Philadelphia Medicine Fall 2021 - 16

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FEATURE continued
The disastrous loss of Hahnemann illustrates the story of many
injustices and is emblematic of the moral and ethical dilemmas
associated with the rapidly changing U.S. health care environment.
the closure of Hahnemann. The consequences are dire. Without
tail coverage, the Residents may no longer be licensed to practice
medicine. The cost of obtaining tail coverage on their own ranges
from prohibitive at best to impossible depending on their specialties.
These are newly practicing doctors with modest salaries and for many,
hundreds of thousands in debt.
This is an emergency solely of the Debtors' making. The origins of
this emergency started in January 2018 with the Debtors' decision
to ignore their contractual obligations to purchase occurrence-based
insurance. Instead, they prioritized cost savings over contract and
purchased cheaper claims-made insurance. The emergency became
more acute as the Debtors abjectly failed this fall to give all affected
Residents adequate notice that their professional liability coverage
was ending and that tail insurance needed to be procured and that
Hahnemann would not honor its obligations to do so. Upon information
and belief, despite the extraordinary efforts of certain Residents,
the Philadelphia and Pennsylvania medical communities and the
various professional and accrediting associates have undertaken, many
Residents remain unaware that their ability to practice medicine is
in peril as of January 10, 2020.b
Some of the physicians with Hahnemann credentials were
employed by the bankrupt entity, some were in private practice
and some of us were Drexel employees. At the time, we had our
patients, residents and fellows foremost in our mind as the Titanic
was sinking. Fortunately, the housestaff were placed in alternative
training environments in the few weeks that felt like eternity. The
Hahnemann physicians within the practice plan were ultimately
grouped together with the physicians in training as they also lacked
tail coverage, albeit for a different reason.
Eventually, in March 2020, the required tail coverage was finally
purchased for the displaced Hahnemann physicians. Whether it
was purchased as a consequence of pressure from the ACGME to
withdraw accreditation from St. Christopher's Hospital for Children
(which the debtors also owned), the Delaware bankruptcy judge
threating to turn the bankruptcy from Chapter 11 to Chapter 7
bankruptcy (which would have jeopardized the fate of the real estate),
the advocacy and interventions of the Pennsylvania Department of
Public Health or the realized funds purported by the Debtors, we
will likely never know.
Realigning house of medicine
In early 2020, I attended a presentation on the Hahnemann
closure to learn more of the role each of the alphabet soup of physician
organizations played in coming to aid the displaced physicians. In
addition to the ACGME, AMA and the ECFMG, presenters included
the Association of American Medical Colleges (AAMC), Federation
of State Medical Boards (FSMB) and others. It seemed to be the
first time that the national organizations that influence the house
of medicine had collaborated to achieve a substantial common goal.
Private equity now controls many hospitals, emergency departments
and nursing homes.9
As more hospitals become subletters of
property where they provide care, this scenario is likely to repeat.
It is terrifying to realize how the property where a hospital sits
becomes more " valuable " than the hospital itself. The Hahnemann
trainees had signed contracts stating they would comply and abide
by Hahnemann's policies and procedures related to the prevention
of fraud and abuse. Who will hold private equity accountable?
In the wake of the pandemic, the reckoning of racial injustice
and tremendous loss of life, our existence has been forever altered.
Many of us just want to move on. We want to get back to " normal. "
As the Hahnemann saga remains in bankruptcy court, it is
imperative to recall the saga and plead for accountability. As then
presidential candidate Bernard Sanders was quoted in July 2019:
" If an investment banker like Joel Freedman is able to shut down
Hahnemann and make a huge profit by turning this hospital into
luxury condos, " he said, " it will send a signal to every vulture fund
on Wall Street that they can do the same thing, in community after
community after community. "
b Debtors defined as CENTER CITY HEALTHCARE, LLC d/b/a HAHNEMANN UNIVERSITY HOSPITAL, et al. Taken from court documents
Case 19-11466-KG Doc 1134 Filed 12/11/19. Philadelphia Academic Health System and its wholly owned subsidiaries declared bankruptcy.
American Academic Health System and the PA Risk Retention Group (professional liability insurance company) did not declare bankruptcy.
16 Philadelphia Medicine : Fall 2021

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Philadelphia Medicine Fall 2021

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