 HBC Dutchess Radio, I'm your host, Jared Carter. Welcome back today. We're privileged to be joined by the Howard University College of Medicine Dean, Dr. Hugh Mighty, who also serves as the vice president for clinical affairs for the university, who joins us to discuss the ongoing issue of Howard University's proposed and supposed role in continuing to provide healthcare for a specifically vulnerable part of Washington, DC and its low income residents in the face of a new proposal from the district city council to build a new hospital in the area. So Dean Mighty, definitely honored to be joined with you today for this important conversation. So you've been pretty outspoken in recent weeks about the potential outcomes for a new hospital that is proposed to be under the management of George Washington University and what it may limit Howard University medical students in their research outreach and rotation planning. Can you talk a little bit about your understanding of this plan and why Howard has to be so vital as a part of it? Absolutely, and thank you. So a couple of things, points of clarification because I think they're very important. George Washington University is a separate entity than the entity who is being proposed to partner for the hospital. So I think it's very important that we clarify the difference between those two. Sure. District of Columbia's government has proposed partnering with an entity that is Universal Health Services. Universal Health Services is a for-profit entity that operates hospitals across the country. They are based out of Pennsylvania. They operate the George Washington University Hospital, which is not the same as George Washington University. They use the name, but they're not the same entity. So I don't want George Washington University to be taking any heat for something that they're really not doing. Okay, so I wanna clarify that. Now, that being said, the proposal that's on the table is for Universal Health Services to be the operator manager of a new hospital being built in Southeast Washington, D.C. East of the River to be, at the current time, we're calling it the East End Hospital. It's proposed to have a new 150-bed hospital. It will be located in Ward 8. Currently, Howard University Hospital, which is the primary teaching hospital for 740 learners. We have 475 medical students, 260 residents, and residents of where you go after you graduate medical school. So we're about 745 of the physician track who need Howard University Hospital for their training. The tie between those two things is as follows. Howard gets one third of the volume that comes from the hospital. Howard comes from Ward 7 and 8, which is East of the River. When the new hospital opens, obviously we expect that we're going to lose that volume as people will go to the new hospital. And we want them to go to the new hospital, obviously. We want people to go to a hospital that's in your neighborhood. And that's vital for us because we do support there being a new hospital. The citizens over there don't have a hospital and they need to have a hospital. Where the issue then comes up for Howard is that as currently proposed, Howard would essentially be locked out of accessing that new hospital on the East End. So we would then have two problems. One would be the volume that Howard would decline. And therefore the revenue at Howard would decline. And two would be if the volume would decline, we won't have a place to train those learners if we don't have access to that hospital. Our point is that we must have access to that hospital and we should have access to that hospital. That hospital is a public hospital. It's being built mostly with public funds in D.C. And we should have access to it. That population is a population that Howard had served for 150 years. It served it when it was Friedman Hospital, now serves it as Howard University Hospital. But that is the key issue is that if we cannot get access to that hospital, our training program for crewed and black doctors will come under great deal of pressure if not seems to exist. So the emphasis here is kind of two-pronged. One, there's a volume of patients that would come to Howard and that would be, you know, succeeded to this new facility, which is I think scheduled for completion in 2023 if the proposal is passed. And then there's the teaching and training component for medical school students. Is there, and obviously the emphasis is there, why the emphasis on the teaching and training opportunities more so than the volume that Howard University Hospital would lose? Because they're tied together. So to have accreditation in order for your programs to have accreditation by the license, the national license and body and for the medical school, the CLCME, there's an ACGME body that oversees residency training. In order to train those physicians, you must have that volume. So it's not just the volume leaving the hospital, it's the volume leaving completely where you will need those volumes to teach and train. So they're tied together. It's not just a hospital that loses volumes. In fact, I would tell you it's not really about the hospital per se. It is about the mission of Howard. Howard has produced the majority of black physicians in this nation for years. That pipeline starts from medical school through residency and losing that volume basically will damage that pipeline. And it's damaging at a time when we know that since the 1970s, the number of black physicians who are being produced have not increased across this nation. Let's talk a little bit about that because part of the important talking points about this issue is just that, the number of black physicians which Howard produces and trains, and specifically in the DC, Maryland, Virginia area, more than 7,000 for sure. And this is an area where there are low income, mostly black citizens that are gonna need black physicians who can appropriately diagnose appropriately off of bedside manner, and those kind of things that that community needs. Why do you think this is such a hard thing for the city council to understand? Well, I think two things. One is like everything else that happens in life, there are things that I think we just simply, they work and they work every day and you don't pay any attention to them until an issue like this arises. And then folks are saying, well, wait a minute, this is really an unintended consequence which is what we're hoping this is, that you would actually create a structure that would threaten a pipeline for creating black physicians. I don't believe anyone had that intent in mind. But as it is, that's where we started and now we've been very busy trying to educate the council members and trying to educate the mayor's office that that is the consequence that will come about if we don't modify or rectify the process that currently stands today. You guys got exceptional feedback from the Howard community when news about this proposal and a lot of its details surfaced. From your perspective as the leader of the medical school, what did you think about so many stakeholders becoming so active about this? Because it's not rare for Howard folks to be active on issues. But this is something that's kind of in the political weeds and they really got into it and they really got into the nuances of what a project that would not include Howard would mean. What was your reaction to their advocacy about this matter? I think I have one big reaction which is thank you. I mean, without their support, we would not have been able to so far get the kind of audiences that we've managed to get. So it's a huge thank you. I think they have been very supportive that moved in very quickly to address the issues as we put them out there. And I will say though, it's not just the Howard constituency. I mean, across the nation, I think people have chimed in knowing that this is really a feeder for the country. You know, we take medical students right now, we have medical students represented by at least 17 of the HBCUs in the country. And we continue to try to feed that pipeline because there are only really four HBCU medical schools that are left in this nation, up to 152. So I'm just really pleased that Howard alums have stepped up. But I also want to thank all those folks outside of that circle who have stepped up to be a part with us and trying to help support what we're doing. One of the interesting things about this development is that there's almost this notion that Howard being a part of it would be something that would be unusual or not overly productive for the area or for the partnership with the healthcare provider. But yet Howard has existing partnerships that showcase a lot of its talent and a lot of its value to the community. Can you talk about some of those partnerships with Georgetown, other institutions, other providers that have worked and are continuing to work and show that this would not be something that would be unusual for the district to welcome? Yeah, so the first thing I'd say about that is we are very much locked up with our current partner in the community because I believe that's where you deliver medicine in that community. So we have a partnership ongoing with Unity Healthcare which is an FQHC. They have multiple clinics that are in that community in seven and eight, five, six, and throughout DC serving the underserved. And we have partnered with them to really try to deliver the care where the care is needed. So for the most part, we train a lot of specialists so we train orthopedic surgeons and we train surgeons and OBGYNs. And we have partnered to try to make sure that that kind of specialty service gets into the community. So we work at that level. On the teaching level, we have partnerships with, for example, Children's National where our students rotate through Children's National. They rotate actually right alongside George Washington University students. We have other places such as Holy Cross Hospital in Maryland where some of our students, our residents, rotate with other residents such as George Washington. So there is a precedent that you go back very far. At one point, the District of Columbia's original public hospital, DC General, was staffed and both our Georgetown colleagues and Howard were shared that hospital. So there's a lot of precedents, not only locally but across the nation where medical schools come together to share a hospital for training. What is your expectation for how this proposal is likely to be received? So we know that the proposal as initially constructed did not include Howard. It's been amended for opportunities for Howard but the vote on its full passage has been tabled until the 18th next week. Have you gotten any insight from some of your legislative liaison, some of the people on the ground that have indicated that it may go one way or another? You know, as of today, I would tell you that I'll take a page from that old thing that it's not over till it's over. I've learned that just from, it's political in some ways. And so, you know, people get together and we negotiate one way and today you feel like people understand them. Tomorrow it may change. So no, so I do not have a feel for where this is gonna go. I think it's important for our community to understand that that although we continue to speak with the government in DC and we continue to speak with council members trying to help them to understand the importance of what we're seeking, it's not gonna be over until they take a vote on the 18th. So we don't want folks to turn around and decide, no, this is good and done because it's not gonna be done until folks vote. So I would tell everyone to stay vigilant because that's what we're doing and we're trying to make sure that, you know, we don't sing any songs until we know for sure where we stand. And the last question you kind of said, you instructed people don't see any songs until it's over. Is there anything that you feel the Howard University community and specifically those with stake in the medical school, the hospital that they could or should do to positively impact the view of what exactly Howard has to offer for this proposal? Even five years out from being built, what could they do now to support the mission of the institution and support those budding physicians who are gonna come in for a difference? You know, the most important thing we can do to support is to keep the vigilance on the council members and on the district that to continue to write the letters and make the calls and the emails and continue to explain to them and express to them the value and the importance that Howard be a part of this deal when the deal is done. Even though it might be three to four years from now the vote is occurring today. You know, it's in the immediate, not today but next Tuesday, but it's in the immediate present. That's where that vote is. It will set the stage for happens three to four years from now, which will be again too far down the road for us to reverse the track, which is why we're calling attention to this here and now.