Paul B. Roth, MD
Paul B. Roth, MD

First, let me say that the current policies were enacted following a two-year-long process in which the University engaged a national health care consulting firm to help identify and implement industry best practices to ensure transparency and establish clear lines of authority for an academic health center within a public university.

They interviewed the leaders of nearly two dozen institutions to gain a consensus regarding the best way to manage a public institution of this size and complexity. That final set of recommendations served as the blueprint for the current policies, and were unanimously adopted by the Regents after a lengthy, open and iterative process in 2010.

Somehow, a myth has arisen since that time – that the HSC Board and the HSC as a whole operate independently from the rest of the University. That has simply never been the case.

Five of the seven Regents are also voting members of the HSC Board. The other two voting members are community representatives appointed by the Regents. These two community members provide an important voice in helping to shape HSC policy – something that was strongly recommended by our consultants.

Mel Eaves, a pre-eminent attorney and former UNM Regent, and Ann Rhoades, a nationally respected human resources expert and current president of the UNM Alumni Association, have provided valuable input over the years regarding HSC operations.

The concern has been expressed that the existing HSC Board structure somehow creates a conflict of interest, apparently because of the inclusion of the community members.

In my opinion, we do not have a conflict of interest. Rather, the current structure creates a confluence of interests that permits for many viewpoints and vigorous debate in the process of coming to a consensus. That is incredibly valuable when it comes to managing an operation of our size and complexity. I also need to emphasize that the HSC Board’s actions always require approval by the full Board of Regents.

The far-reaching changes to the HSC’s structure and function that are being proposed today represents a retreat to pre-21st century academic medicine.

The health care industry in general and academic medicine in particular are facing sweeping and in some cases disruptive changes. The current leadership team and governance have been essential in maintaining and enhancing our clinical capability and ensuring our continued financial health in these challenging times.

I believe these policy changes could dramatically undermine our success going forward. And when Regent Doughty stated yesterday that the reason immediate action is required is to help with the budget crunch, the real reason for the changes became obvious – to move scarce resources from the HSC to cover the deficits on Main Campus.

That would be very problematic, given the HSCs budgetary challenges for FY 2017, which we will discuss at the upcoming budget summit. In fact, whenever Main Campus faced financial difficulties, Dave Harris, the President, the Provost and I would meet and discuss ways in which the HSC could help.

Over the past five years, the HSC has both transferred cash and assume debt and expenses from Main Campus totaling about $45 million – about $9 million a year.

Additionally, due to the current difficulties and the growing deficits in FY 2017, we have assumed an additional $1.2 million in expenses from Main Campus.

And if we falter – if we fall behind and see our resources dwindle – it will have a disastrous impact on the whole University. Worse still would be the negative consequences for our students and faculty and our ability to deliver state-of-the-art, complex and specialized health care to all New Mexicans.

If this sounds like catastrophic thinking, it may be because I, the HSC leadership team, faculty, staff and students have been forced to rely entirely on speculation because we have been inexplicably kept out of the loop in what is being proposed.

We have had no input or opportunity to comment on any of this. Indeed, the 72 hours notice we (and the public) received regarding this agenda item allows no meaningful opportunity for sober consideration of a proposal of this magnitude. 

The values of shared governance by the faculty, the expertise of the University leadership and the Regents are what makes UNM the strong, vibrant institution it is today. While some may feel that an inclusive process of deliberation is too slow or too messy, experience shows that it leads to better outcomes.

I strongly urge the Regents to delay taking any action today and allow for a process that is consistent with these values.