This will be huge if they can make this happen. I wonder if there will be pushback from uf State Congressmen.
FSU Academic Hospital
- Thread starter DFSNOLE
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Congressmen can't do squat. TMH buildings, land, down to the equipment in the hospital are owned by the city. It's just all leased out for $1 to the hospital holding company. The good thing is President McCullough is acting quickly.
I hope it works out for FSU, but it's not a slam dunk. I have seen UCLA thrive and grow dramatically by acquiring regional hospitals and health centers while at the same time USC has struggled to get traction with their hospital and health center acquisitions and have had some high profile, very expensive failures. UCSF and Stanford have had mixed success with expanding their respective healthcare systems/hospital network in northern California.
USC Keck has always done okay, but more importantly they have what was formally LAC+USC next door making it a super med complex, and the full relationship with CHLA.
FSU’s mandate for academic med is kind of weak. It’s primary care oriented. This was done to avoid competition with uf. Fsu was denied a medical school for decades. Eventually, ucf, usf and even fiu were allowed to build medical schools without the same types of restrictions put on fsu. This was probably the biggest way that UF has managed to surge so far ahead of fsu as an academic force, and how the others have caught up. A real shame.
fsu engineering was also neutered by the Famu pairing. Engineering and medicine are high money makers and also high status relative to all sorts of factors.
Universities in big cities tend to better situated for academic medicine in my opinion. Though, there are plenty of college town models, uf, uva, university of Michigan. UCLA and ucsf have so much money surrounding them, it’s really a different game. You’ve got philanthropy advantages there but also venture capitalists and entrepreneurial factors that can help launch the pedestrian intellectually into more rarefied air. And, if you’ve got skill, it’s better in that environment to flourish. The resource and patient population access is just easier than if you were trying to do the same thing in Tallahassee.
I am curious to see how university of Texas Austin’s medical school develops. There’s a lot of money there. And, they’ve got tons of tech around them. They’re very new.
fsu engineering was also neutered by the Famu pairing. Engineering and medicine are high money makers and also high status relative to all sorts of factors.
Universities in big cities tend to better situated for academic medicine in my opinion. Though, there are plenty of college town models, uf, uva, university of Michigan. UCLA and ucsf have so much money surrounding them, it’s really a different game. You’ve got philanthropy advantages there but also venture capitalists and entrepreneurial factors that can help launch the pedestrian intellectually into more rarefied air. And, if you’ve got skill, it’s better in that environment to flourish. The resource and patient population access is just easier than if you were trying to do the same thing in Tallahassee.
I am curious to see how university of Texas Austin’s medical school develops. There’s a lot of money there. And, they’ve got tons of tech around them. They’re very new.
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UT Southwestern is an enormous complex in Dallas and seems to be thriving. Likewise Baylor on the other side of town.
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The State of Florida has been controlled by uf types in the Legislature and hamstrung as far as expansion at FSU specifically. Other universities have strong and assertive representation in the Legislature and have never been viewed as a threat to the status of uf. USF is located in Tampa and elected representatives from there may have alumni status at uf - but they know that their electability depends on protecting the assets in their districts.
But it’s impacting the state in a negative sense because our explosive growth has made us lag behind the two states ahead of us in population-California and Texas. NY is ahead of us as well.
The Panhandle in particular is lagging and legislators from NoFla must step up. If FSU is held back in guarantee you uf is actively expanding and would jump in.
I agree that the core medical school has done okay; it is more on the business and expansion side that I have seen them struggle. The partnership with LA General has been fraught and continues to worsen with the rebranding and reorganization of the last couple of years. The CHLA relationship seems resilient, but it is also messy. My partner has managed labs at CHLA for a USC professor and at the VA for UCLA professors, and I have been a consultant with several projects under both the UCLA and USC systems for years. The political wrangling and the territorial and resource disputes in the USC system were non-stop and disruptive in a manner that we did not experience in the UC health systems.
More relevant to this thread, the expansion of clinical services and the acquisition of various outpatient and specialty clinics across southern California have been much more successful for UCLA Health than they have been for USC from my perspective. Of the big 3 health systems, UCLA seems to have done the best, with Cedars in second and USC trailing noticeably.
Stanford is doing what Stanford does and slowly, methodically adding to its fiefdom on the peninsula, but the UC/UCSF brand is more visible and successful throughout the rest of the Bay Area and north. South of LA, UCSD and UCI health don't really have any private competition other than small regional centers like Scripps.
Notably, the various UC health systems do not fight each other or attempt to undermine each other's expansion or success.
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Having been in the UC system for so long and seeing how the campuses really cooperate and support each other, I have become increasingly frustrated and confused by the in-fighting and outright sabotage that seems to define the SUS in Florida. It just does not make any sense that the state would hamstring itself and its universities and health systems in that manner, especially when you have models like Texas, New York, California, etc. that show what can be accomplished with effective collaboration and leadership.
Excellent academic school. My son attended grad school there.
Old battles. I think ucf, usf and fiu have been developed very well over the last couple of decades. UF is obviously pretty competitive. Overall, Florida public universities are a great value, especially with bright futures.
Old battles can be ended. Berkeley was an absolute bully to the other UC campuses back in the 20s and 30s; they would not even allow UCLA to call itself "UCLA" in the early years. It mandated that the university be called the Southern Branch of the University of California (SBUC), and they thought it would be cute/clever to mandate that our mascot be that acronym in reverse: the CUBS. Yet, those rivalries were largely settled in favor of the "One University" model that characterizes the system today and allowed it to grow exponentially across all ten campuses. Can you imagine UF subsidizing FSU athletics to the tune of $10 million per year the way that UCLA subsidizes Berkeley athletics, much less the general sharing of resources and support throughout the system.
If anything for comparison for others not familiar, "LAC+USC" what is now LA General is similar to the TMH front just on a much much smaller scale both are safety-net hospitals, both are city owned, and can still have that along with a strong academic presence and it improves the quality of healthcare.
On the FSU front, we know where this will end up, McCullough even brought Kyle Clark and Carolyn Egan to the TMH meeting on Monday, they are ready to whip out the checkbook and Commissioner Goad is all for a sale.
“FSU has an interest in purchasing the hospital and the city manager has an interest in selling the hospital. TMH is hoping to keep the hospital locally owned and controlled, so there is an effort to work together to see if we can reach an agreement.”
On the FSU front, we know where this will end up, McCullough even brought Kyle Clark and Carolyn Egan to the TMH meeting on Monday, they are ready to whip out the checkbook and Commissioner Goad is all for a sale.
“FSU has an interest in purchasing the hospital and the city manager has an interest in selling the hospital. TMH is hoping to keep the hospital locally owned and controlled, so there is an effort to work together to see if we can reach an agreement.”
In reviewing the USC/LA General situation, I hope that FSU observes that USC never owned or attempted to buy LA General. Even with LA County paying USC over $170 million per year to provide faculty to the hospital, it is a huge drain on Keck's resources. Safety-net hospitals are incredibly expensive to maintain and operate, and massive university health systems like UCLA and UCSF have several revenue-generating hospitals and dozens, if not hundreds, of outpatient clinics to support their efforts with the general hospitals. Even with that infrastructure, UCLA never assumed ownership or financial responsibility for Harbor-UCLA Medical Center, and UCSF never assumed ownership or financial responsibility for San Francisco General Hospital. Even Shands at UF failed to make Alachua General Hospital sustainable and shut it down not long after buying it. The only way that I can see the TMH purchase making sense would be for FSU to change its mission dramatically.
McCullough's letter of intent to the city practically guarantees TMH would become an academic medical center, therefore the mission which they already were headed down with FSU Health. The iron is also getting hot to strike now with more NIH grants being more available for bargaining due to the political climate.
If you want to compare a safety net gain locally, it would have to be Duval Hospital and Asylum, now known as UF Health Jacksonville. The city still subsidizes some operating expenses and building maintenance. TMH deal is looking like a cash transaction taking over whole from the city.
UF here in Jacksonville is a major facility with excellent doctors in all specialties. Many are also on the faculty of their medical school.
Tallahassee needs better health care facilities. No one should need to drive to Jacksonville or Tampa in 2025.
UF Jacksonville is a good example of the issue: safety net hospitals are massive resource drains that require subsidizing from the public and from the university’s revenue generating health system.
This creates a bind: if FSU buys TMH and changes its mission to that of a revenue generating academic medical center, then what takes its place as the safety net hospital for the Tallahassee area?
I think it’s clear that FSU can not afford to operate TMH as a safety net hospital, as not even much, much wealthier university health systems can.
I worry that FSU is approaching this as an opportunity to buy a turnkey teaching hospital, whereas what they may actually be buying is a white elephant, i.e., a financial black hole and a public relations problem.
This creates a bind: if FSU buys TMH and changes its mission to that of a revenue generating academic medical center, then what takes its place as the safety net hospital for the Tallahassee area?
I think it’s clear that FSU can not afford to operate TMH as a safety net hospital, as not even much, much wealthier university health systems can.
I worry that FSU is approaching this as an opportunity to buy a turnkey teaching hospital, whereas what they may actually be buying is a white elephant, i.e., a financial black hole and a public relations problem.
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uf Jax was previously always known as the county public hospital and thus has always been funded to some degree by local taxpayers. When uf expanded its presence it was definitely an upgrade locally.
The medical campus has expanded to become an incredibly large center encompassing several buildings as well as several other facilities throughout Duval County. They are actively expanding not just in the Jax area but also in the geographic areas to the north and east of Gainesville.
I do believe the simultaneously growing presence of Mayo here has forced the uf health system to expand as well. But not everyone here can go to Mayo, and the uf system has been very successful at obtaining grant dollars through their research efforts.
The medical campus has expanded to become an incredibly large center encompassing several buildings as well as several other facilities throughout Duval County. They are actively expanding not just in the Jax area but also in the geographic areas to the north and east of Gainesville.
I do believe the simultaneously growing presence of Mayo here has forced the uf health system to expand as well. But not everyone here can go to Mayo, and the uf system has been very successful at obtaining grant dollars through their research efforts.
