Good-Faith Questions Deserve a Hearing

To the Editor:

Alfred G. Gilman, provost of the University of Texas Southwestern Medical Center (“A Misleading View of a Texas Medical Complex,” Letters, May 1), and the letter from Ruth Sharp Altshuler, a prominent Dallas philanthropist and supporter of the center, have accused me of irresponsible reporting and “scurrilous insinuations” in my article on the policies and practices at the center and the investigations of the center by a local Dallas TV station and The Dallas Morning News. They believe that I unfairly depicted both the work of the medical center and its chief executive, Kern Wildenthal.

To prepare the opinion column, I called at least 40 people in Texas as well as a few representatives of hospital associations to get their views about what has happened at the Southwestern Medical Center. The article was based on the views of a variety of people to whom I spoke in Dallas and elsewhere.

The critique by Dr. Gilman and Ms. Altshuler centers on two basic issues: the activities of the Southwestern Medical Center and the use of charitable contributions for fund raising and other purposes.

I want to be very clear about two facts. The first is that I never questioned the medical reputation and outstanding achievements of the center and its physicians. If anybody is responsible for some of the practices that I and others have cited, it has not been the responsibility of practicing doctors but that of the administrators who run the center.

The second is that I did not attack the reputation and administrative abilities of Dr. Wildenthal. On the contrary, I called him a “phenomenal fund raiser” who had built the center into a prosperous medical enterprise. I should add that I did not once use the word “scandal” in the article itself, but the editors used it in the headline they wrote.

Let’s discuss the alleged favorable treatment provided to a VIP list of wealthy, politically prominent, and well-connected people. In November, The Dallas Morning News reported that the “UT Southwestern Medical Center at Dallas keeps a detailed list of wealthy, high-profile, and influential people and their family members to ensure that they get favored treatment if they become patients.” This mirrored the allegation made by Robert Riggs, the investigative reporter for the Dallas CBS television station.

John McConnell, executive vice president for health-system affairs at the Southwestern Medical Center, confirmed to the News this special treatment for favored patients, including personal greetings on arrival to the hospital, free parking, a personal escort to an appointment, a special unlisted number for contacting doctors, special access to doctors on weekends, and the services of a special assistance office.

Dr. McConnell and other hospital representatives said that such special attention to some patients did not amount to preferential medical treatment or better care.

Medical Center representatives said that such VIP treatment was common practice in hospitals throughout the country.

But the News said that several other hospitals in Texas stated that they did not provide this scope of access for their donors and other prominent patients. In his letter to The Chronicle, Dr. Gilman calls the News statement “poppycock” and says that the newspaper knows it is false. But Dr. Gilman fails to provide a shred of evidence other than his general assertion that this is a very common practice nationwide to support his allegations that the statements made by the News and other hospitals were not true.

Dr. Gilman does not explain why it was necessary for the medical center to have a VIP list in the first place, or why only certain people had access to an unlisted telephone number or why special attention was provided to the wealthy and influential members of the community, if the intention was not to grant favored treatment to privileged patients.

Both Dr. Gilman and Ms. Altshuler imply that I don’t know much about fund raising. I founded and ran a highly respected national nonprofit organization, the Center for Community Change, for 23 years and have been a major fund raiser for scores of coalitions and nonprofit organizations. I trust it was not an accident that in 1997 I received a lifetime achievement award from the Association of Fundraising Professionals.

Paul Bass, chairman of Southwestern Medical’s fund-raising foundation, told me that just as in business, it is the bottom line that matters. But nonprofit values and public accountability should be the chief concern in fund-raising activities. Fund-raising costs should be reasonable and not excessive, no matter what the level of money raised. Charitable contributions, in a real sense, are partly taxpayer money, and as such, should be accountable to the taxpayer.

Although Dr. Wildenthal and his colleagues have raised more than $1-billion for the medical center, that shouldn’t permit them to spend lavishly on rewards for major donors, such as very expensive bottles of French wine ordered from Paris or bouquets of pricey flowers.

A great fund raiser like Dr. Wildenthal doesn’t need to hand out such gifts to be successful. Nor, with a salary of more than $1-million, does he need tax-deductible dollars to pay for his memberships in civic and cultural organizations. That should come out of his pocket; the rest of us, making much less, have to pay for our own memberships in such organizations.

Dr. Gilman notes that an audit by the University of Texas gave the Southwestern Medical Center a clean bill of health for its fund-raising expenditures. The audit did not cite any criteria or standards by which to evaluate the appropriateness of the medical center’s fund-raising expenses; it merely stated that every item was appropriate. The center should have hired an outside auditor familiar with nonprofit standards and procedures if it wanted to produce a top-quality report.

Finally, Dr. Gilman accuses me of a lack of objectivity because I said that Dr. Wildenthal was resigning rather than retiring from his position as chief executive. I certainly did not imply he was resigning because of criticism from outsiders. This comment by Dr. Gilman does not reflect well on his attack on those of us who in good faith have raised important questions about the activities at the Southwestern Medical Center.

Pablo Eisenberg
Washington