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6. Separate Governance
- Johns Hopkins University Press
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c h a p t e r s i x Separate Governance In June 1995, the Baltimore Sun, the city’s principal newspaper, ran a story that revealed to the public that all was not well at its leading medical institution:∞ Two Hopkins titans, hospital President James A. Block and the dean of the School of Medicine, Dr. Michael E. Johns, are engaged in a fierce struggle. Once friends, they have quarreled over power and issues a√ecting their separate jurisdictions. Dr. Block, though president of the hospital and the Johns Hopkins Health System, has no authority over the medical school and its 1,000 faculty physicians. The School of Medicine is a powerful, nearly autonomous division of the university. The dean rivals the hospital president in influence on the East Baltimore campus. Sun readers now knew what most at Hopkins knew. A serious conflict between the leaders of the Johns Hopkins Hospital and the Johns Hopkins University School of Medicine was roiling one of the country’s most respected academic medical centers. ‘‘In twenty-three years, I’ve never seen anything like it,’’ a senior faculty member≤ remembers the director of one of the clinical 160 Johns Hopkins University and Hospital departments saying at the time. The resolution of this conflict would lead to a fundamental restructuring of the governance of the two institutions and how they related to each other. Two Corporations The organizations that James Block and Michael Johns would lead were founded by one man, Baltimore merchant Johns Hopkins.≥,∂ In August 1867, the General Assembly of the State of Maryland created, at his request, two corporations, ‘‘The Johns Hopkins Hospital’’ and ‘‘The Johns Hopkins University .’’ In doing so, the legislature gave formal recognition to the donor’s wish to establish separate structures for his two legacies. Although hospitals had formed their own medical schools in London and New York, only with the construction of the Hospital of the University of Pennsylvania in the next decade would an American university with a medical school first build its own teaching hospital under the authority of the university’s corporate structure. Hopkins, said to have been the richest man in Baltimore in his time, had built a fortune of approximately $7 million when he died on December 24, 1873, at the age of 78.* A significant part of this wealth derived from shares in the Baltimore and Ohio Railroad, of which only the State of Maryland and the City of Baltimore owned more shares than Hopkins.∂ Never having married, Johns Hopkins allotted most of his assets equally to the founding of a university and a hospital, each to bear his name.† It was, at the time, the largest philanthropic bequest in the history of the United States. The donor himself selected the site for the hospital on Loudenschlager’s Hill in the eastern section of the city, a portion of which had been occupied by hospital buildings since the end of the eighteenth century. The State of Maryland had decided to move ‘‘The Maryland Hospital for the Insane, at Baltimore ’’ to new buildings in the country, and Hopkins, who was a member of its board of visitors, agreed to buy the property for $150,000, the debt then owed by the institution, on condition that the city permanently close the *See the Web site in reference∂ for the obituary of Hopkins published in the Baltimore Sun, December 25, 1873. †Hopkins was named after his grandfather who had the same name.∂ Their first name derived from the family name of Margaret Johns, a paternal great-grandmother of the founder. The Johns family immigrated from Cornwall, the westernmost county of England, where the name is fairly common . The terminal ‘‘s’’ is a contraction for ‘‘son,’’ hence, ‘‘son of John.’’∑ [3.85.211.2] Project MUSE (2024-03-28 10:37 GMT) Separate Governance 161 streets that lay within the property. He gave the land to the new hospital corporation, while instructing his trustees,≥ I have given you in your capacity of trustees, thirteen acres of land, situated in the city of Baltimore . . . upon which I desire you to erect a hospital. . . . In all your arrangements in relation to this hospital, you will bear constantly in mind that it is my wish and purpose that the institution should ultimately form a part of the medical school of that university for which I have made ample provision by my will [my italics]. Hopkins’s statement that he hoped the...