A Misleading View of a Texas Medical Complex

To the Editor:

It is sad and harmful when a person as intelligent as Pablo Eisenberg allows his judgment to be clouded by personal feelings about what philanthropy ought to be and by his fervor to find ignoble behavior on the part of philanthropic organizations.

Because Mr. Eisenberg regularly critiques others’ ethical standards, he should feel a special obligation to be guided by complete and accurate information. Regrettably, in his column (“A Texas Scandal Raises Questions About Nonprofit Hospitals,” Opinion, April 17) about the University of Texas Southwestern Medical Center and its president, Kern Wildenthal, Mr. Eisenberg did not pursue the truth. He relied on incomplete and misleading information from tainted sources to portray an institution’s activities as venal. A willingness to ask for simple, complete, and verifiable facts would have yielded very different conclusions.

Let’s get to the bottom of this. How has UT Southwestern come to Mr. Eisenberg’s attention?

For the past several months, UT Southwestern has been the subject of scrutiny from the media, especially by a local TV investigative reporter (described as “intrepid” by Mr. Eisenberg) and, more responsibly, by Dallas’s daily newspaper. We have responded to more than 150 open-records requests and have provided tens of thousands of pages of documents; we have been audited scrupulously by our administrative overseers from the University of Texas system; we have been totally willing to provide this information.

Who has fueled these flames and why?

We trace these events to two predominant sources: One is a former employee, dismissed for fraud, and the second is a faculty member, relieved from his administrative duties but still employed as a tenured professor. These individuals and their attorneys appear to be pushing the buttons. They all have great stakes in the outcomes — financial and otherwise.

Kern Wildenthal’s style of fund raising is intensely personal and labor-intensive, and it has been hugely successful — turning modest gestures of appreciation into a $1.4-billion endowment that will support medical research, education, and patient care in perpetuity. Most medical schools and major universities approach this goal with large staffs, expensive brochures, and other accouterments. Dr. Wildenthal has done it by himself — making sure that donors feel connected with our institution and know their support is appreciated. One is left to wonder why Mr. Eisenberg finds evil in this highly effective approach. Dr. Wildenthal is a man of extreme honesty, integrity, and wisdom. He holds the administration, faculty, staff, and students of UT Southwestern to the highest standards. He does not compromise these standards.

Here are the facts:

• UT Southwestern Medical Center is by any standard a world-class academic and health-care institution. Our reputation rests on exceptional basic and applied research programs and, for more than a half century, delivery of excellent medical care to the local indigent population at Parkland Memorial Hospital, the only public hospital in Dallas, a city in which 25 percent of the population is uninsured.

• The growth of UT Southwestern under Dr. Wildenthal’s leadership has been unprecedented. The budget has increased from little more than $100-million in 1980 to nearly $1.5-billion in 2008.

• Philanthropy has been a critically important component of this growth, especially since state support has declined during this period from half of our total budget to now only 10 percent. The cost of raising these funds (less than 3 percent of the gifts received) has been extremely low.

The most serious of Mr. Eisenberg’s accusations is that we provide a different standard of care to patients at our university hospitals and clinics compared with those at Parkland Memorial Hospital. Similar accusations have appeared in legal pleadings filed by the tenured professor’s attorney. The so-called evidence for this is: (1) disclosure by The Dallas Morning News that we maintain a “meet and greet” list of patients in our private facilities that includes both friends of the medical center and those who require special assistance in reaching their destination, and (2) the accusation that we send “affluent people to private hospitals and clinics and needy people to Parkland.”

The statement that “other hospitals in Texas contacted by The Dallas Morning News offer no special perks to favorably connected patients” is poppycock, and The Dallas Morning News knows well that this statement is false. This is an extraordinarily common practice nationwide. The provision of courtesy perks of little real value in no way constitutes a double standard of medical care. To suggest such is an affront to the professional behavior of the physicians on our staff.

Has Mr. Eisenberg just discovered that medical care for those who can afford it or have insurance is usually delivered in private hospitals, while those who cannot pay and have no insurance often receive care in public facilities? This is a fact of life in major cities in the United States.

UT Southwestern physicians see all of the multitude of patients who seek care at Parkland, as well as those who come to our university hospitals. Most UT Southwestern physicians treat patients in both facilities, and many patients receive care in both facilities at different times. The standards of care at our university hospitals and Parkland are the same, and both are excellent.

No state tax funds are appropriated to UT Southwestern for the provision of patient care. Might the amenities at Parkland be nicer? Should the waiting times be shorter? We wish for both these things, but such decisions are made by Dallas County and its taxpayers.

The next series of accusations involves (1) “excessive and unnecessary” gifts for donors and entertainment, (2) lack of knowledge on the part of donors about how their funds are used, and (3) refusal to answer the TV reporter’s questions, and similar items.

What is wrong with providing modest gifts to donors to thank them, while keeping them involved with the institution, informing them of progress, and letting them know we have not forgotten their support? This is simple courtesy.

What is immoral, unethical, or inappropriate about a gift of popcorn during the holidays to a $100,000 donor, custom-made cookies to honor a $10-million contribution when dedicating a $50-million building, or wine given to note a special event in the life of an especially generous donor?

Mr. Eisenberg’s objections seem absurd. He says the gifts are unnecessary. “Wouldn’t wealthy donors have given their money without receiving an expensive bottle of wine?” Well, this controlled experiment has not been done, Mr. Eisenberg, especially not by you.

Dr. Wildenthal’s fund-raising strategy is not expensive compared with the costs of others, and it works. Potential donors see how others are appreciated. Substantial amounts of money have been raised on a relative shoestring. These funds are then used to support research, education, and patient care, including the care of indigent patients.

Incidentally, the great majority of the wine used by UT Southwestern is modestly priced and domestic, served at fund-raising dinners and similar events, where donors are matched with the faculty members who were the recipients of their philanthropy. The donors meet scientists and physicians, learn about their work, and are thanked for their generosity; many are inspired to give again.

The accusations of profligate spending at a nearby Mexican restaurant (Rosita’s) are especially ludicrous. On average, 10 or so of the highest-level UT Southwestern executives work on Saturdays. At noon, Dr. Wildenthal yells lunch, and, since our cafeteria is closed on Saturdays, the group gathers for an inexpensive meal at Rosita’s. Any member not present misses significant consensus-gathering discussion. A great deal of weekend work is rewarded with a few tacos (paid for with funds donated for this purpose). This is a great deal for the taxpayers.

UT Southwestern’s donors know how their funds are used. Hundreds of annual progress reports are written by the faculty. Funds used for gifts and entertainment come from a small number of donors (including Dr. and Mrs. Wildenthal) who have authorized their donations for such purposes.

Mr. Eisenberg cites one example of an irate individual, Ron Brittain, who objects to how funds are used from the bequest of his uncle, Jesse Brittain. First, Ron Brittain is not a donor. The “intrepid” reporter took Ron and a film crew to his uncle’s grave to conduct his tabloid-style interview. If Mr. Eisenberg had asked for facts, we would have provided information that shows clearly that the fund is being used as Jesse Brittain’s closest friend and executor outlined to UT Southwestern officials.

UT Southwestern has responded in great written detail to the TV reporter with factual information. Before the first television report, a high-ranking UT Southwestern physician-administrator agreed to a lengthy interview on camera. This was edited to a few seconds of misleading material. Why would we consider falling into this trap again?

All of the questioned expenses have been scrutinized exhaustively by auditors from the University of Texas system who report to Dr. Wildenthal’s supervisors. They found absolutely no fault. Indeed, the audit report states that the expenditures were “appropriate and reasonable.”

All of our money is publicly accountable, and we recognize that. We have provided the complete audit report to The Chronicle.

Thus, contrary to the inflammatory headline used in Mr. Eisenberg’s article, there is no “scandal” at UT Southwestern. Rather, our responsible practices have been scandalously misrepresented.

One other jab by Mr. Eisenberg shows his lack of objectivity: He says Dr. Wildenthal is “resigning” his position. Dr. Wildenthal announced his retirement many months ago. He will remain on the faculty and continue his involvement in the community.

Finally, Mr. Eisenberg implies that the “intrepid” reporter lost his job because of his brave attacks on the establishment If his dismissal had anything to do with his stories on UT Southwestern (for which there is no evidence), I suspect it was because those in charge realized that he had spent enormous amounts of time and money to find cookies, tacos, appropriate events, and gifts of appreciation, and an outstanding medical center that renders great service to the people of Dallas and, via research and education, to the world. That’s the story, Mr. Eisenberg.

Alfred G. Gilman
Executive Vice President for Academic Affairs and Provost
University of Texas Southwestern Medical Center
Dallas