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CHAPTER 7 Development Before the merged corporation was officially established on November 1, 1997, UCSF Stanford Health Care had acquired headquarters of its own but not at either UCSF or Stanford. "There had to be firewall between UCSF and the UCSF Stanford, which mustn't be viewed as a shadow of the University of California," says Bruce Wintroub, the recently appointed chief medical officer for UCSF Stanford Health Care.1 Furthermore, "siting the central core at either university would have been unacceptable to the other," says Robert Wachter of UCSF, "despite the schlep factor of traveling."2 Executive Park Van Etten and his colleagues had chosen Executive Park in the 3Com Center3* and located the executive offices and several of the business functions there.4 Executive Park is 10 miles from the Parnassus buildings . The trip takes 15 to 20 minutes when the traffic is reasonable. Stanford is 25 miles or about 35 to 40 minutes away. Based at Executive Park are the general counsel, the contracting officer, the marketing director, the director of materials management, the chief information officer, and the offices of auditing, compliance, and the chief financial officer with his divisions of budgeting, accounting , and accounts payable. Most of the billing functions remained at the hospital sites. Human resources, though integrated, is for the most part conducted at the hospitals. The university continues to handle personnel issues for those San Francisco employees who remain on the UCSF payroll. A former Stanford employee directs human resources, and a former UCSF executive is head of strategic contracting. New employees, *The center is located next to 3Com Park, formerly Candlestick Park or "the Stick," where the San Francisco 4gers football team plays and the San Francisco Giants baseball team used to play until it moved to the new Pacific Bell Park downtown in 2000. Candlestick Point, where the stadium is located, is said to have been named for a bird that used to populate the region.3 327 328 Mergers of Teaching Hospitals not from either site, direct finance and information systems. Throughout 1998, William Kerr, the chief operating officer of UCSF Stanford Health Care, supervised operations for each of the hospitals- UCSF, Stanford, Lucile Packard Children's, and Mount Zion - through chief operating officers at each site. Despite the reasons for creating Executive Park, the corporate headquarters aroused much criticism. Jonathan Showstack, the UCSF sociologist who studied the process leading up to the merger in his dissertation,S sees it as adding "a huge increase in administrative costs and people."6 He finds the 3Com facility "awful. It's not close to where anyone lives and is a physically unpleasant place with poorly designed space."6 "You can't run an institution like ours from Executive Park," says UCSF neurosurgeon Charles Wilson. "There's a huge geographical problem . People there get out of touch, less interested in the day-to-day problems. You get easily isolated and not smell the smoke."7 In addition to the problems of working at 3-Com, the distance between UCSF and Stanford proved to be a major distraction. "The 40 miles between the two campuses really makes a difference for doctors and patients," finds Lee Goldman, the Department of Medicine chair at UCSF. Although some arrange to do it, "It's barely manageable for most doctors to work at both campuses on the same day. "8.9* The former Harvard professor believes that the distance interferes more with uniting faculty of the two schools than does the lesser geographical separation between the principal components of Partners or New York-Presbyterian Hospital.8 The separation, however, did have at least one political advantage. "The faculty realized that the 40 miles made it virtually impossible for most of the departments to integrate despite the talk about putting together high-end services," says Dr. Robert Wachter, associate chair of the Department of Medicine. Realizing the unlikelihood of merging clinical units, many UCSF faculty members felt less inclined to oppose the merger "because it would not hurt their fiefdoms or autonomy."2 Chief Medical Officers One of the first administrative steps taken by UCSF Stanford Health Care was the creation of a chief medical officer for the merged entity *"1 got caught by a Giants baseball team playoff once," remembers Carlos Esquivel, the Stanford transplantation surgeon. "I just gave up and went back home. We tried telemeetings, wasn't the same. Once at a televised board meeting the TV went dead."9 [18.224.68.109] Project...

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