Page II

Mr. C. Robert Benedict

December 27, 1977

3. I was accepted to the University of Michigan and had an athletic
scholarship.

4. While attending the University of Michigan, I was number three in
the national collegiate wresting championships and received the
FIELDING YOST award for combined athletic and academic achievement.
5. After three years of pre-med, I was accepted at the College of
Osteopathic Physicians and Surgeons in California where I was in
the upper 15% of my class and number two on the senior qualifying
finals. I was president of my professional fraturnity, Iota Tau
Sigma.

6. I was accepted at the Los Angeles County Osteopathic Hospital for
internship, a coveted internship.

7. Following my internship, I was accepted in one of two general
surgical residencies available in the state of California.

8. On completion of my residency in general surgery at Long Beach
Osteopathic Hospital, I returned to practice in my home-town of
Greeley, Colorado.

9. During the eleven years of practice, I was accepted as a member
in the American College of Osteopathic Surgeons.

10. Following acceptance in the American College of Osteopathic Surgeons,
I successfully passed the boards of general surgery.

11. Following being turned down at Weld County Hospital, Dr. John Grow
Sr., an eminent cardiovascular surgeon, head of the Grow Surgical
Group (eight cardiovascular surgeons), allowed me to scrub in open
heart surgery for one and a half years every Tuesday. He certainly
accepts me and speaks well of my work. It is unlikely that a better
physician exists in the allopathic profession in the state of Colorado
than Dr. Grow.

In conclusion, I apologize for having to list some of the places where I have excelled over the years but it is difficult to establish any kind of discrimination unless you know something about the individual you are discribing. I hope this is helpful and I would be glad to help you in any way that I can.

Sincerely yours,

iss in Do

Miles D. Lee, D.O.

ck

Enclosure

Recent action of the West Michigan Health Systems Agency Board with serious potential impact on Grand Rapids Osteopathic Hospital prompts this letter.

It is our understanding that a motion was defeated 14 to 13 on the question of allowing an Osteopathic Hospital obstetrical service to be exempted from the proposed Health Systems Agency goal of 1,500 minimum deliveries per year in population centers of 100,000 or more. A letter from Mr. McCarthy, our President, had drawn your attention to the fact that strict Interpretatlon of that goal could close all but one osteopathic obstetrical service In the entire United States (actually, there are two hospital corporations which could meet this goal; however, only one is a single, unitary institution); this purely on the basis of arbitrary numbers and with no objective analysis of comparative cost or outcomes in terms of successful deliveries of healthy Infants from healthy mothers. This also, despite the fact Grand Rapids Osteopathic Hospital has demonstrated mortality, morbidity and length of stay statistics equal to or better than most centers that deliver In excess of 2,000 bables a year. (See Michigan Department of Public Health "Perinatal Mortality By Hospital Birth, Michigan 1970-72" as distributed June 23, 1975.) We are hospital number 133 In this study.

The HSA Board members should be aware of the Impact on services to this community should It propose to force closure of the obstetrical unit of Grand Rapids Osteopathic Hospital.

1. Closure of the postdoctoral training program for Interns.
rotating Internship in an AOA approved osteopathic hospital is
required for osteopathic practice licensure In Michigan. An AOA
approved program requires obstetrical experience in an osteopath-
Ically oriented Institution. Our Internship program currently is
training 14 Interns, many of whom will become family practitioners
In the West Michigan area. These Interns would be deprived of
exposure to the treatment of newborn Infants as well as the man-
agement of obstetrical delivery.

The only way an intern program could be continued in the absence of obstetrical service at Grand Rapids Osteopathic Hospital would be to send osteopathic Interns to another osteopathic hospital which would meet the volume requirements of the HEW Guidelines. The one such osteopathic hospital in the country obviously cannot provide such training programs for the 1,000 D.0. graduates expected In 1978 and In future years.

1919 boston st., s.e. / grand rapids, michigan 49506 / phone (616) 452-5151

2. Closure of the Residency training programs in Obstetrics/Gynecology
Our four-year residency program in this primary care specialty
provides for training of three residents at a time at present.
These residents are not only being trained to deliver a needed
service, they participate in the teaching of undergraduate medical
students, the care of patients in obstetrics and gynecologic sur-
gery and in the operation of a clinic for the medically indigent
and high risk women of the area. All obstetricians on our staff
at this time are graduates of our program.

3. Closure of the OB/Gyn Clinic which would deprive high risk-mothers of pre-partum, post-partum and gynecology services, as well as a choice of physician and hospital.

4.

Closure of educational classes for expectant parents which stress Teaching of the physiology of pregnancy, Tabor and delivery as well as parenting and Infant care.

5. Probable disruption of the Hospital's major affiliate status with
liichigan State University College of Osteopathic Medicine. ATT Five
osteopathic hospitals with major M.S.U. affiliate status In Michigan
are required to provide a teaching program for students in eight
major medical disciplines Including obstetrics. The HEW Guide-
lines, if strictly applied, would close all but one of the five
major teaching hospitals affiliated with the University, creating
an Impossible student load for the one remaining hospital.

In addition to all of the above, closure of the obstetrics services of Grand Rapids Osteopathic Hospital would waste the many thousands of dollars recently expended to renovate our obstetrical labor, delivery and nursery areas to comply with State requirements. This renovation was done with the approval of the lichigan Department of Public Health and completed in 1976.

Therefore, we are concerned that Mr. McCarthy's letter to WHSA pointing out one area of national concern from an osteopathic hospital standpoint was simply summarized and not mentioned at the meeting prior to Mr. Leegwater's, a vice president of our hospital, raising this issue. We had hoped our letter would make WMHSA sufficiently aware of the problem to permit opportunity for dialogue, which, unfortunately, never materialized.

We further understand that the proposed amendment ultimately considered by the HSA Board dealt with two completely separate issues, namely: the exemption of osteopathic hospitals from the 1,500 delivery rule and a proposal to permit additional CAT Scanners in the region under certain circumstances. Since these questions were not divided, it would seem difficult to assess what might have been the outcome on either had they been considered separately.

In view of all the above considerations, we would like to ask that the matter of obstetrical delivery numerical requirements be reconsidered, at least as they apply to osteopathic teaching hospitals and in particular to Grand Rapids Osteopathic Hospital.

Given the opportunity, we would be most happy to present further testimony before the WMHSA Board regarding this vital issue.

AMERICAN OSTEOPATHIC ASSOCIATION

TESTIMONY SUBMITTED TO THE

SENATE HUMAN RESOURCES COMMITTEE

SUBCOMMITTEE ON HEALTH

RE: HEALTH PLANNING

AMENDMENTS OF 1978