January 13, 2000

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Richmond Flowers announced that he is transferring and will play out his final year of eligibility at UT-Chattanooga. See page 25

Hi

Gift funds study of end-of-life care I A $13.5 million dona-

tion will establish Duke as a national leader in improving medical and pastoral care for the dying. By GREG PESSIN The Chronicle

$13.5 million A gift arranged by hospice innovator Hugh Westbrook, Divinity ’7O, will establish an interdisciplinary institute at Duke to study and promote compassionate care of patients in the

JOHN MOTTERN/AFP

OUTSIDE A REPUBLICAN DEBATE in Durham, New Hampshire last week, the candidates' most fervent supporters wave their banners. Voters in the Granite State go to the polls Feb. 1.

Higher ed: not a primary issue Presidential candidates are not focusing on higher education By DAVE INGRAM The Chronicle

DURHAM, N.H. The first state primary of the 2000 election cycle is only a few weeks away, and candidates from both parties gathered at the University of New Hampshire last week to outline their agendas. The debate topics ranged widely, from health care to foreign policy, but candidates said little regarding higher education and financial aid, the issues with the greatest direct impact on student life. Broadly speaking, education regularly appears near the top in surveys of all Americans’ major concerns. In a New York Times/CBS News poll conducted in early November, respondents placed education below only health

care, Social Security, the budget deficit and taxes as an important problem for government. However, the public’s focus on education usually reflects concerns about the quality of local schools, not necessarily the issues that are most important to universities and their students. “I don’t think higher education is going to be high on the agenda of any candidate,” said John Burness, the University’s senior vice president for public affairs and government relations. “K through 12 education is in such difficulties nationally that the focus is going to be there.” Indeed, most of the candidates’ conversations about education have not focused on See

PRIMARIES on page 24 P

last stages of life, President Nan Keohane announced late Wednesday afternoon. Westbrook organized gifts from the Foundation for the End of Life Care, the DadeFund of the Dade Community Foundation and VITAS Healthcare, the hospice provider he

co-founded in 1978. Using a three-pronged approach—training, public education and research and teaching—the Duke Institute on Care at the End of Life will address the ways in which caregivers, from pastors to surgeons, can best attend to the dying elderly. “I would hope the institute would have direct influence so that in 20 years from now, we would see changes in terms of public policy and care at the bedside as well as a deeper and more effective understanding of what it means to die well,” said Divinity School Dean Gregory Jones.

The institute’s work will

focus mostly on bringing together the issues—religious, financial and medical—involved in medical decisions

for dying patients and their families. “Good pain management from the medical side allows for patients to deal with the end of life and... the spiritual and other issues,” said institute director Dr. Keith Meador, an associate clinical professor of psychiatry. “On the other side, family and spiritual care will promote better pain management.” Since Westbrook founded VITAS, the company has grown into the largest hospice care provider in the United States, serving 32,000 patients each year—more than four times its closest competitor. Westbrook, an ordained United Methodist minister and now CEO of VITAS, lives in Miami. “This will be the first comprehensive institute ofits kind that will address areas with care at the end of life,” Westbrook said. “That says a lot about the status of end-of-life care. It is something that happens every day and we avoid talking about every day.... Duke’s willingness to not only study and teach but to commit

itself to delivering end-of-life care are the important elements that make Duke the unique place for the institute to be created.” In addition to doctors and See

GIFT on page 10

>

Durham Regional staff reacts nervously to financial woes By MARKO DJURANOVIC The Chronicle

Durham Regional Hospital’s severe and widely publicized financial troubles have made some of its employees uncertain about the hospital’s future. The hospital merged with Duke University Health System in July 1998 in an attempt to make it more solvent, but it now faces a serious $4.3 million deficit. This downturn has raised some concerns among employees about promises from Duke, especially the “no layoffs” policy, a Duke pledge that no Durham Regional employee would be fired within the first three years of the merger. Most employees at Durham Regional were very uneasy to talk about the issue and none were willing to go on record. “I’m thinking about the latest developments,” said an operating room employee, “but I’m not terribly concerned since there’s not much I can do about it.” His words echoed a general sense within the hospi-

Durham

officials work on

tal’s staff that Durham Regional is losing some of the independence it had before the merger. A long-time technician expressed concern over the latest developments. “I think the budgetary loss is being played up to gain a greater control of the hospital by the DUHS,” he said. “We used to have control over our own Mike Israel destiny—now we don’t.” Mike Israel, CEO of Duke Hospital, maintained that there is nothing to be gained by manufacturing a crisis. He affirmed that DUHS simply bears the responsibility for operating the hospital, while the county commissioners approve the strategic plans. However, Israel did acknowledge that in order for the commissioners to retain this power, the hospital has to

city-county

make a profit of 3.5 percent of its operating budget, “But even if someone thinks that we are Machiavellian enough to think up such a scheme,” said Israel, “they should know that we pushed back the goal of reaching a 3.5 percent margin by three years.” In general, Israel said that although he understands why employees might be worrying, he was confident that Durham Regional’s financial problems will be solved. Some employees worried about the changing character of Durham Regional. Several nurses said they would not like to see Durham Regional go the way of DUHS, becoming more like a business and less personal. Durham Regional CEO Richard Myers countered that the hospital is a business and as such has to be brought into alignment. “We simply cannot operate within a deficit,” he said. Furthermore, Israel added that DUHS is not like See HOSPITAL on page 14

merger, page 4 � Duke stings Georgia Tech,

page

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