University of Michigan Health System

The three University of Michigan Hospitals--University Hospital, C.S. Mott Children's Hospital, and Women's Hospital comprise the core teaching facility for the Medical School. The Health System also includes a network of 30 health centers and 120 outpatient clinics located throughout the region and handles more than one million outpatient visits and 35,000 inpatients annually. The University Hospitals are a training resource for approximately 4,000 students a year.

The Health System is affiliated with the University of Michigan Medical School and the Schools of Dentistry, Nursing, Public Health, Social Work, and the College of Pharmacy.

Facilities

When the Department of Medicine and Surgery at the University of Michigan first held classes in the fall of 1850, the medical course consisted exclusively of lectures over a six-month term. Six months of training under a qualified physician were required following the school term. The first university hospital was not opened until 1869, in order to provide clinical instruction concurrent with classroom lectures. Located on North University Avenue, it was the first university-owned hospital in the United States and consisted of the former residence of a professor converted into a twenty-bed ward.

The Campus Pavilion Hospital, providing sixty beds, was built in 1875 to replace the original hospital. It consisted of two frame pavilions 114 feet long and 30 feet wide, and had few of the amenities (such as good ventilation and an operating room) viewed as essential soon after the hospital was erected--members of the faculty were lobbying for a replacement almost from the first. Starting in 1897, the Hospital remained open throughout the summer, as a condition for continued state support, initially granted in 1877.

In 1891, the pavilions were replaced by the Catherine Street Hospital, recognized in 1900 as the largest teaching hospital in the country. It was originally comprised of two main structures, one for the Department of Medicine and Surgery and one for the recently established Homeopathic Medical College The Homeopathic College moved to its own facility on North University in 1900, and its wing of the Catherine Street Hospital became the Surgical Ward, the other, the Medical Ward. When University Hospital eventually replaced it, the "old Hospital group" consisted of twenty buildings. An innovative and effective contagious disease ward was erected in 1897, the Palmer Ward for pediatrics in 1906, and the Psychopathic Hospital, with 40 beds, was completed in 1906 to be run by the state until 1937 when the legislature turned it over to the University.

University Hospital ("Old Main") replaced the group on Catherine Street in 1925, and provided 700 beds for the practice and teaching of medicine. It remained for almost sixty years. The world's first successful lung removal was performed by University of Michigan physicians in 1932, and the first heart transplant in Michigan was performed there in 1968. Additional facilities added included two additional floors devoted to tuberculosis in 1931, and the Neuropsychiatric Institute in 1937.

During the September 1958 meeting of the Board of Regents, the Bylaws were changed to reflect the naming of the medical campus (Medical School, University Hospital and School of Nursing) to the University of Michigan Medical Center. Research buildings and specialized hospitals and outpatient clinics were added over time to supplement the Medical Center's facilities. The Women's Hospital opened in 1950 and Adolescent Psychiatric Hospital in 1955. Pediatric wards in University Hospital were replaced in 1969 with the C.S. Mott Children's Hospital, and the James and Lynelle Holden Perinatal Hospital was built in 1972 to provide care for premature and critically ill infants. W.K. Kellogg Eye Center, a 32-bed facility providing patient care, education and research in eye diseases, was established in 1976. Kellogg Eye Center has since become an outpatient facility.

Despite the new construction, the Hospitals were still unable to support the growing training needs of the Medical School. Several affiliated--or "core"--hospitals were recruited to offer resources to University of Michigan medical students. The core hospitals included St. Joseph Mercy Hospital, Veterans Administration Hospital (Ann Arbor), Wayne County General Hospital, and Henry Ford Hospital (Detroit.)

The Replacement Hospital Project--in planning stages throughout the 1970's--began in 1978, culminating in 1986 with an 11-story, 550-bed adult general hospital. Attached to University Hospital is the A. Alfred Taubman Health Care Center, where patients are seen in 120 outpatient clinics.

Since then, the Medical Center has continued to expand. In 1990, services for women and children were integrated with new and renovated space amounting to 221,000 square feet. In the mid-1990's, Women's Hospital opened a 22-room Birth Center where women could keep a private room throughout labor, birth and recovery. The Cancer Center and the Geriatrics Center moved into a new building in 1997.

In 1996, the Medical Center was renamed the University of Michigan Health System.

Administration

In 1869, Dr. Abram Sager submitted a memorandum outlining the functions and principles of the University Hospital. He maintained that all patients applying to the hospital for care would submit to be utilized for clinical instruction, and that no patient be turned away because of an inability to pay. However, for many years the Regents controlled the financial operations of the hospital in order to ensure that patients were charged an amount sufficient to cover the cost of maintenance, because they insisted the hospital be self-supporting. For a period, between 1877 and 1918, income was supplemented by state support.

Day-to-day supervision of the hospital was carried out by the Hospital Superintendent. The position became a part of a more systematic administration in 1891, after the completion of the Catherine Street Hospital. Joseph Clark was appointed in 1888, his son, Harry W. Clark in 1897, E.S. Gilmore in 1900, and Jay B. Draper in 1908. Draper administrated a rigid payment policy that resulted in a surplus for the hospital which raised concern among the medical faculty. Though there had always been hospital committees of the medical faculty, their power had been limited. But partly in reaction to the surplus, and with the approval of the Regents, a new Hospital committee was created in 1912 to direct all medical affairs of the Hospital. Dr. Reuben Peterson, chairman of the committee, was made Medical Director.

In 1917, it became evident that a member of the medical faculty could not contribute enough time to the position of Medical Director, and a new Medical Superintendent and Director, Dr. Christopher G. Parnall, was appointed to give all of his time to the affairs of the Hospital. He was responsible for much of the plan and design for the new University Hospital. He resigned in 1924. Dr. Harley Haynes followed Dr. Parnall. Haynes--who was given the title, Director of University Hospital--put the new University Hospital into operation. He retired in 1945 and was succeeded by Albert Charles Kerlikowske. In 1969, Edward J. Connors assumed the position.

Also in 1969, President Fleming appointed the University Hospital Study and Advisory Committee, chaired by Fedele F. Fauri (sometimes referred to as the Fauri Committee), to study the administration of the medical campus. The committee recommended that the Medical School and the hospitals be administered together by a single person, the Director of the Medical Center. The Regents accepted the recommendation and appointed William N. Hubbard, Jr.--who was also Dean of the Medical School--to the position.

Hubbard served until 1970, when John A. Gronvall succeeded him in both positions. Gronvall, in 1974, dismantled the administrative changes initiated by the Fauri Committee, and the Director of the Medical Center position was abolished. In the same year, Connors resigned as Director of University Hospital after an audit of his travel expenses, and Jeptha Dalston stepped into his place.

When Gronvall resigned in 1982, having served his last eight years only as dean, President Shapiro took advantage of the change in leadership to reintegrate the administration of the Medical Center. He created the position of Vice Provost for Medical Affairs in 1984, and George D. Zuidema was appointed. The Dean of the Medical School and the Executive Director of the University Hospital reported to Zuidema, who in turn reported to the Vice President for Academic Affairs.

Dalston retired in 1985, and was replaced by John D. Forsyth, whose title was Executive Director of University of Michigan Hospitals. Zuidema retired in 1994, and Rhetaugh Dumas was appointed to his position, with the new title of Vice Provost for Health Affairs.

The mid-1990's saw the beginnings of drastic change in health provision. Managed health care and capitation--where the health provider, instead of the health insurer, takes on the financial risk--threatened upheaval, especially for an academic medical center. In order to remain competitive, management of the University Hospitals was reconfigured to imitate that of a corporation. In 1996, the University of Michigan Health System was created, and to John Forsyth's position was added the title, President and Chief Executive Officer of the Health System.

Later that year, Forsyth resigned, and Larry Warren was appointed, first on an interim basis, and later, permanently, as Executive Director of U of M Hospitals, and President and Chief Executive Officer of U.M.H.S. Douglas L. Strong replaced Warren as Chief Executive Officer in 2005.

Dumas resigned in 1997, and the position was once again renamed. Gilbert Omenn was appointed as Executive Vice President for Medical Affairs. One of three executive vice presidents at the university, Omenn reported directly to the President. President Mary Sue Coleman appointed Robert P. Kelch to the Executive Vice President for Medical Affairs position in 2003.

From the guide to the Health System (University of Michigan) publications, 1892-2006, (Bentley Historical Library, University of Michigan)