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(04/12/01 9:00am)
Penn researcher James M. Wilson, currently the target of a federal investigation, has never discussed publicly his 1999 gene therapy study which resulted in the death of 18-year-old Jesse Gelsinger.
Nevertheless, Wilson -- who is the head of Penn's Institute for Human Gene Therapy -- has been chosen to teach a preceptorial on the very subject in which the Food and Drug Administration is questioning his ability to conduct research.
Wilson, who was one of the most respected gene therapy researchers in the nation prior to the Gelsinger controversy, is slated to teach about 100 students in next semester's preceptorial, titled "Human Gene Therapy."
"The guy is obviously a brilliant man with a lot of knowledge in the field," said Paul Gelsinger, whose son Jesse became the first known person to die from gene therapy treatment. "But I doubt he has a total ethical grasp of the work he's doing."
The FDA charges that Wilson "failed to adequately protect the safety and welfare of subjects" and that he "submitted misleading and inaccurate statements" to Penn's review board. The agency also alleges that Gelsinger was enrolled in the study despite medical test results indicating his ineligibility.
Last November, a civil lawsuit filed by the Gelsinger family against Wilson, Penn and several other scientists and institutions was settled for an undisclosed sum.
Gelsinger, a self-made lobbyist for stronger federal oversight of gene therapy trials, questioned whether Wilson is fully qualified to teach the preceptorial.
"All Jim demonstrated to me was a huge concern with losing his life's work, not the life of my son," Gelsinger said. "There's a real imbalance there."
The course, to be offered next semester, enjoyed an overwhelming response during Penn's advance registration period by students wishing to enroll.
"The response was over 10 times the capacity registered for" the preceptorial, said Meredith Chiaccio, chairwoman of the preceptorials program.
"There's going to be a lot of questions thrown out there," said Chiaccio, a College junior. "The discussion, I imagine, is going to be pretty engaging."
Despite Chiaccio's hope for a discussion of the Gelsinger case, however, there is some question whether Wilson will even address his tragic study.
"My guess is, Jim won't [know] until a week before he starts it," Provost Robert Barchi said.
The framework of the preceptorial program allows faculty a wide latitude as far as class structure and subject is concerned.
"They're not necessarily formal topics," Barchi said of the typical preceptorial offering. "They're solicited by [the Student Committee on Undergraduate Education] and organized by SCUE without any involvement by the administration."
Chiaccio acknowledged that, despite her optimism, she cannot guarantee Wilson will mention the September 1999 death of Jesse Gelsinger.
"He's never been willing to come out publicly and address what happened," Paul Gelsinger said of Wilson.
"It would be a huge letdown if students got into the class with him and were not able to address [the case]," Chiaccio said, adding that she understood the position Wilson is in.
"Here's a guy whose career is in jeopardy," she said.
Jeffrey Kahn, director of the University of Minnesota's Center for Bioethics, was confident Wilson will carefully tread the line between delivering information and defending himself.
"He's not trying to pass himself off as something he's not," Kahn said.
But Wilson's controversy is exactly what prompted students to push for the preceptorial.
According to Chiaccio, Preceptorial Committee member and College sophomore Aaron Short approached Wilson to teach the course in an attempt to develop a forum for a discussion of the Gelsinger case.
"We look for professors who attract a lot of news themselves," Chiaccio said, adding that this was "one of the driving forces behind asking Dr. Wilson to participate in this."
Wilson is currently in the midst of FDA proceedings aimed at disqualifying him from ever again conducting human gene therapy research.
But, even considering the FDA proceedings -- which can continue into the fall semester -- Chiaccio said that ethical concerns were minimal.
"When we originally heard from Aaron that he had gotten hold of James Wilson, we were excited," Chiaccio said. "The ethical concerns... honestly, there weren't a whole lot of them."
"Controversy, in a sense is good, because I guarantee you there are going to be students in that class wanting to know his side of the story," Chiaccio added.
In an e-mail statement, Chiaccio later expressed concern regarding the appearance of insensitivity on the part of the preceptorial program.
"I don't want us to be painted as callous students who are willing to do anything to get students' interest," she wrote.
(03/28/01 10:00am)
Penn real estate officials and Freshgrocer management continue to tussle over the future of the supermarket at 40th and Walnut streets, following last week's announcement that the project has been delayed indefinitely.
University contractors continue to work on sections of the supermarket's floor, but the repairs are far from complete, according to Freshgrocer project manager Tony Varallo.
"We will not open until they give us a date for completion," Varallo said yesterday.
Freshgrocer operator Pat Burns announced last Thursday that the grand opening of the supermarket -- scheduled for April 1 -- would be pushed back until the University corrected all problems with the floor.
Penn is responsible for construction of the project, a major piece of the 40th Street revitalization effort. Varallo said that The Freshgrocer's management had a meeting on Monday with Penn's top real estate official, Tom Lussenhop.
"We had a meeting with the University to discuss [our] punch list [of concerns]," Varallo said. "There are over 180 items on our list that need to be addressed. A lot of them are major."
Lussenhop declined to comment on the nature of the negotiations or on any potential opening date for The Freshgrocer, other than to say the supermarket would open "very soon."
Burns claims that the store's tile and concrete floor was not installed properly, resulting in bumps, cracks and other visible defects. As a result, he has chosen not to open for business until the problems are corrected.
Burns could not be reached for comment yesterday.
Varallo said that the three major sticking points -- the condition of the floor, an inoperable conveyor belt intended to transport customers' groceries to the car garage above and a faulty climate control system -- still have not been addressed adequately.
"We've come on deaf ears when it comes to the floors," Varallo said.
But Penn's Vice President for Facilities Services Omar Blaik characterized the floor problems as "nothing major."
Regarding the conveyor belt, Varallo said he has reached a point of near total frustration.
"If customers can't get their groceries, who's going to shop here?" he asked.
According to Varallo, the University has offered "no commitment as far as [the] completion" of the repairs.
Lussenhop, however, has maintained the University's commitment to the completion of the project.
"Contractors working for the University are making repairs to certain portions of the floor," Lussenhop said.
But Varallo said that the repairs that have been made are not satisfactory.
"The workmanship is not up to standards," he said. "It's going to be a constant maintenance issue."
Varallo added that contractors working for Penn's real estate company, Trammell Crow, did not show up yesterday.
"We're looking to get the store open," Varallo said. "They should be here every day."
The opening delay has forced Freshgrocer employees to remove perishable items from the store's shelves. Deliveries of products, intended for the supermarket's opening, have also been canceled.
The Freshgrocer -- initially called Freshgrocer.com -- pushed back its original opening date to January 10 as construction delays surfaced. When January passed, the store was then set to open March 1.
On February 28, The Freshgrocer hosted a reception for Penn and city officials. At the time of the reception, however, Freshgrocer officials had abruptly canceled the March 1 opening, eventually settling on the April 1 date.
"What is going on here is hurting our name," Varallo said. "Our vendors are mad."
Numerous area residents have had to put their plans for employment at Freshgrocer on hold, as well.
According to Varallo, 48 new applications were received over a three-hour time period on Monday. Yesterday, almost 80 people applied for positions at the supermarket.
Close to 60 people are also in possession of time cards waiting to be used.
"We're losing so much money here, it's unreal," Varallo said.
(03/27/01 10:00am)
With the U.S. Postal Service facing financial turmoil, the University's planned development on the lands now occupied by the 30th Street Post Office may have to wait longer than expected.
According to University officials, the Postal Service -- which owns the lands near the Schuylkill River -- has delayed its planned move to the Philadelphia Processing and Distribution Center, which is to be constructed next to Philadelphia International Airport.
"With the Postal Service losing about $3 billion a year, they have put a nationwide freeze on all capital projects in their system, including their new facility in South Philadelphia," University spokeswoman Lori Doyle said.
But Postal Service officials denied that the proposed relocation has been canceled.
The move is "not affected," according to Postal Service spokesman Ralph Stewart. "That's not to say in the future it might not be, but as of right now, it's not affected by the freeze."
On March 8, the Postal Service -- a private enterprise that operates as part of the federal government -- announced that it is "facing a potential loss of $2 billion to $3 billion this fiscal year."
According to the statement, the Postal Service Board of Governors decided in a meeting on March 7 to "take unprecedented action on additional cost-control options, including an immediate freeze on capital commitments that will affect over 800 facilities."
While the new distribution center in South Philadelphia was not on the list of frozen projects, the statement did warn that the list "is subject to change."
According to the University's new Campus Development Plan, Penn ultimately plans to build a biomedical complex on the postal lands, which straddle the west bank of the Schuylkill River.
And while the plan aims for a long-term eastward extension of campus, the Postal Service has indicated that the move of the 30th Street Post Office is still far in the future.
"We still have a long ways to go before that site is up," Stewart said.
A former city official familiar with the Post Office's planned relocation noted that the Postal Service has acquired the property for the new distribution center, but is in the process of assigning contracts.
But the source, who spoke on the condition of anonymity, said that the recent financial trouble has halted that process temporarily.
"There has been a temporary moratorium, so that they can prioritize all the different capital projects," the source said.
The official did, however, note that the Postal Service's interests would be best met by pursuing the move.
"The modernization of facilities are major initiatives that they need to complete sooner rather than later," the source said.
The source acknowledged that the city is deeply committed to ensuring that the postal lands are eventually redeveloped.
Earlier this month, the Delaware River Port Authority approved $830,000 to aid in the development of lands around 30th Street.
"None of us at the table want to see the situation transpire where the Postal Service vacates the property without a redevelopment plan," the source said.
Jack Shannon, Penn's Managing Director of Economic Development, has indicated that the University is prepared to do what it takes to ensure a smooth transition for the Post Office.
"We are committed to working with the Postal Service and other stakeholders within the parameters of the Postal Service's development needs to achieve a win-win situation," Shannon said.
(03/26/01 10:00am)
Former Health System Chief Executive Officer William Kelley was given a hero's welcome on Friday as his portrait was officially unveiled in the Biomedical Research Building.
Reading like a "who's who" of medical professionals, the list of speakers at the symposium -- entitled "Predictions for the New Millennium" -- included Human Genome Project head Francis Collins and Medical School Vice Dean for Education Gail Morrison.
"They have come to honor one of their own," said University President Judith Rodin, who opened the event.
Kelley, who was ousted from the Health System's highest post by Rodin just over a year ago, expressed no ill will towards the University.
"I think it's wonderful," Kelley said of the gala. "It's a fantastic thing they're doing and I appreciate it."
Under Kelley's leadership -- from 1993 to the beginning of last year -- the Medical School climbed in the national rankings from No. 10 to No. 3. The University also rose to the No. 2 spot in funding from the National Institutes of Health.
"Bill Kelley is one of the dominant figures in academic medicine," said Edward Holmes, vice chancellor for health sciences at the University of California at San Diego. "He transformed the School of Medicine into one of the premier medical schools in the country."
After hearing presentations on the future of healthcare, the audience of about 200 -- which included Penn alumnus and Physiology and Medicine Nobel Laureate Mike Brown -- was treated to a fully catered reception of various hors d'oeuvres.
All of the speakers had some connection with Kelley, such as Penn alumnus and former Board of Trustees Chairman Roy Vagelos.
"I first met Bill when he was at NIH and he took a course of mine," said Vagelos, who donated $10 million to the Chemistry Department in 1995 and another $10 million in 1997. "We both survived."
"Every building has had the impact of Bill Kelley," Vagelos continued. "In my view Bill was the dean of medical school deans."
Kelley, who led the drive to integrate the Hospital of the University of Pennsylvania, Presbyterian Medical Center, Pennsylvania Hospital and Phoenixville Hospital under the umbrella of the Health System, was also seen by some as the reason for the poor financial performance of the beleaguered system.
In 1999, close to 2,800 positions were eliminated in a series of layoffs. And by last year, the Health System had racked up nearly $300 million in losses.
But last month the Board of Trustees reported that the Health System has begun a financial recovery and will likely post a profit this year. Penn has also chosen to restructure the Health System into a new non-profit entity with its own CEO.
Despite the financial problems which plagued the system at the close of Kelley's tenure, Health System Chief Financial Officer Peter DeAngelis attributed the recent turnaround to Kelley's efforts.
"In a sense, it was initiated under Bill's leadership," DeAngelis said.
Peter Quinn, chairman of oral and maxillofacial surgery agreed.
"When the medical historians look back at the University of Pennsylvania, they'll see this inordinate blip of activity in the past decade," said Quinn, who organized the symposium and reception. "[Kelley] achieved the foundations of everything."
Kelley was forced from the Health System's top spot last February. According to Quinn, preparations for the portrait unveiling began in May.
Looking back on his achievements, Kelley thanked the Medical School faculty.
"I'm immensely proud of the thousands of faculty," Kelley said. "They did a magnificent job of doing exactly what we planned."
Besides his portrait, Kelley was presented with a certificate by representatives of the Medical Student Government.
(03/23/01 10:00am)
As the University continues negotiations with National Amusements, observers are speculating on the chances of an independent film theater opening at the half-completed theater at 40th and Walnut streets as was originally planned.
Penn Executive Vice President John Fry confirmed yesterday that Penn is currently in talks with the entertainment giant to pick up the abandoned site where Sundance Cinemas left off.
General Cinemas, which was providing financial backing for the former project, filed for bankruptcy protection in October and pulled out of the deal in November. Sundance soon followed suit, backing out of its agreement with the University.
While Sundance was supposed to bring independent films to campus, the Dedham, Mass.-based National Amusements has made its money -- close to $3 billion in sales in 1998 -- by offering mainstream movies to the public.
But according to Sharon Pickenson, spokeswoman for the Greater Philadelphia Film Office, National Amusements does indeed have a division devoted completely to independent films, known as Cinebridge.
National Amusements spokeswoman Jennifer Maguire declined to comment on National Amusements' operations in the independent film field.
General Cinemas spokesman Brian Callahan, however, elaborated on National Amusements' experience in the arthouse theater market.
According to Callahan, that experience is minimal, as National Amusements is currently operating only one independent film project.
"That's a fairly new concept," Callahan said, noting that National Amusements decided to back an Edwards Theater in Orange County, Calif., after the original financial backer pulled out. The theater was intended to show independent films.
"It's a new theater that someone else was supposed to open," Callahan said.
But whether or not the potential National Amusements theater on campus would cater to the mainstream crowd, Joan Bressler of the Philadelphia Film Office sees any potential deal in a positive light.
"We're delighted to have more screens in the University area and that the building will be put to good use," Bressler said. "I just love the idea of a functioning building rather than an empty building."
Bressler acknowledged that the market does lean towards more big-budget pictures.
"A lot of people love mainstream movies," she said.
Still, some would prefer to see an arthouse on Penn's campus.
"It would be great to have an arthouse around the University," Communication Professor Joseph Turow said, noting that "National Amusements is a major reputable company."
"Whether they'll bring the type of cinema the community wants remains to be seen," Turow added.
Officials at the corporate headquarters of Cinemagic, Inc., which operates the Cinemagic 3 theater on the 3900 block of Walnut Street, were unavailable for comment regarding possible competition from National Amusements.
Members of Penn's Film Studies program said they were hoping that the Sundance theater would include academic space for the program, which hopes to offer a major eventually.
And English Professor James English expressed caution regarding a potential deal with National Amusements.
"What I'm concerned about is the relation of this facility to curricular events in the Film Studies program," said English, who is the acting director of the program. "Are the facilities going to be able to be used for imaginative, creative uses by the Film Studies faculty?"
But those affiliated with the program acknowledged that any deal is better than none.
"It's terrific that anything is opening up," said College junior Marc Brunswick, who is co-chairman of the Film Studies Undergraduate Advisory Board. "It might not match the Ritz theaters [downtown], but even if they have a few [independent films], its better than nothing."
"Everyone is just in a wait-and-see mode right now," English added.
Last month, when it was revealed that the University had identified a possible tenant of the vacated construction site, English expressed his hope that a deal would be completed.
"It's a disappointment to Film Studies that the Sundance thing fell through," English said at the time. "We still are certainly hoping that Penn manages to put together a deal."
(03/21/01 10:00am)
International cinema chain National Amusements has recently entered negotiations with the University as a potential backer for the halted theater project along the 40th Street corridor.
The Dedham, Mass.-based company would resume construction on the former Sundance Cinemas site at 40th and Walnut streets, after nearly four months of inactivity.
"We have been discussing the location with the officials of the University," said Jennifer Maguire, spokeswoman for National Amusements.
Maguire, however, refused to discuss specifics of the negotiations.
"We are not at liberty at this time to release any further information," she said.
Last month, Penn Executive Vice President John Fry said the University was speaking with several potential theater operators, with one emerging as a particular favorite.
"We're in discussions with them right now," Fry said at the time, but declined to release the name of the potential partner. "We've identified a national chain and have entered into substantive discussions with them."
Fry was unavailable for comment yesterday, and University spokeswoman Lori Doyle would not confirm that Penn is closing in on a deal with National Amusements.
"We are having discussions with a number of theater operators," Doyle said. "We have not made a decision at this point."
In October, General Cinemas, which was providing financial backing for the project, filed for bankruptcy protection. The company pulled out of the deal in November, leaving construction at a standstill.
Sundance, unable to find a financial replacement for General Cinemas, subsequently canceled its deal with the University.
Since construction on the site was halted, the future of the independent film-oriented theater and restaurant complex has remained hanging in the balance.
Following the collapse of the General Cinemas deal last year, Penn officials said they hoped to avoid partnering again with a national theater chain. Over the past several years, the movie exhibition industry has been plagued by financial difficulties, with many national chains forced to close theaters and declare bankruptcy as a result.
But the presence of National Amusements appears to mark a change in this strategy. In addition, National Amusements would likely bring more marquee movies to the theater -- another shift in plans that Fry identified last month.
"My sense is that [the movies] will be more mainstream, but there will still be a strong bent towards independent film," Fry said in February.
Doyle said yesterday that the University remains committed to giving the new theater some independent flavor.
"Our desire is to end up with a development deal that tenants the building with the type of theater operator we initially envisioned," Doyle said.
National Amusements raked in close to $3 billion in sales in 1998. It operates over 1,390 movie screens worldwide, although it owns only four theaters in the state of Pennsylvania, all in Pittsburgh.
Media powerhouse Viacom is the parent company of National Amusements. Viacom has holdings in companies including the video retailer Blockbuster, Paramount Pictures and the TV networks CBS and UPN.
(03/05/01 10:00am)
To the dismay of students across campus, midterms will likely be given and classes remain on as scheduled today.
The storm which, according to some estimates, was supposed to blanket the region with as much as two feet of snow will now dump no more than eight inches before heading out to sea.
"We are opening tomorrow as far as I'm concerned," University Executive Vice President John Fry said last night. "If there's any change in conditions, we will obviously change our plans."
If forecasters are correct, those conditions will not be met.
Reports Saturday night indicated that blizzard-like conditions would prevail through tomorrow. One advisory given by the National Weather Service predicted driving to be "very difficult and dangerous... if not impossible."
But the NWS said yesterday that their previous predictions had changed.
By Tuesday night, the storm is expected to head off to sea, and between three and eight inches of snow will have fallen, according to NWS forecaster Dean Iovino.
"The storm [came] and started pulling in some warmer air we didn't expect," said Iovino, who is with the Mount Holly, N.J. office of the NWS. "It looks like now its going to be rain mixing with sleet and snow into [this] morning and change into all snow."
Yesterday, what little snow fell never entirely accumulated on the ground, but kept the city wet.
The storm was the same one that plagued the southeastern United States with tornadoes last week. It was expected to hit the city with a force unseen since the blizzard of 1996, which saw over a foot of snow in 36 hours.
Concerns about how the storm would affect the Philadelphia area were so great that a snow emergency was issued Saturday night, only to be rescinded yesterday morning.
"Right now we're playing it by ear," said Luz Cardenas, spokeswoman for Mayor John Street. "We're fully prepared to get all of our men out there."
The Streets Department placed about 500 people on call to salt Philadelphia's streets should icy conditions develop. City officials will be meeting at 7:30 this morning to determine how to handle the developing weather situation.
Pennsylvania's Department of Transportation was left in a similar situation of uncertainty.
"The forecast is fluctuating so much that our maintenance managers in each of the counties are keeping a close eye on what's happening," said Charles Metzger, spokesman for PennDOT's District Six, which includes the city and its surrounding counties.
As of last night, the counties of Berks, Bucks, Chester and Montgomery -- where many Penn professors reside -- were still under a Winter Storm Warning issued by the NWS.
"Snowfall totals of one to two feet will be common with locally higher amounts across northeastern Pennsylvania," the NWS statement said.
PennDOT, which has 400 trucks available to spread 60,000 tons of salt, is responsible for maintaining clear passage on the state's highways.
Last night's traffic conditions remained relatively mild, with a mix of rain and snow continuing throughout yesterday as the temperature remained at 35 degrees for most of the afternoon.
But for today, there are some concerns that this afternoon's rush hour out of the city will be either slow-going or extremely dangerous.
"Rush hour should be hellacious," said Robert Chartuk, spokesman for the eastern region of the NWS. "Making it back out will be difficult."
Precipitation is expected to switch over completely to snow by this afternoon.
But even that prediction is uncertain, Chartuk cautioned.
"It's a tough call," he said. "We know there's a large storm, [but] predicting that fine line between rain and snow is a little difficult."
Cardenas said the city will remained prepared should conditions turn sour.
"Our understanding is that the worst of it is not until tomorrow afternoon," she said.
(03/01/01 10:00am)
President Bush's call Tuesday night for Congress to double the budget for the National Institutes of Health has left some experts wondering where the money will come from.
Penn Professor Arthur Caplan, director of the University's Center for Bioethics, applauded Bush's move. But he warned that the National Science Foundation -- which, unlike the NIH, funds research in the non-biological fields -- could end up being penalized, damaging all research.
"It's certainly a good move to invest more in health care right now," Caplan said. "It absolutely should not come at the expense of the NSF."
The NIH is second only to the Department of Defense in funding research and development.
According to Robert Field, director of the health policy program at the University of the Sciences, Penn's standing with the NIH puts it in a position to further benefit from Bush's proposal.
"The rich get richer," Field said. "Since Penn has a great track record, it would make a likely beneficiary."
Penn is currently second in the nation in NIH funding and received over $290 million in Fiscal Year 1999 from the federal agency.
Don Ralbovsky, a spokesman for the NIH, could not determine how next year's budget would affect the University, should it pass.
"My sense is that we really couldn't, this early in the budget process, determine the impact to individual institutions," Ralbovsky said.
In recent years, due in part to the blossoming fields of genomics and AIDS research, the NIH budget has grown significantly. Bush has promised to double the NIH budget by 2003.
In Fiscal Year 2000, the NIH dispensed close to $13 billion in grants, while the NSF distributed less than $4 billion.
Congressman Sherwood Boehlert (R-N.Y.), chairman of the House of Representatives Committee on Science, has been leading the charge on Capitol Hill to increase basic science funding.
Boehlert questioned Bush's intentions at a conference last month, cautioning that the president's proposed 13.8 percent increase in NIH funding is not fair to other agencies, including the NSF and the Department of Energy.
"A cursory look at the numbers certainly gives one the feeling that things may be a little out of whack," Boehlert said, pointing out that the NIH could be "eating up a disproportionate share of the federal budget."
Caplan warned that reducing the NSF's share of the federal budget would be an unwise move.
"It makes no sense to develop your upper body but have very weak legs," he said. "Robbing Peter to pay Paul is a very bad strategy."
With regard to the entire industry of scientific research, Caplan said he advocated increasing funds allocated to both the physical and biological sciences.
"I'd rather see us take that money out of defense... and out of the tax cut," Caplan said. "This ought to be 13 percent across the board."
He predicted that should the NSF end up losing, it would change the academic environment.
"You will get some nasty back-biting if somebody thinks the war on cancer will go further by not investing in the next organic chemistry research building," Caplan said.
While Bush has not yet revealed his plans for the NSF, his administration is firmly committed to his NIH proposal.
"This budget funds the president's priorities," White House spokesman Scott Stanzel said. "There will always be those who will have critiques of different programs."
While few question Bush's commitment to health research, Caplan signaled his uncertainty towards Bush's stance with regard to other research.
"He is supportive of health care," Caplan said. "I'm not quite as sure about his support of basic science."
(02/23/01 10:00am)
A half-billion dollar cancer center, backed by the University and the Children's Hospital of Philadelphia, has not moved beyond the planning stages because of financial obstacles, according to sources familiar with the negotiations.
Although Penn has already begun construction of a 2.2-acre parking garage on the site of the former Civic Center, its plan for the joint cancer center - to be built on the same site at 34th Street and Civic Center Boulevard - is still in the works.
Sources close to discussions between the University of Pennsylvania Health System and CHOP have confirmed that the only remaining hurdle is the funding.
And Beverly Ginsburg, executive director of Penn's Cancer Center, said that the Civic Center facility remains a long-term goal.
"The project has gone through all levels of review and analysis by the Health System," Ginsburg said. "We're clearly committed to this."
University President Judith Rodin highlighted Penn's interest in the project.
"We are quite interested in reanimating our conversations about a joint cancer center on the Civic Center site with Children's Hospital," she said in an interview last Friday. "They are in the middle of their own strategic planning process, and so the plan may be delayed."
Ginsburg gave details of a plan that is supposed to combine the research aspects of both Penn's and CHOP's oncology departments.
"The concept is that there could be an integrated cancer initiative between Children's Hospital and the University of Pennsylvania Cancer Center so that in one building owned by CHOP there would be clinical activities including cancer services," she said, explaining that the center would be "linked to the [current] Cancer Center."
Although the entire faculty of the oncology department at CHOP are also Penn professors, the separation of the facilities between the Hospital of the University of Pennsylvania and neighboring CHOP has presented some difficulties.
"We will hopefully have a new department of radiation oncology at the Civic Center campus that will treat both pediatric as well as adult patients," Ginsburg said.
Experts say that, should a joint center be built, it is of primary importance to keep pediatric and adult services separate.
"Places where children and adults are cared for in the same facility don't benefit children," said Anna Meadows, an oncologist at Children's Hospital. "However, when research is done in a single facility, everybody wins."
The current plan, Ginsburg said, includes a facility that keeps pediatric and adult patients separate.
"From a patient perspective, there should be two separate entrances and towers," Ginsburg said, noting that clinical research would be carried out in a unified environment.
Ginsburg, while noting that she could not guarantee a date for completion, estimated that within the next five years there would be noted progress on the initiative.
"My hope would be [that] between three and five years, we would see something on the Civic Center site," Ginsburg said.
Although Cynthia Atwood, a CHOP spokeswoman, denied that negotiations are underway, she acknowledged that Penn and CHOP have similar goals regarding the property.
"It's definitely an area of mutual interest," Atwood said. "But there are no formal negotiations at this point."
One source familiar with the project, who spoke on the condition of anonymity, estimated Penn's cost to be a "couple hundred million dollars."
"It's really a question of how big and how much," the source said.
Ginsburg concurred.
"It's an issue of funds," she said.
When both Penn and CHOP acquired the Civic Center lands from the City of Philadelphia in 1999, University officials had estimated a $450 million development on the property.
According to expectations, Penn would contribute $350 million, with the other $100 million coming from CHOP.
Penn's cancer center is already one of the most highly regarded centers in the country, and is designated as a Comprehensive Cancer Center by the National Cancer Institute.
(02/22/01 10:00am)
Now that the Health System will stay within Penn's administrative umbrella, many doctors are breathing a collective sigh of relief.
Last Friday, University President Judith Rodin announced the intention of the Board of Trustees to spin off the $1.9 billion Health System into its own non-profit corporation owned by the University.
The decision came after months of speculation on the future of the Health System, which posted losses of more than $300 million over the past three years. Possible options included a partial or total sale of the Health System's assets.
"There was not much enthusiasm for a joint venture with a for-profit entity," said Arthur Asbury, interim dean of the School of Medicine.
In a way, the Health System physicians got their wish -- Penn is no longer up for grabs.
But some doctors say the current plan is not so different from a plan last year that met opposition from some Medical School faculty.
Last February, a "blue ribbon committee" of University Trustees and top Penn administrators -- including Rodin, Provost Robert Barchi and then-HealthSystem CEO William Kelley -- was considering a proposal to separate the Health System from the University.
"The proposal was to split off the hospitals... as one corporation and have the Medical School remain affiliated with the University," Stephen Emerson, chief of Hematology and Oncology at the Hospital of the University of Pennsylvania, said at the time. "We didn't support the notion."
The proposal would have allowed the University to retain ultimate control over the Health System, but that plan was never carried into effect.
In some ways, however, Penn's recent actions bear resemblance to the plan that was abandoned a year ago.
A doctor with the Health System, who wished to remain anonymous, said that the plan voted down last year was the "exact same option" announced by Rodin last week.
According to Rodin, the work of last year's committee "factored into the final deliberations" of the special committee which endorsed the current plan.
Rodin attributed the faculty's change of mind to a change in the times.
"I think the sense of being excluded contributed to the [original] reaction," Rodin said, pointing to the inclusion of faculty members on the special committee as a solution to that problem.
She added that the absence of Kelley -- who spearheaded the creation of the Health System in the mid-1990s -- may have factored into the change in the faculty's attitude, as well.
Both Rodin and Asbury described the faculty's attitude to the current plan as positive.
"I'm sure what we heard was a deep sigh of relief," Rodin said.
Asbury concurred.
"Their reaction has been quite favorable," he said, explaining that the "overwhelming feeling was basically relief that the decisions" were to not sell.
In the past, faculty members feared that separating the Health System's finances from those of the Medical School would complicate research and teaching efforts.
While the administration is enthusiastic about the new direction for the HealthSystem, some doctors are approaching the decision with caution.
"It's better than a sale to a for-profit," a HUP physician said, adding, however, that "the best would have been a continuation of the status quo."
"It would be a disaster if it was a for-profit institution," he said before last week's decision was reached. "It would mean the demise of the academic center as we know it."
The physician, who asked to remain anonymous, questioned the special committee's representation of the medical faculty.
"One could question how much input that task force had," the physician said. "It was short-tracked. In the end, it limited the amount of input."
Bernard Bloom, a Wharton professor of health care management, concurred.
"I don't think [the committee's proceedings were] transparent enough for the Penn community to examine what has been going on," Bloom said.
(02/20/01 10:00am)
It's been a week since the election of Ariel Sharon -- contrary to The Associated Press, his first name is not 'hawkish' -- and, predictably, the violence between Israelis and Palestinians has not subsided in the slightest.
This is tragic because each day the violence continues is a day closer to June 1, 2002, when I will step off an El Al airplane at Ben Gurion International Airport as a new Israeli citizen.
Each new day of violence points to the possibility that I may fight in a war.
Last week I watched intently CNN's coverage of the Israeli election. Had I voted, I probably would not have voted for Sharon.
Had I voted, I would not have voted to stop the peace process, a motive heralded by the American media as an issue on the Israeli ballot.
The election was not at all meant to curb the violence in the short-term. It was also not an attempt to declare the peace process dead, as those of the Palestinian Authority have suggested.
"The most important issue is to take the necessary steps to restore security to the citizens of Israel," Sharon said on Wednesday after a Palestinian man drove a bus into a crowd of Israelis outside Tel Aviv, killing eight.
The election was not a condemnation of the 1993 Oslo Accords; it was the affirmation of security above any agreement, above any concession.
Yasser Arafat's Fatah faction -- aided by the terrorist organizations Hamas and Hizbullah -- has decided to pursue the violent path to peace. The Israeli people have decided that a true peace can only be achieved when the violence has stopped.
"We cannot expect peace to be made in an atmosphere of violence," former President BillClinton said last week. "Nobody gives in when somebody's throwing bombs or bullets or even rocks."
Unfortunately, the Palestinian people who choose to prolong the violence have not gotten the message.
Unfortunately, countries such as Syria and Iran, which invest yearly in the hope that one day Israel may not exist, have not come to the realization that the Israeli people are there to stay.
Far be it from me to suggest that the responsibility for the latest intifada rests solely on the shoulders of Arafat and his Palestinian Authority, or to infer that Israel has acted justly and blamelessly in its 30-year occupation of the West Bank and the Gaza Strip. There is plenty of blame to go around.
But the international community must realize that so long as bus attacks, car bombings and shootings continue, Israel will consider itself a nation under attack.
As long as that assumption is maintained, soldiers will be forced to fight, and yes, kill, to defend Israel.
Some would contend that the Palestinians are merely an oppressed people who are fighting for independence from an imperialistic regime; that a future Palestine is a burgeoning America and since the colonists were not wrong in taking up arms in 1776, the Palestinians are not wrong in fighting for their homeland.
Some would contend that Israel conducted terrorist attacks prior to 1948 when it was fighting for its homeland. Any criticism of the Palestinians for the same reason is, thus, disingenuous.
Each claim has its merits.
But whether or not the Palestinians' fight is just, the Israeli people cannot be expected to acquiesce while their children are slaughtered protecting a homeland many of their fathers and grandfathers died trying to establish.
Clinton was absolutely correct in his speech at the Aventura Jewish Center last Saturday when he urged, "We have got to find a way to find mutual respect here."
Like myself, the average Palestinian wants nothing more than a decent home in which to raise his family -- a decent education for his children and the promise of a better life for theirs.
I look forward to one day being able drive from Modi'in to Jerusalem without fear of being shot at -- as happened to an unlucky Israeli a couple of weeks ago.
I trust the average Palestinian looks forward to one day being able to work in Israel without the fear that he will be singled out because of his ethnicity.
But both Israel and the Palestinian people have to look at the present, at a life filled with refugee camps and terrorist attacks.
So Israel has turned to Sharon, hoping to find, as his campaign slogan trumpeted, "peace in security."
Let's hope that a secure peace is not only possible, but inevitable. A future without it is no future at all.
(02/19/01 10:00am)
For two months, a committee of medical faculty and University Trustees debated the future of the Health System, and on Friday the Board of Trustees and University President Judith Rodin approved the committee's recommendations.
But the fate of the new non-profit entity that will be the Health System is now in the hands of a skilled group of non-medical professionals -- lawyers.
"I think there's going to be a lot of questions that are going to be on hold in terms of governance and management," said Robert Field, director of the Health Policy Program at the University of the Sciences. "To a sense, it depends on how good of a job the lawyers do."
When the Health System's finances took a turn for the worse three years ago, Moody's Investor Service responded by lowering the University's bond rating. Just how the University will fare, should history repeat itself, has left both the experts and the University administration guessing.
Penn is betting that the recent financial success of the Health System -- which has posted modest profits in the first half of this fiscal year -- coupled with the added flexibility that a new entity brings will enable the Health System to grow from its own revenues.
"We're going to grow with organic growth, not just with cutting," Rodin predicted, noting that last year, Presbyterian Medical Center -- one of the four hospitals owned by the Health System -- grew by almost 30 percent.
But whether the new arrangement of the Health System will encourage investment is a question that will be answered ultimately by the investors themselves.
"It's all in the perception of the bond-rating agencies," said Wharton professor Sean Nicholson, an expert in health care management. "If they believe in the insulation, it will work."
Legal teams are now in the process of ensuring that Penn's insulation from the Health System will succeed, without eliminating ultimate University control.
"The important thing is that, over the next week or two, what we're going to try to do is work out what [the] bridging mechanism means in practice," Rodin said.
But some stressed that concerns of liability are unfounded.
"The size of the debt you have is not important," said Bernard Bloom, a Wharton professor of health care management. "What is important is your ability to service the debt."
According to Rodin, the Health System has been effectively managing its debt.
"We're paying down principle every month from the revenue generation of the Health System, as well as interest," Rodin said.
Bloom, who is also a professor in the School of Medicine, said that the Health System is in a good position to be self-sufficient.
"We're no longer losing money, we're making money," he said. "It's not as fast as we were five years ago, but we're making money."
But whether or not financial difficulties lie ahead -- given the fact that an influx of desperately-needed capital will most likely be put off for a year -- the Health System will have few lifelines left should times turn sour.
"There will be more pressure on the Health System to be self-sustaining," Field cautioned, echoing a statement from Rodin that the Health System is "going to have to make it on their own."
"If it does well, it will benefit," Field said. "If it has trouble, the University would be less willing to bail it out."
Interim Health System CEO Robert Martin is confident that the new entity will be able to survive in the ever-changing Philadelphia marketplace.
"The main difficulty is that in a world of constrained resources we have to have a disciplined approach in allocating those resources among legitimate claims that [each division] has," Martin said. "I think we'll be able to effectively do that."
(02/19/01 10:00am)
After years of financial struggles and months of speculation and rumors, Penn has opted not to sell the $1.9 billion Health System.
Instead of a break-up or an outright sale, the Health System -- which includes the flagship Hospital of the University of Pennsylvania, Presbyterian Medical Center, Pennsylvania Hospital and Phoenixville Hospital -- will be spun off into a new non-profit entity with its own CEO.
"We are committed as a University to an integrated Health System," University President Judith Rodin said after a meeting with the Board of Trustees on Friday. "Therefore, we do not plan to sell any of the hospitals of the Health System."
Citing the need to respond effectively to a rapidly changing market environment, Rodin stressed the need to have a permanently separate CEO leading the Health System.
"We are going to begin the necessary work to create a separate [non-profit entity] which [will] be wholly owned by the University and [will] have the kind of flexibility in the marketplace that the current Health System does not have," Rodin said.
Prior to the departure of Peter Traber last summer, the CEO of the Health System also served as the dean of the School of Medicine.
Currently, Robert Martin is interim CEO of the Health System and Arthur Asbury is interim dean of the School of Medicine.
Martin was supportive of Rodin's decision, emphasizing that since Traber's departure, the separation of the two head positions has been successful.
"For the last nine months or so, we've had a pretty good trial period," Martin said. "We've been able to make choices and decisions in a spirit of collaboration over the past year."
Last Wednesday, the special committee of medical faculty and Trustees appointed by Rodin in December held its final meeting, where the recommendation not to sell was finalized.
On Friday, the committee's recommendation was delivered to the full Board of Trustees, where it was approved without a vote.
"The Trustees did not vote today," Rodin said on Friday. "What they did was endorse a direction. That direction will be pursued and a vote taken at a later time."
Rodin estimated that it will take between nine months and a year to complete the necessary steps to enact the committee's recommendations.
"There's significant regulatory approval to do this," Rodin said, noting that the Internal Revenue Service would have to sign off on the new entity. "The vote [by the Trustees] would come when there was a separate [entity] to vote on."
The Health System, which owes close to $800 million to bondholders, was at one point rumored to be on the wish-lists of such high-profile health systems as Pennsylvania-based Tenet and Nashville, Tenn.-based Vanguard.
Rodin maintained that while the debt was a large concern for the University -- Moody's Investor Service lowered the University's bond rating in 1999 because of the Health System's poor performance -- she believes that the Health System is in the process of pulling itself out of debt.
"Over time, as the new entity begins to earn even better margins, they'll be able to restructure their debt," Rodin said. "At that point, there will be the opportunity for the University to be freed from its obligations."
While the new Health System will remain separate from the University, a "bridge" will be maintained between the School of Medicine and the new entity.
The new dean of the School of Medicine will also be an executive vice president of the University and will work with the CEO in much the same way Martin and Asbury work together now.
"[Because of] the way in which the academic missions are intertwined with the clinical services missions, they need to be connected," Asbury said. "We can't have a health services component that is separate from the academic missions."
With regard to the nearly 70 private practices currently owned by the Health System as part of its Clinical Care Associates, Rodin said each practice will be reviewed on a case by case basis.
"Those [practices] whose interests are not aligned with the University of Pennsylvania Health System have really gone by the wayside," Rodin said.
(02/16/01 10:00am)
University Trustee Charles Heimbold was targeted by about 20 protesters yesterday morning when they marched to the Inn at Penn after a press conference in Houston Hall.
A coalition of AIDS activists and senior citizens accused Heimbold, the outgoing CEO of pharmaceutical giant Bristol-Myers Squibb, of overcharging those in need of life-saving medication.
"Bristol-Myers Squibb [is] best described as a cartel of prescription drugs," said Pedro Rodriguez, who represented the National Alliance of Senior Citizens. "It is also part of a group that exerts a large amount of influence in public policy."
At issue is a series of complaints brought against Bristol-Myers, including unfairly extending patents in order to dominate the market and withholding needed AIDS medications from developing countries.
The Gray Panthers, a senior citizen activist group, sent a letter to Federal Trade Commission Chairman Robert Pitofsky yesterday. Some of the complaints are related to the marketing of the anti-anxiety drug BuSpar.
"The result [of extending the patent of BuSpar] is to delay consumer access to more affordable versions of the critical medication," the letter said, "while at the same time providing Bristol-Myers Squibb with as much as $1.75 billion in non-competitive sales."
Philadelphia AIDS activists from the group ACT UP joined with the Gray Panthers in forming the Stop Patient Abuse Now! group to bring to light what they feel are questionable actions regarding the marketing of Bristol-Myers' AIDS drugs.
According to a statement released at the press conference, Bristol-Myers earned over $200 million in sales of the AIDS drug Videx in 1999. Videx was invented by the federal government.
"Mr. Heimbold should commit himself and his company to policies... which do not bring disrepute on the institutions and groups with which he is affiliated, including the University of Pennsylvania," read a resolution delivered by the activists to the Board of Trustees.
Patrick Dunahill, a spokesman for Bristol-Myers, maintained that his company has not been deceptive in its trade practices and has not overcharged its customers.
"We remain committed to the vigorous defense of our intellectual property," Dunahill said.
Dunahill called the groups' charges "not balanced."
"It's certainly not fair or accurate," he added.
But Tim Fuller, executive director of the Gray Panthers and spokesman for SPAN, expressed confidence in his coalition's ability to affect change.
While admitting that the size of the coalition is "now quite modest," Fuller said that "it will grow to be a very large group."
With regard to AIDS drugs, Julie Davids of ACT UP maintained that medications could be delivered at a fraction of their current price.
"The drugs could cost pennies," Davids said. "This is just the beginning."
Echoing Davids' sentiments the United Nations yesterday called on the pharmaceutical industry to offer AIDS medications to developing countries at "highly reduced prices."
Bristol-Myers Squibb is part of a group of five drug firms that have offered to discount their anti-retroviral drugs by as much as 80 percent.
(02/15/01 10:00am)
Questions of whether Penn plans to unload the beleaguered Health System finally may be answered, as University President Judith Rodin will likely present recommendations regarding a potential sale at a Board of Trustees meeting tomorrow.
Last night, the special committee of Trustees and medical faculty charged with drawing up those recommendations met in a closed-door session, according to University spokeswoman Lori Doyle.
The full group of University Trustees begin their scheduled two-day winter meeting today at the Inn at Penn.
"If something is to be shared with the Trustees, it would be on Friday," Doyle said.
What exactly that announcement will be is a question that has left Medical School faculty, department chairs and Health System doctors guessing.
Rumors of everything from a sale to Nashville, Tenn.-based Vanguard Health Systems to an alliance with the Children's Hospital of Philadelphia have been circulating through Health System e-mails for the past three weeks.
"I've heard equally definitive rumors that [the University is] not going to sell the flagship," a doctor said regarding the Hospital of the University of Pennsylvania, located on 34th Street. "I've also heard definitive rumors that CHOP is going to buy it."
Regardless of what will be decided, if a decision is announced tomorrow, changes must be made to the existing framework of the Health System, Doyle said.
"The HealthSystem has a very large debt burden and has a continual need for new capital," Doyle said.
The $1.9 billion HealthSystem includes HUP, Presbyterian Medical Center, Pennsylvania Hospital, Phoenixville Hospital and about 70 private practices.
Currently, the Health System owes close to $800 million that it received from investors in the form of tax-exempt bonds. Should the Health System be sold to a for-profit company like Vanguard, those bonds would most likely be paid in full.
"They would pretty much have to [repay]," said Robert Field, director of the Health Policy Program at the University of the Sciences, noting that the Health System would "no longer issue tax-exempt bonds to raise money."
But a sale to a for-profit is just one option on a menu of choices that include bringing in an outside firm to manage the Health System's assets.
The special committee was appointed by Rodin in December to provide the Trustees with recommendations on how to absolve the University of the debt incurred by the Health System over the past few years.
"It's no secret that the institution is under great financial pressure," Alan Wasserstein, chairman of the Medical Faculty Senate, said last month.
Wasserstein is also a member of the joint Trustee-faculty committee.
The Health System has lost $330 million in the past three years.
The growing financial instability of the Health System led Moody's Investor Service to lower the University's bond rating in 1999, making it more difficult for the University to borrow money.
While the University has owned and operated HUP for more than 100 years, the Health System was established in 1993 as a strategic move designed to counter the growing power of Health Maintenance Organizations.
Unfortunately for the Health System, efforts to integrate area hospitals and private practices been difficult, causing considerable financial distress.
Other academic institutions have found themselves in the same position the University is now facing.
Over 10 years ago, the University of Chicago separated from its teaching hospital, and in 1996, Philadelphia-based Thomas Jefferson University created a separate organization for its hospital.
But Penn is also sailing in uncharted waters.
Should Penn sell the Health System, it would be an unprecedented move, given the University's size.
"It would far and away be the largest, most prestigious institution to do so," said John Kastor, a professor of medicine at the University of Maryland.
(02/14/01 10:00am)
The complicated puzzle that is the human genome is almost completely decoded -- and Wistar Institute researcher Harold Riethman has played a large role in understanding a segment of it.
Riethman and his team, which included scientists from the University of California at Irvine, sequenced 34 of 46 telomeres -- the sections of DNA that are found at the ends of the 23 chromosomes contained in human cells. Their work appears in this week's edition of the journal Nature.
"[Telomeres] are kind of sticky," said Carol Ezzell, an editor of Scientific American. "They are difficult to do sequencing on."
But Riethman focused his research on those "sticky" telomeres -- which can be compared to the plastic tips on the ends of shoelaces that prevent the laces from becoming unraveled -- to discover the boundaries which limit the mapping of the human genome.
"There's no way to gauge how much is left, how much is complete," Riethman said of the current gene map, which was unveiled Monday in Washington by the Human Genome Project. "[Telomeric sequencing] provides some insurance that most or all of the DNA is contained in the sequence itself."
Sequencing is the process of reading the strings of over three million bases -- chemical compounds referred to by the letters A, C, T and G -- which make up DNA. The bases code for genes much like letters make up words.
The 30,000 or so genes then direct the production of proteins that determine everything from the color of our eyes to our susceptibility to disease.
The map produced by the Human Genome Project, an initiative jointly run by the National Institutes of Health and the U.S. Department of Energy, covers only 96 percent of the genome.
Much of the data contained in the genome represents relics from human beings' evolutionary ancestors.
"The book of life is actually at least three books," said Director of the National Human Genome Research Institute Francis Collins at the press conference in Washington.
One of the books Collins referred to is "a history book -- a narrative of the journey of our species through time."
Riethman said that his work may provide answers to questions such as "how different ethnic groups are related and how humans are related to other species."
"Segments of DNA adjacent to the very tip of chromosomes can be species-specific," Riethman said.
But answers to those questions are at least a few years off.
"We still have a lot of gaps," Riethman said, pointing out that sequencing is only the first step in decoding the function of the genes the telomeric regions encode. "For the next two or three years we're going to focus intensively to get those [gaps] closed up."
"The next step," Riethman added, "is to analyze the large segments [of DNA] that are either present or absent in different segments of the human population."
"It's as though we have climbed to the top of the Himalayas," Director of the Whitehead Institute Center for Genome Research Eric Lander said of the Human Genome Project in a statement. "For many years to come, we will be exploring the intricate details of the terrain ahead."
"We've got a long way to go before we will ultimately understand all the secrets that the genome has to tell us," Lander added.
(02/09/01 10:00am)
As President Bush pushes his plan for a national missile shield to protect the country against attack, a potentially more sinister and silent weapon is looming on the horizon -- bioterrorism.
The threat that various organizations could one day, or already are, stockpiling biological weapons such as smallpox virus is a scenario that has prompted the federal government to come up with a plan to defend against such an attack.
To deal with the possibility of a smallpox outbreak, the National Institutes of Health has granted Penn researchers Stuart Isaacs and John Lambris over $1 million to create new therapies to protect against the disease.
"Smallpox may be largely forgotten, but it certainly isn't gone," Isaacs said. "There is a possibility, however slight, that terrorists could obtain the virus and release it within the U.S."
According to Isaacs, his work is part of a larger program aimed at protecting the country against smallpox.
"[While] our work is part of work that is being funded by the NIH, the Department of Defense is probably funding other investigations," Isaacs said.
Last September, the Centers for Disease Control in Atlanta contracted the OraVax corporation in Cambridge, Mass. to produce a new smallpox vaccine.
At one point over 20 years ago, smallpox -- a disease which can kill as much as 30 percent of those infected -- was considered "eradicated" by the World Health Organization. Because of the WHO's success in eliminating the disease, it was deemed in the 1970s that further vaccination was unnecessary.
But now, there is only a small amount of the vaccine stockpiled worldwide to respond to a terrorist attack.
"The U.S. response to a smallpox outbreak in Philadelphia would be to have a widespread vaccination," Isaacs said.
But vaccination presents problems itself.
Because the current vaccine is based on a live form of a virus related to the smallpox virus, complications can result from an act meant to prevent disease.
"With any live virus vaccine there are potential adverse reactions, maybe even potential death," Isaacs said.
Consequently, while OraVax attempts to create a new vaccine that targets the virus, the Penn team is looking to target proteins produced by the virus.
"We are looking at a combination punch to knock out the effects of the smallpox virus," Lambris said.
One therapy under research would prevent the virus from entering cells, where it multiplies.
Although smallpox is just one disease among many that could be used as weapons by terrorists, smallpox is, according to Isaacs, one of the most probable.
"Smallpox is listed as the number one or number two agent to be used," Isaacs said. "It can be dried down to a powder and released in the air."
Tara O'Toole, a researcher at the Johns Hopkins School of Public Health, wrote in a paper last year that one smallpox attack would cause an epidemic in just under a month.
Should an attack occur next week, Isaacs said, time lost in diagnosis would allow the disease to spread.
"In the first few cases it will take a while to make the diagnosis," he said. "Some might die, some might recover, but in the meantime they've spread it to other people."
(02/08/01 10:00am)
Katie Couric, the host of NBC's Today show, is set to spend next month urging millions of viewers to call the Penn Health System.
Couric, who lost her husband to colon cancer in 1998, will lead the National Colorectal Cancer Research Alliance's public information campaign for the second year in a row -- an event that will involve the Penn Cancer Center.
During a segment on the Today show and related commercials, which will air at the beginning of March, viewers will see a toll-free number for information on colon cancer flashed across the screen. That number will be assigned to a phone bank operating out of Penn's Cancer Center.
"You could just imagine Katie Couric talking about it on the Today show," said Randi Marcus, the volunteer coordinator at the Cancer Center. "The phone will go off the wall."
Anil Rustgi, an advisor to the NCCRA, said the decision to use Penn's facilities was based on the success of the Cancer Center's OncoLink Web site, which receives "thousands of hits a month."
"The NCCRA wanted to use the [University's] OncoLink as a vehicle for obtaining inquiries from patients interested in participating in studies," Rustgi said. "OncoLink is held as a paradigm [and] is nationally renowned."
Rustgi, who is also chief of gastroenterology at the Hospital of the University of Pennsylvania, said that the NCCRA's choice of Penn is a "tribute to the Cancer Center."
"It speaks to [the] Cancer Center's foresight in establishing [OncoLink] years ago," Rustgi added.
Last year, NCCRA's campaign was fraught with confusion -- a problem that Steve Telliano, Couric's spokesman, said will be fixed this year.
"Last year, we had different [phone] numbers for different purposes," Telliano said. "We weren't able to house everything in one place."
"This year," Telliano added, "we put them all together into one."
The Cancer Center's phone bank, according to a statement from Marcus, will disseminate information about colon cancer and "enter caller information into a computerized registry that matches callers to prevention trials."
"This year, [the campaign] will primarily be an update [to last year's efforts]," said Robert Wilson, a spokesman for the Entertainment Industry Foundation, which sponsors the NCCRA. "The campaign will show how the public can get information and support the cause locally."
Wilson said that Today will be devoting a large segment to the NCCRA campaign. Last year, Couric's report was broken up into five days worth of coverage.
Rustgi stressed the importance of preventing colon cancer, a disease that claimed approximately 57,000 lives out of 156,000 cases in 1999.
"As a result of the media attention [last year], there's been a huge increase in the people who are being screened for colon cancer," Rustgi said, emphasizing that early detection is the key to prevention.
According to the NCCRA, over 90 percent of colorectal cancer cases can be cured when detected early.
During last year's campaign, Couric stressed the importance of early cancer detection by undergoing a colonoscopy on the air.
A goal for the NCCRA this year is to "fill all clinical trials," according to Telliano.
"We felt there was a need to set up a research clearinghouse," Telliano said.
Marcus, who has already signed up volunteers, estimated that she will need 20 per day.
"There are some from the outside, some from [Penn]," she said. "I get a few people every day, but gosh, I need more."
(01/30/01 10:00am)
The special committee appointed to examine the future of the University of Pennsylvania Health System is still deliberating, but an independent meeting last night brought the Medical School faculty into the discussion.
More than 250 faculty members packed Stemmler Hall to hear a presentation designed to brief the Penn community on the possibility of a sale or merger involving the Health System.
University President Judith Rodin appointed a committee last month to analyze options for the Health System, which has lost more than $300 million over the past several years. Last year, Moody's Investor Service lowered the University's bond rating, largely because of the Health System's poor fiscal performance.
"It's no secret that the institution is under great financial pressure," said Alan Wasserstein, chairman of the Medical Faculty Senate, in his introductory speech.
Of chief concern to medical faculty is how the academic mission of the Medical School will be affected by any deal, particularly one that would involve a for-profit partner.
And while he emphasized that he could not comment on the ongoing negotiations between the committee and a variety of organizations, Wasserstein assured the audience "that the faculty will be involved in a broad and deep way" in the final decision.
"Whatever options we have, there are going to be difficulties," Wasserstein said. "I don't think we have to focus on the issue of sale to a non-profit."
In an interview after the talk, Wasserstein said that ""the for-profit option has got the faculty most energized," and that he thought they would have been "more angered" than they seemed after the meeting.
But the symposium did little to answer faculty concerns over the specifics of a possible sale. It instead focused on what other academic institutions have gone through in the mergers, sales and divestitures of their health systems.
"I don't think I learned anything tonight that would sway me one way or another," said Kenneth Brayman, a transplant surgeon at the Hospital of the University of Pennsylvania .
School of Medicine interim dean Arthur Asbury gave a bleak picture of the Health System's finances before the guest speakers told of their institutions' successes and failures.
"Capital spending last year and this year has been relatively spare," Asbury said, noting that investment is crucial to an institution's success in the long-run.
Asbury also pointed to the Health System's debts as a large part of the problem.
Four experts in the field of health care management each addressed a different segment of how reorganization has affected different universities.
And although their presentations took a broad look at all the possibilities that lie in the Health System's future, the bulk of the time was devoted to the subject of a for-profit buyout.
David Blumenthal, director of the Institute for Health Policy at Massachusetts General Hospital in Boston, advised the audience that should a deal be reached with a for-profit company, a strong contract must ensure that academic control remains in the hands of Penn.
"Everything should be in writing," Blumenthal said, adding that "you should have an iron-clad buyback provision."
Blumenthal's conclusions were based on case studies of three buyouts of teaching hospitals.
And while Blumenthal was quick to make clear that each of the hospitals he studied had little similarity to Penn, he emphasized that some lessons could be learned.
In each case except one, the university retained 20 to 25 percent control of the hospital after the sale, a deal Blumenthal recommended for Penn.
Of primary importance, Blumenthal reminded the audience, is that any option will have negative consequences.
"In the face of financial distress, you all have to pick your pain," he said.
Michael Black, vice dean for administration and finance at the School of Medicine, was one of the more vocal critics of Blumenthal's analysis.
"I think it's misleading when you show the capital goes for academics," Black said when the floor was opened to comments from audience members. "The reality is the capital went to the hospital."
Black's criticism stemmed from his experiences, which he said indicate that in many sales of teaching hospitals, profits are not directly fed to the medical school.
"Our overall goal is to protect the academic enterprise," Asbury said in an interview last week.
When asked after the meeting about the amount of time devoted to discussing sale to a for-profit institution, Wasserstein deflected suspicions that a buyout by a for-profit is more probable.
"The format had no bearing to the committee's negotiations," Wasserstein said.
John Kastor, who presented the wrap-up discussion on mergers in general, noted that should Penn sell the Health System, it would be an unprecedented move, given the University's size.
"It would far and away be the largest, most prestigious institution to do so."
(01/30/01 10:00am)
Even though Penn's Health System recently turned the tide of financial losses last year, officials say adjustments must be made to the structure of the organization.
The Health System owns four hospitals in the Philadelphia area, including the flagship Hospital of the University of Pennsylvania.
According to Arthur Asbury, interim dean of the School of Medicine, the $330 million deficit of three years ago was trimmed to a $30 million operating loss in Fiscal Year 2000. But "balance sheet issues and capital needs" are forcing the University to rethink its relationship with the Health System.
"Change is ever present," Asbury said last night in a talk sponsored by the Medical Faculty Senate. "Adapting to change continuously is the way we preserve our academic mission."
Phoenixville Hospital, Pennsylvania Hospital and Presbyterian Medical Center were all acquired in the 1990s to insulate the Health System against powerful health maintenace organizations.
"The major strategy behind the acquisitions was... to establish a Delaware Valley network of sufficient size and robustness in order to deal on a level plain with the health care payers," Asbury said in an interview last week.
But while Phoenixville and Presbyterian posted modest profits in Fiscal Year 1998, Pennsylvania Hospital recorded a net loss of over $8 million.
HUP has been by far the biggest drain on Health System resources, hindered by Medicare losses from the Balanced Budget Act, enacted by Congress in 1997.
While HUP's losses due to the BBA have been in the millions, Phoenixville was only impacted "somewhere between $300,000 and 500,000 a year," according to Kevin Mahoney, executive director of Phoenixville Hospital.
"We're one of the lowest cost providers in the Delaware Valley," Mahoney said of Phoenixville, which was acquired in 1997 by the Health System.
Mahoney attributed the hospital's success to its "community orientation, high quality medical staff and long-term employees."
But in spite of its successes, Phoenixville may find itself on the auction block.
Wharton professor Mark Pauly, who specializes in health care finance, sees Phoenixville as a potential bargaining tool in a deal with an outside company.
"Universities don't like to be owners of risky businesses," Pauly said.
Mahoney would not comment on any discussions involving Phoenixville Hospital and the possible break-up of the Health System.
Robert Field, director of the Health Policy Program at the University of the Sciences in Philadelphia, noted that any divestiture should be based on some fundamental criteria.
"Does a university have to own those components of its medical program?" Field asked, noting that for over 100 years, Harvard University has not owned the hospitals to which it sends its medical students for training. "Penn has to decide what elements it needs for the academic mission."
Another factor in a decision to sell, according to Field, is whether an individual component of a health system -- such as Phoenixville Hospital -- is worth more as an integrated part of the health system, whether or not the system as a whole is sold.
"Unloading a component that in the short-term is profitable could be a short-sighted strategy," Field said.
Pennsylvania Hospital executive director Timothy Morgan could not be reached for comment.
Capital spending is "necessary in order to meet requirements for annual reinvestment in the academic enterprise," Asbury said.
"HUP needs to have further investments made," agreed John Kastor, a professor of medicine at the University of Maryland. "So do the other hospitals."
Unfortunately for the Health System, that capital just does not appear to be there.
"Large transfers... sometimes at the rate of $100 million per year are obviously no longer possible," Asbury said.
