In yet another round of high-profile physician exits from University Medical Center, the hospital is losing two top organ-transplant surgeons and a specialist who oversees kidney transplants.
Among those leaving is Dr. Ernesto Molmenti, who arrived at UMC only two years ago to revive the defunct liver transplant program and strengthen the faltering kidney and pancreas transplant programs.
These latest departures follow the resignations, confirmed earlier this week, of UMC's chief trauma surgeon, Dr. John Porter, along with two other trauma surgeons, all serving the city's lone trauma center.
Although hospital officials insist these losses are merely coincidental, and part of the academic contract cycle at this time of year, rumors of internal turmoil have been circulating within UMC in recent months.
"Physician turnover is obviously a way of life in academic health centers, so that is something we just have to deal with," said Dr. Keith Joiner, dean of the University of Arizona College of Medicine.
People are also reading…
"What is happening is part of the larger national issue — the widening gap between private-practice salaries and academic salaries. At a teaching hospital, the teaching must be paid for, with funds that might go to salaries and benefits. It's a fact of life.
"Dr. Molmenti's case is the best example. The package he's being offered is just way out of our reach. In certain specialties — and transplant is one of them — private practice is paying salaries two to three times what teaching hospitals can pay."
Molmenti will join North Shore University Hospital on Long Island, N.Y., to open a new kidney-transplant center there in June.
"Yes, we've seen some major losses," Joiner said.
"They are tough, but we're hardly going to give up. We're going to deal with these pressures, though we know it's not going to get easier."
Along with Molmenti, UMC will lose lung-transplant surgeon Dr. Kimberly Gandy, who also is a pediatric heart surgeon, and Dr. Sam James, a nephrologist who is medical director of the kidney-transplant program.
Molmenti arrived at UMC with considerable fanfare in summer 2005, recruited from Johns Hopkins University School of Medicine in Baltimore. Named chief of abdominal transplantation, he restarted the liver-transplant program within months, after its shutdown amid controversy four years earlier.
During his two years here, he performed UMC's first split-liver transplant — dividing a donor liver between a baby and an adult man. Under his guidance, UMC became the first hospital in the state to offer liver transplants to children, and began doing pediatric kidney transplants as well. Molmenti himself performed liver, kidney and pancreas transplants.
Efforts to contact Molmenti this week were unsuccessful.
Assuming Molmenti's duties as UMC's new chief of abdominal transplants will be Dr. Rainer Gruessner, recruited here from the University of Minnesota to assume leadership of UA's entire department of surgery when he arrives in July.
Skilled in liver, kidney, pancreas and intestinal transplants, Gruessner is "a world-class academic surgeon," Joiner said in announcing his appointment last month. He is a specialist in living-donor organ transplants, and in minimally invasive surgery.
Charged with "substantially expanding the size of the department of surgery," as Joiner put it, Gruessner suddenly will have his hands full on that front. Most pressing is the immediate need to recruit at least four new trauma surgeons to fully staff the city's level-one trauma center.
The other two positions in the transplant program will be filled by doctors within UMC.
"The transplant program will go on," said Judy Dye, the UMC vice president who oversees the program.
"We are very sorry to lose all three of these physicians, but we expect to see a smooth transition, especially for our patients. They will continue to get top-quality care throughout the transplant process."
The sudden loss of a slew of vital UMC physicians, most notably surgeons, "is all very much coincidence" driven by the needs of the individual doctors and not by internal dynamics at UA and UMC, Dye said.
"There are completely separate reasons for each of the transplant physicians leaving. And they have nothing at all to do with the exits of the trauma surgeons," she said.
When lung-transplant and pediatric heart surgeon Gandy leaves at the end of June, lung transplants will be performed by Dr. Michael Moulton, currently performing cardiothoracic surgery at UMC.
Gandy's exit is not just a loss for UMC, but also for the entire Tucson medical community, now suffering a severe shortage of pediatric specialists. She was the first specialty-trained pediatric heart surgeon in Southern Arizona and had planned to open a "center of excellence" for children in the region with irreversible heart disease.
Gandy could not be reached for comment because she was out of town this week.
Stepping in to oversee the medical care of kidney transplant patients will be UMC nephrologist Dr. Howard Lien, after James leaves for a position in the San Francisco area, Dye said.
James joined UMC's kidney-transplant program in 1995 and has served as medical director since 2001.
Of rumors of internal strife within UMC and its possible effect on physician decisions, Joiner said, "I don't think there's anything new there. It's not been any secret about the fact there is stress within the system."
He cited the takeover of the former county hospital, renamed UPH Hospital at Kino, by University Physicians Healthcare, the doctors' group at UMC, along with the recent opening of UMC North, the new treatment clinic for the Arizona Cancer Center, as two major stressors within the UMC/UA system.
"It's taken a situation that's intrinsically difficult — being an academic health center — and exacerbating it."
On StarNet: For more health news, features and multimedia, check out our health site at azstarnet.com/health
