UPI cutbacks bring resignations

The surgeons resigned in response to an attempt by University Physicians Inc. to reduce debt by increasing workloads and penalizing departments that fail to make money. University Physicians is the business management firm for doctors within the College of Medicine.

University Physicians finished its fiscal year in June 1997 more than $6 million in debt. The company earned $7 million in the previous fiscal year, said Norm Botsford, executive director of University Physicians.

Since the orthopedic surgeons, the orthopedic section and the surgery department remained in the red, 10 percent of the surgeons' pay was withheld starting Jan. 1. The departments were given the opportunity to reclaim the deductions in full if the department could get out of debt by June 30.

Botsford said that a board at University Physicians decided to implement the wage withholding system because it wanted to recuperate the debt and make physicians understand the seriousness of having expenses greater than income.

"There is a lot of unhappiness," Botsford said. "We (University Physicians) are working hard for a solution."

This apparently was little consolation to the resigning surgeons - John Ruth, chief of the orthopedics section; James Benjamin; Jon Nisbet; Francisco Valencia and Roland Roberto.

"Our hope is that they (the resigning surgeons) negotiate with UPI," said Judy Bernas, an Arizona Health Sciences Center spokeswoman. "They have resigned from UPI, not UA."

University Physicians and the College of Medicine have been negotiating with the doctors for more than a month, Botsford said. Meanwhile, the physicians are still seeing patients.

Botsford said his understanding of the doctors' intentions is that they will go into private practice but continue to hold their teaching positions at the College of Medicine. That will last only a limited time, however, until University Physicians can recruit faculty involved in teaching, research and patient care.

University Physicians claims its debt is a result of the difficulties in balancing hospitals' cost of providing care, and health maintenance organizations' efforts to keep expenditures low, Bernas said.

Academic physicians become entangled in the debate because they are forced to see more patients and take pay cuts.

With time dedicated to teaching and research, university physicians have limited time to increase their workload without compromising academic pursuits.

"The orthopedic surgeons have been working so hard. They have practically killed themselves," Botsford said.

For many academic physicians, the benefits of researching cutting edge medicine outweighs the salary discrepancy. Orthopedic surgeons at UMC make about $200,000 a year, compared to the $500,000 salary a Tucson orthopedic surgeon can make in private practice.

Eliminating the perks of academic medicine, such as paid research expenses, sabbatical leave and increased educational opportunities, could result in more surgeons seeking private practice.

Botsford said attempting to control costs often puts doctors and administrators at odds.

"I know it's demoralizing to the physicians - it's demoralizing to me," he said. "We all love the College of Medicine. We want it to succeed and keep the group together."

None of the resigning physicians could be reached yesterday. Dr. James Dalen, dean of the College of Medicine, was out of town and could not be reached for comment.