediatric cardiologist subspecialist at MSU, she described the department as a “thriving division with many subspecialities.”

But Goble said she and other faculty members, such as Elna Saah, a doctor with MSU’s Department of Pediatrics and Human Development, have watched the number of subspecialities with the college decline.

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“We have to send patients out to Grand Rapids or Ann Arbor,” Saah said. “It’s become more and more difficult to attract people to the East Lansing area.”

When her partner retired in 2008, leaving Goble as the only cardiology specialist in the college, she began looking for a replacement.

“When people came to look at the position … they said, ‘It looks like you are in a state of transition,’ and took jobs elsewhere,” Goble said.

Beyond academics, MSU brings another needed component to heath care in the East Lansing area, Holley said.

As a public institution, they accept all patients with Medicaid. Holley’s children are three of 59,255 people in the Ingham County area on Medicaid, according to the Michigan Department of Community Health. But in Holley’s experience, finding someone to take the Medicaid hasn’t always been easy.

“(Doctors) are very particular on whether they’re taking Medicaid or not,” Holley said
Ajovi Scott-Emuakpor, a professor and pediatric subspecialist, said the CHM was built in East Lansing and has an obligation to the citizens there.

“We have a responsibility to the public,” Scott-Emuakpor said.

‘Unclear’ horizons
The expansion in Grand Rapids has allowed the college to increase its number of students, faculty and research, Rappley said. But exactly how this will affect the East Lansing campus and community is still unclear as none of the funds in Grand Rapids can be used in East Lansing.

“When we engage in clinical practices in our various communities … any profit that is generated over and above the requirement to pay the salary for the physicians is used to build more education programs and more research in that community,” Rappley said. “It encourages investment from our partners.”

That same principle applies in East Lansing, Rappley said.

“Everyone is concerned that resources will be taken away from the community,” Rappley said. “They say our doctors are being taken to Grand Rapids, and that’s not true. … We are building here.”

For Holley, the issue is only partly about money. The other part is the children she loves and the doctors who have kept them alive.

“Some (physicians) say you don’t have to worry about it right now, but as a parent you do. You worry about it constantly,” Holley said. “You move (specialists) out to Grand Rapids, and you’re leaving us like a fish out of water. I don’t know if we could follow them.”

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