August 4, 2006

To all faculty and staff of the Miller School of Medicine,

U.S. News & World Report magazine recently announced that six specialties at the University of Miami/Jackson Memorial Medical Center received top rankings in this year’s “America’s Best Hospitals” issue – including Bascom Palmer Eye Institute, which was once again ranked the No. 1 eye hospital in the country.  This great news provides a perfect springboard for celebrating the evolving relationship between the University of Miami Miller School of Medicine and Jackson Health System.

The relationship between the University of Miami faculty practice and Jackson Memorial Hospital has been in existence since 1952. It is a unique public-private relationship that  is best described as an academic affiliation where UM permits its faculty to practice in the clinics, wards, laboratories, and operating rooms of Jackson Memorial Hospital and to provide advanced education to Jackson’s post-graduate trainees as members of the hospital’s attending medical staff. UM’s faculty also uses Jackson facilities to provide advanced clinical education to medical students of the University of Miami. A significant consequence of this affiliation is the fact that while most county hospitals like Jackson provide only general care to their patients, Jackson, with the expertise of the UM faculty doctors, is able to provide advanced specialized care in many medical disciplines. Vital medical services that include transplantation, top-tier trauma care and neonatal intensive care as examples are all readily available to Miami-Dade County patients admitted to Jackson Memorial Hospital.

Several of the services that UM doctors are permitted to provide at Jackson have been ranked as among the best nationally. This year Neurology and Neurosurgery, Urology, Kidney Disease, Digestive Disorders, and Ear, Nose and Throat were recognized by U.S. News & World Report. Ophthalmology care provided by the UM Bascom Palmer Eye Institute medical team is considered the best in the United States. No other hospital in Miami-Dade County or South Florida comes close to such performance, illustrating  the impact of the affiliation between the University of Miami Miller School of Medicine and Jackson Memorial on the quality of care that is being delivered to patients admitted to Jackson.

It is important to recognize that there are significant differences between the UM/Jackson affiliation and the organization of other academic institutions. For example, in many academic institutions, the hospital and the university are part of the same fiscal organization. In contrast, the affiliation between the Miller School of Medicine and Jackson Memorial Hospital involves two separate legal entities -- one a private not-for-profit educational institution and the other a public hospital, exclusively owned and operated by the Public Health Trust of Miami-Dade County. Although they independently operate their own facilities at the medical center and have separate operational and fiscal control and management, they share a longstanding interest in the success of the academic and patient care missions of the medical center.

UM doctors provide substantially more care to charity patients than faculty physicians at most universities across the country,at a much lower level of reimbursement and at a minimal compensation level. Hence, the affiliation between Jackson and the University of Miami as well as the components of Jackson’s payments to UM for faculty services, negotiated in the Annual Operating Agreement, illustrate strongly the formidable commitment of both Jackson and the University of Miami faculty to provide the same high level of care to charity patients and insured patients alike.

Jackson’s administration is also challenged by the fact that the portion of patients without insurance who get their care at Jackson substantially exceeds that of other hospitals, both in the region and the country. The hospital’s opportunity to generate resources that can be reinvested in buildings and technologies or invested in UM academic programs is extraordinarily limited. Thus, the affiliation between Jackson and UM is challenged by extraordinary constraints compared to most other academic institutions across the country.

Under the circumstances,  it is particularly remarkable that these two institutions have been able to maintain a level of care recognized by our peers as top in the country, and these accomplishments should be celebrated by our two institutions as a distinguishing mark of success.  However, we should not be satisfied with where we have arrived and we should always aim to achieve higher goals. In this context, the two institutions are looking at opportunities to expand their horizons and improve the care we bring to our patients.  This patient-centric philosophy is in the heart of our faculty and staff. We shall move into the future proud of our affiliation, humble in front of the opportunity of caring for our patients, but steadfast in our quest to always progress.

Our remarkable affiliation brings an exceptional level of care to all our patients. But our contribution to South Florida goes far beyond health care – this medical center not only provides jobs for thousands of people, it also serves as a unifying point of pride for our community.

This is a time of great excitement and growth at the University of Miami/Jackson Memorial Medical Center. We thank each one of you for your contribution to our vital community mission.