OHEP at Thirty
The year 2003 marks the 30th anniversary of OHEP, since the founding agreement of constituent institutions was signed in 1973 and incorporation was formalized the next year. A one-page history of the consortium since that date is published in the OHEP brochure. There was, however, a seven-year gestation period beginning in 1966. This period is semi-complex, multi-factorial, almost interesting, and involves interrelationships and inter-institutional thought and planning.
Beginning in 1966, three young physicians, new to the medical scene in Pontiac, Michigan, individually and in concert, developed a vision for medical education in Oakland County. The county was growing and had a great future but was not yet a center for medical care and medical education, especially when compared to the larger and older medical establishments to the south in Wayne County. There was agreement on the need for some type of organization to supplement and support the small residency programs in the handful of small Oakland County hospitals. These hospitals were Pontiac General Hospital (now North Oakland Medical Center), the first hospital in Oakland County, St. Joseph Mercy Hospital, founded in 1928 (now St. Joseph Mercy Oakland), the rather new and not yet large Beaumont Hospital, and two hospitals that had recently moved from locations in Detroit, Providence Hospital and Crittenton Hospital (now Crittenton Hospital Medical Center). In addition, there was the psychiatric hospital, Clinton Valley Center (formally Pontiac State Hospital) that had an acute medical surgical unit and Pontiac Osteopathic Hospital. Relatively new Oakland University that had started as a branch of Michigan State University was also on the scene.
Wayne County, still in pre-Detroit Medical Center days, had many hospitals. These included Harper, Grace, Women’s (later Hutzel), Children’s, the relatively new Sinai Hospital of Detroit, Mount Carmel, St. John, St. Joseph Mercy Hospital (“on the boulevard”), Oakwood, the down river hospitals, Wayne County General Hospital (“Eloise”), Cottage, Bon Secour, Deaconess Hospital, Doctor’s Hospital, Blaine Hospital, and Henry Ford Hospital. Harper and Ford hospitals ranked among the largest hospitals in the nation. Wayne State University had the Medical School and the University of Detroit (later University of Detroit Mercy), the Dental School.
The twenty-year period between 1955 and 1975 was one of great flux in medicine. There was a perceived shortage of physicians and the output from LCME schools doubled from 8,000 graduates per year to 16,000 graduates per year. Many new medical schools opened (from about 78 to 126), and many schools increased in size. Wayne State University was a good example, metamorphosing from one of the smaller schools in the country to perhaps the largest. A handful of two-year medical schools changed to “regular” four-year programs.
The ACGME was also changing. In the field of surgery, for example, many community hospitals with surgical residency programs had, at the time, Type II or Type B surgical residency programs. In that format, surgical training involved a one-year internship, three years of residency, and two years as a preceptor under a surgeon with American Board of Surgery (founded in 1937) certification. University programs were generally Type I or Type A, which involved one year of internship and four years of residency. In 1966 and 1967, the former programs were being discontinued by the ACGME and community hospitals that could not qualify for the Type I (Type A) program would lose their residency training programs. There were about 27 general surgical residency programs in Michigan at the time. It was in this milieu that the three (sort of academic) young physicians came on the scene.
In the early 1960s, there was still some degree of “talk” of relocating the old Children’s Hospital and even the School of Medicine to Oakland County. This never progressed very far. The new Children’s Hospital was built on the new campus of the planned Detroit Medical Center and the new (“newer”) Medical School was scheduled to move from 1400 Chrysler Expressway to the newly planned Scott Hall on the new Medical Center Campus. Detroit Receiving Hospital (called Detroit General Hospital for a few years) was scheduled to move from the old site at the Chrysler Expressway to the new Medical School Campus. Detroit Receiving Hospital was still on the old site during the Detroit riots of 1967 that hastened population and business movement from Detroit to Oakland County.
The early concept of a consortium of hospitals in Oakland County was developed in some detail a few years prior to the statewide and national interest in organizations of this type. As plans continued to develop, the framework would be built in conjunction with a special role for Clinton Valley Center (CVC) and Oakland University. An interest had developed in establishing a new medical school under the auspices of Oakland University. The first two years would be based on campus at Oakland University while the clinical years would consist of third year clerkships and fourth year electives in the Oakland County Consortium Hospitals. The major clinical base would be located at CVC, which had an expanding medical-surgical unit, a number of operating rooms, and a functioning privately funded animal research laboratory. There had been preliminary approval from the State of Michigan for plans to consolidate all patients from the state mental hospitals and all inmates in the state correctional institutions needing surgery or major medical care for transfer to the medical-surgical unit at CVC. There was even a groundbreaking, carried out with considerable fanfare, for a new medical surgical acute care hospital building on the CVC campus.
During the early life of OHEP, a delegation from the planning group of the new consortium traveled to Brown University in Providence, Rhode Island since the new medical school there was a model for a medical school base at an established university and utilization of community hospitals for the clinical years. McMaster University in Ontario had similar model planning as did the 2 newest medical schools in Ohio. Additionally, Michigan State University was also planning the same type model at the same time. A smaller delegation of physicians from the planning group traveled to the Mayo Clinic in Rochester, Minnesota since there was also new medical school planning there and since many residents at Mayo received M.S. degrees in conjunction with their residency programs, an interest in Oakland County at the time.
So far – well and good! But who were the people involved in all of this ferment? What happened to them and what happened to the big plans?
The “three young physicians” already noted were Drs. Robert Cutler, Robert Tupper, and Allen Silbergleit. The president of Oakland University was Dr. Donald O’Dowd (Ph.D.) who was very interested in establishing Oakland University as a healthcare institution including a medical school. A young academic internist, Dr. Moon J. Pak (M.D., Ph.D.) was the newly appointed Associate Provost of the School of Health Sciences at Oakland University. He was also Professor of Physiology at Oakland University and Chair of “The Study Committee for the Feasibility of a Program in Medical Education at Oakland University”. Additionally, he was Oakland University’s representative to OHEP. At CVC, a dynamic surgeon, most interested in medical education and organization, was the medical director of the medical surgical unit. This was Dr. Donald Dawson. Beaumont Hospital was represented during the early planning period by obstetrician/gynecologist Dr. Ralph Margulis and his deputy, a young and newly minted thoracic surgeon at Beaumont Hospital, Dr. Gary Welsh, who was also Chief of Thoracic Surgery at CVC. As plans progressed, Dr. Robert Wessels, a highly respected senior surgeon and Chief of Surgery at St. Joseph Mercy Hospital was also appointed Chairman of Surgery at the CVC and Dr. Allen Silbergleit, Program Director of Surgery at St. Joseph Mercy Hospital and a close colleague of Dr. Welsh, was also appointed as Chief of Thoracic Surgery at CVC. He led the smaller delegation to the Mayo Clinic while Dr. Pak led the larger delegation to Brown University. At St. Joseph Mercy Hospital, the administrator, Sister Mary Xavier Kinney, was very supportive of medical education and of her “two surgeons” (Drs. Wessels and Silbergleit). The first Medical Director at St. Joseph Mercy Hospital was also a surgeon, Dr. John Ylvisaker, who stepped into his administrative role after many years of surgical practice at St. Joseph Mercy Hospital. He was extremely supportive of the cooperative consortium effort and active in the early formation. So was Dr. Alexander Ullmann, the scholarly chief of pathology at Crittenton Hospital although there was no residency program at Crittenton’s new Rochester location. The original group of planners recognized that South Oakland County and the newly relocated (from Detroit) Providence Hospital in Southfield must be a key component in the new educational structure. The earliest input from Providence Hospital came from Dr. Joseph Rinaldo, medical director and gastroenterologist, who had recently moved to Providence Hospital from Mount Carmel Mercy Hospital in Detroit, Mr. Tom Gentile, Providence Hospital DME, and Providence Hospital’s star young surgeon Dr. John (Jack) Pfeifer. At planning sessions for the proposed new medical school, the dean would be Dr. Pak. Chief of surgery would be Dr. Pfeifer or Dr. Silbergleit, and Nicholas Mizeres, Ph.D. of the department of anatomy at Wayne State University was approached to chair the new department of anatomy.
So what happened? Changes here were also multifactorial and interrelated. Beginning in the late 1960s and during much of the 1970s, the economy was changing for the worse. It also became apparent, at least in some quarters, that the “serious doctor shortage” was more apparent than real and the era of new medical school growth in the United States was coming to an end. Indeed, national groups were working on consensus reports that would be published a few years later and predicted a large physician surplus. Additionally, the era of state hospital closures was imminent. At Oakland University, Dr. O’Dowd’s successor, President Joseph Champagne (Ph.D.) some perceived, was becoming more interested in affiliating with commerce and industry than with healthcare. The groundbreaking at CVC did not progress to a building. The original (1966) concept of a consortium, however, remained stronger than ever. By the time OHEP was incorporated, a few of the earliest innovators had left or were leaving for new horizons and a few new powerhouses were on the scene. Dr. Tupper left Pontiac General for a position in Lansing where one of his staff was a young graduate student named Ernest Hammel. Grand Rapids was Dr. Tupper’s next locale and he has since become a key figure in the Michigan State Medical Society (MSMS) CME planning program. Dr. Cutler was moving to a full time private practice of allergy and he has remained a key supporter of education at St. Joseph Mercy Oakland to the present. At Providence Hospital, Mr. Tom Gentile, an organizational and administrative whiz, had provided invaluable staff support in the planning that led to OHEP and he was a major figure in the birth of the organization.
The founding meeting of the organization was held in the boardroom of St. Joseph Mercy Hospital in 1973, and was chaired by Dr. Ylvisaker, Medical Director at St. Joe. Hospitals represented were St. Joseph Mercy Hospital, Pontiac General Hospital, Beaumont Hospital, Providence Hospital, and Crittenton Hospital.
It took two years to find an appropriate person for the job of executive director of the new organization and to get the program fully operative. Dr. Pak and others found the individual who would be a great executive director of the new endeavor and this was Dr. Tupper’s protégé, Ernest Hammel, now a new Ph.D. The founding fathers of the new consortium, for the most part, had very strong ties with Wayne State University and/or the University of Michigan and it was clear that these institutions would also be a part of the new consortium. Wayne State University, the home team, would be most directly involved.
And so, the consortium was established in 1973, 30 years ago this year. The name of the new consortium was the Oakland Health Education Program or OHEP for short. The name change to the OHEP Center for Medical Education came later, so much later that some people now ask, “say, what do the letters “OHEP” stand for anyway”? The first long discussion on changing the name of OHEP took place in 1991 and related to this modification. Further and more recent discussions included some “far out” suggestions for very different names but did not result in any further name change. George Santayana, 100 years ago, had some opinions on name changes in various civilizations!
So where are the founders and the other early figures now? The only people, currently still active in OHEP who go back to the very beginning, are Drs. Silbergleit and Pfeifer and Mr. Gentile. Dr. Silbergleit is still Program Director of Surgery at St. Joseph Mercy Oakland after 37 years, presumably a national record for durability! This may signify lack of ambition, his grown kids say! He also has been long-term chair of the OHEP Surgery Committee. Dr. Pfeifer was Chairman of Surgery at Providence Hospital for 21 years and went on to become Professor of Surgery at the University of Michigan, his present position. He is still active in vascular surgery, limiting his practice to the venous system. He remains long-term Chair of the Meadow Brook Program. Mr. Gentile has assumed a major role in the St. John-Providence Hospital merged parent institution. Drs. Wessels and Ullmann and Sister Xavier are deceased. Dr. Wessels is remembered by the Wessels Surgical Resident Research Fund at St. Joseph Mercy Oakland and the medical library of Crittenton Hospital is named the Ullmann Library. A large portrait of Sister Xavier dominates the wall of the main lobby at St. Joe’s. Dr. Ylvisaker became President of the MSMS, is now retired and still flies his own plane. Dr. Pak left academia and is now in the private practice of primary care internal medicine and is on staff at Crittenton. Dr. Dawson left long ago to become director of a psychiatric hospital in Massachusetts affiliated with Harvard Medical School. The Donald Dawson Medal for the first place award of the OHEP Resident Research Forum, is named after him. Dr. Dawson also donated the private animal research laboratory at CVC to Oakland University, moving the entire content of the laboratory to a small frame building at the edge of the Oakland University Campus. Dr. Welch retired from the practice of medicine to pursue business interests. Dr. Champagne became President of Crittenton Hospital for a while after leaving Oakland University. Dr. Hammel retired in 2002 after leading OHEP for over 25 years.
The multitude of changes during the past thirty years have included changes in medical terminology. Medical directors have become vice presidents for medical affairs and hospital administrators have become presidents and CEOs. OHEP, now the OHEP Center for Medical Education, has grown considerably.
Allen Silbergleit, M.D., Ph.D.
SEMCME at Thirty-Four
Epilogue to OHEP at Thirty - Prepartum
The essay “OHEP at Thirty – Prepartum” was printed and distributed at the OHEP Board of Directors 30th Annual Meeting held at the Orchard Lake Country Club on July 29, 2003. With the recent announcement of a new medical school at Oakland University (OU) in partnership with Beaumont
Hospital, there may be renewed interest in some items of that essay which outlined the near establishment of a medical school at OU about 30 years ago.
What are some of the highlights during the past four years in the organization formerly known as OHEP? (Shades of the entertainer formerly known as Prince!) First is the name change to the Southeast Michigan Center for Medical Education (SEMCME), a bit of a mouthful but appropriate considering the enlargement beyond Oakland County. Additionally, the headquarters originally on the OU campus and later Southfield, relocated to the Wayne State University (WSU) medical campus. Recent membership changes include the entry of St. Joseph Mercy Hospital – Ann Arbor, the return of Crittenton Hospital to the fold with the WSU Family Medicine program and the downsizing of North Oakland Medical Center (NOMC) with the decrease of the hospital’s graduate medical education footprint.
The concept of a future medical school at OU goes back to 1966, the year OU became an independent school, separating from the Michigan State University affiliation.Aspiration to become a “national” university was present at the very beginning and a commitment was made for an eventual medical school and law school. The two champions for medical education at OU were President Donald O’Dowd (PhD) and Provost Moon J. Pak (MD, PhD). During Dr. O’Dowd’s tenure (1969-1979) and Dr. Pak’s tenure (1968-1981), specific and detailed plans including curriculum were made and approved by the Faculty Senate and the University Board of Trustees. A specific site on campus was designated for the medical school basic science building. The plans specifically
named OHEP and the Oakland County member hospitals as the clinical base for the medical school. Dr. O’Dowd, however, left to lead the State University of NewYork system. A major building, O’Dowd Hall, stands on the OU campus in his honor.
Dr. Pak left his tenured position when it became evident that the new medical school was not imminent. He still has a busy and successful internal medicine practice near Crittenton Hospital where he is on staff. On April 17, 2007, a special event was held at OU’s Meadowbrook Hall to honor Dr. Pak for his role in establishing the health science programs at OU and for preparing the groundwork for medical education.
Now for an update on the other early (earliest) Oakland county figures in medical education leading to the formation of OHEP and the early years of OHEP. Death has claimed two colleagues noted in “Prepartum” since the essay was written four years ago. Dr. Gary Welsh died a few years back. His
son is following in his footsteps as a thoracic surgeon at Beaumont Hospital. Dr. Nicholas Mizeres, who helped pioneer basic science teaching for surgical residents in Oakland County, retired as Professor of Anatomy at WSU but continued to teach until a few years ago. He died a few months ago
and a memorial service honoring his life and career was held at Scott Hall on May 31, 2007.
Everyone else is still going strong! Dr. Robert Tupper was an inspiration to Oakland County medical education in the early days. He was Director of Medical Education (DME) at then Pontiac General Hospital, which probably had the strongest graduate medical education program in Oakland County at the time. His protégé was Dr. Ernest Hammel and he was a factor in Dr. Robert Cutler coming to Pontiac and then St. Joseph Mercy Hospital (SJMH). He was active in inter-hospital education efforts, partly in parallel to other efforts of the time. His interests included the potential new medical school at OU and he was active in post-graduate medical education (continuing medical education or CME) on an inter-hospital basis, about the time that formal “CME programs” were coming on the scene. When he was leaving Pontiac at the end of 1972, the framework of our current educational structure was taking form. In Grand Rapids, he was very successful in consolidating hospital education programs, which was a key factor in the planned relocation of the Michigan State University College of Human Medicine to Grand Rapids. Now retired, he is still active in the Michigan State Medical Society’s CME Accreditation Committee.
Dr. Robert Cutler was DME at then St. Joseph Mercy Hospital in the late 1960’s when medical education at the hospital was being rebuilt. It is very likely that without his great leadership and medical staff respect for his sheer intellect, all residency programs in the hospital could have disappeared. He was most active and the best attendee in a multitude of meetings leading to the formation of OHEP. Dr. Cutler still has a very active and busy allergy practice in his office building across Woodward Avenue. He was honored at a Recognition Dinner at Orchard Lake Country Club on June 27, 2007 for his many years of service to the hospital.
Dr. John Ylvisaker is one of the most senior (the most?) of the OHEP founders and has been retired for years. He was one of the strongest and most unequivocal supporters of the new consortium when it most needed support and he had the clout to be effective. His vision may have been the widest of any and he might have envisioned an organization that managed all medical education in the county. He no longer flies his own plane.
Dr. John (Jack) Pfeifer, whose early input into OHEP was unsurpassed, remains fully active as Professor of Surgery at the University of Michigan (U of M). During most of OHEP’s history, he was a pillar of strength on the Surgery Committee, brought national attention to Michigan with the first surgery resident curriculum, and was a principal in the Surgery Committee’s bringing Wayne County and Macomb County surgical programs into OHEP and hence the expansion beyond Oakland County. He is an eminent vascular surgeon and an authority on the venous system. He still sees many
patients and is still a great lecturer. He is honored by the U of M with the named/endowed John Pfeifer Professorship in Surgery.
Tom Gentile, an essential figure in the birth of OHEP, is still a ball of fire! He retired from the St. John-Providence system but remains active on all fronts. His honors include the presentation this evening.
Dr. Joseph Rinaldo, also a major figure in the birth of OHEP, was known to many of the co-founders when he was still at Mt. Carmel Mercy Hospital. His following 20-year tenure as Medical Director of Providence Hospital included clinical practice and research in addition to administration. Many remember his great lectures and his highly organized files of 35mm slides when the Kodak carousel mwas new, having replaced lantern slides. His retirement in California didn’t last long since he founded the Motility Laboratory at the University of California San Diego Medical School. His second retirement is holding but he is a working poet!
Dr. Ralph Margulis, one of the “original” lights of OHEP, has had a career encompassing leadershipin essentially all of the practice and educational positions at Beaumont! His university positions have included both WSU and OU. He is still active as Senior Vice President for United Physicians.
Dr. Allen Silbergleit, a supporter since pre-OHEP and ever since, remains active in practice and as Chair of the Division of Surgery at St. Joseph Mercy Oakland (SJMO). He completed a 40-year tenure as Program Director (PD) in Surgery at SJMO, an all- time record that would be in the Guinness Book of Records if there were a category for PD’s! (There are even weirder categories.) A few honors have come along. One is recognition by peers at the Association of Program Directors in Surgery at the March 2006 annual meeting in Tucson, AZ. One is the naming of SJMO’s annual education day as the Allen Silbergleit Clinic Day, beginning in 2005. The 50th Allen Silbergleit Clinic Day is scheduled for November 7, 2007. The ACGME conferred the Parker J. Palmer Courage to Teach Award at
the annual meeting on February 12, 2007.
One of the important early contributors in the founding of OHEP was Dr. Jerome Rosenthal (PhD) but he was not even mentioned in the 2003 Prepartum essay, probably because of his very junior status at the beginning. He was a graduate student of Dr.Allen Silbergleit in the WSU Department of Physiology, initially at 1400 Chrysler and then at Scott Hall. He received his PhD in 1974 and was Coordinator of Medical Education at SJMH from 1972-1979. His efforts included countless meetings that led to the formation of OHEP and he was active in the early days of the consortium. His laboratory research, coordinated with research in the surgery residency at SJMH, received national attention at the American College of Surgeons when it was noted to be “best research of the year.” He left SJMH in 1979 to become Assistant Dean of the medical school at the University of Illinois and later was an administrator with the AMA in Chicago. Currently, he is head of the Editorial Department at Harvey Whitney Books (publisher of the Annals of Pharmacotherapy) in Cincinnati. He has one of the most impressive private collections of razors and razor blades in the United State
All of the 16 past presidents of SEMCME are being honored this evening, including the five who were active “prepartum” in the founding of the consortium. All of the past presidents have rendered great service in the enhancement of the organization, growth and at times, even survival. All deserve and receive immense gratitude and boundless appreciation from the Board of Directors.
Allen Silbergleit, MD, PhD