Governance of Teaching Hospitals: Turmoil at Penn and Hopkins

4. Kelley in Trouble

c h a p t e r f o u r Kelley in Trouble As he approached 60 years of age, William Kelley could look with satisfaction on his accomplishments at the University of Pennsylvania since starting there on October 1, 1989. With the help of his longtime friend and colleague, Bud Pittinger, the Hospital of the University of Pennsylvania had generated large surpluses, allowing Kelley to build a medical establishment with a size and complexity previously unknown at Penn. He had bought three hospitals and the practices of 270 primary care physicians and had constructed a system to service the capitated contracts that he and many others believed would dominate the economics of health care for many years. By directing half of the surpluses from HUP into the academic development fund for the medical school, Kelley had recruited superb scientists and clinicians, developed contemporary research programs, and constructed new buildings at the medical center and the suburbs for clinical work and research. He had sponsored a comprehensive revision of the curriculum for the increasingly competitive students Penn’s medical school now attracted. Kelley had constructed what Pittinger called ‘‘an unbelievable academic engine’’ and made Penn ‘‘one of the great leaders in academic medicine.’’∞ 78 University of Pennsylvania Those who have known Kelley throughout his career were not surprised that he had accomplished so much for Penn medicine, and similarly, would understand why he reacted as he did when the troubles descended on him. Kelley’s Education and Experiences before Penn William Nimmons Kelley was born in Atlanta, Georgia, on June 23, 1939, six days before his father began his internship. Oscar Lee Kelley had just received his M.D. degree from Emory University, where both he and eventually his son would attend college and medical school. After completing his hospital training and briefly holding a job with the prison system in Florida, Kelley’s father moved the family to Palm Beach to begin practicing as one of eight physicians in the county. Then came threeand -a-half years in the Army Air Corps during World War II. His specialty training, taken after the war, consisted of an eight-week cardiology program at one of the Harvard hospitals. William Kelley remembers accompanying his father to Boston for the course.* By 1946, Oscar Kelley was again practicing in Florida. ‘‘He took me for house calls in his Model A Ford,’’ Kelley remembers. ‘‘We were often paid in eggs and oranges.’’≤ Not all of the senior Kelley’s patients, however, paid with produce. During the winter when wealthy families came south to their mansions, Kelley’s father cared for several of them and imported surgeons from distant medical schools to perform well-paid operations on his winter clients. ‘‘I never thought of doing anything other than medicine,’’ says Kelley, whose father taught him how to insert intravenous lines as a teenager.≤ Graduating from Palm Beach High School in 1956, Kelley attended his father’s college and medical school. ‘‘Emory’s the only place I’ll pay for,’’ his father told him, and that is the only medical school to which he applied.≤ Since Emory, unlike some other universities, did not award a degree at the completion of the first year in professional school to students like Kelley, who transferred from the undergraduate college after three years, Kelley has no bachelor’s degree.† By 1963, *Now a cardiologist takes three or more years of fellowship after three years of internship and residency in medicine before qualifying to practice the specialty. †William N. Kelley: undergraduate, 1956–1959, M.D., 1963, Emory; medical intern and resident, Parkland Hospital, Dallas, 1963–1965; fellow, National Institute of Arthritis and Metabolic Disease, National Institutes of Health, 1965–1967; senior resident, Massachusetts General Hospital, 1967– 1968; assistant professor to professor of medicine, chief, division of rheumatic and genetic diseases, Duke, 1968–1975; chair, department of internal medicine, Michigan, 1975–1989; executive vicepresident , 1989–2000, dean, school of medicine, 1989–2000, chief executive o≈cer, Medical Center, Kelley in Trouble 79 when he became a doctor, Kelley had married Lois Faville, the daughter of close family friends whom he had first met in kindergarten, and was by then the mother of two of his four children. Kelley’s father had long planned that Bill would join him in practice after completing his training, but an experience in a research laboratory at Emory changed that. The visit to...