DMN vs. UT Southwestern: This Time It’s More Personal Than the Last Time When It Was Personal

It’s strange. Normally to see a fight like this, you’ve got to go out to a sports bar or pony up $60 to order the pay-per-view at home. But the Dallas Morning News and UT Southwestern are giving us this one for free. If you haven’t been following along, let me explain. No, there is too much. Let me sum up: the paper has been dogging Parkland and UT Southwestern over billing practices, a federal investigation, and, most recently, how much the paper should have to pay for open records requests. This past Sunday, the paper published two unflattering stories about patient care at Parkland. The stories further raised the hackles of Daniel Podolsky, the president of UT Southwestern Medical Center. He wrote an impassioned letter to the editor that is making the rounds and which I share below. You can read the entire thing, but here’s the crux of it:

In an effort to uncover problems — and with a strikingly absent concern for context — Dallas Morning News reporters have been publicly seeking via their blog to hear from Parkland patients who experienced complications in their care. If the reporters were to ask the opposite question, I have no doubt that they would have been inundated with stories from grateful patients whose lives were saved and transformed by the care they received at Parkland from UT Southwestern faculty working with trainees and students. The Dallas Morning News is not delivering to the people of Dallas the quality of journalism they deserve by looking for exceptions and using them to cast aspersions on the overriding quality of medical care available at Parkland from UT Southwestern attending and resident physicians and all other Parkland employees.

Right now, there are people over at DISD who are saying, “Amen!”

Listen, the paper is doing its job. But it’s only doing half of its job. Podolsky is right. With a huge organization like Parkland, if you go looking for horrific, ugly stories, you’ll find them. If you file enough open records requests, you’ll find something nasty to write about. And you should write about it. That’s how a good newspaper with a strong investigative team fulfills its mission.

But that’s only part of the mission. Because if you treat large public institutions like Parkland and DISD as only an investigative beat, your hard-working investigators will, as a matter of course, make those institutions look corrupt and incompetent. So in addition to doing the necessary investigative work, you also have to explain to your readers what’s really happening on a larger scale. That’s the context Podolsky is talking about. Giving context, though, that’s not as sexy as telling stories about operations gone awry.

To the Editor:

I write to respond to the articles published in the Dallas Morning News on Sunday, November 14, 2010 concerning clinical care provided by Parkland Memorial Hospital and UT Southwestern Medical Center.

On behalf of all the physicians at UT Southwestern Medical Center, I first want to express our deep regret for the complications experienced by Ms. Jessie Mae Ned that were highlighted in the article. Irrespective of the causes, which remain unclear, as physicians, we are dedicated to preventing suffering and to doing our best to treat and hopefully heal every patient we encounter.

Out of respect for Ms. Ned’s privacy, I will not engage in a point by point discussion of her case, but I do want to note for readers of the Dallas Morning News that the presentation of it was both incomplete and distorted.

I write to express deep disappointment that the Dallas Morning News would present an inaccurate picture of medical education and training and a story that very unfairly impugns the reputations of the highly respected and dedicated doctors and medical students involved in her care.

The anecdotal approach the Dallas Morning News has taken to writing about issues of quality of care by focusing on highly unfortunate, but also highly unrepresentative, outcomes and presenting them in sensationalized ways to imply general trends does a great disservice to its readers, this community, and our institution. There is not a hospital in the country, much less in Dallas, that does not have some number of unfortunate patient care incidents and outcomes.

While none should be ignored, focusing on them as emblematic incidents is a fundamentally misplaced approach to serious and meaningful engagement with quality of care issues. Nationally, state of the art approaches to quality improvement look not just at individual cases, but approach them systematically through institutionalized quality improvement programs, such as those at Parkland and UT Southwestern University Hospitals.

Responsible writing about patient care quality at Parkland would focus on two facts: its remarkable record of success, especially in light of its extraordinary volume of treating 43,000 patients and performing tens of thousands of procedures each year; and its ongoing quality improvement program, which is the hallmark of a first rate institution.

Medical care is complex and despite the best efforts of the best physicians, carries risks that cannot be ignored. But the Dallas Morning News does Parkland, its patients, and UT Southwestern attending and resident physicians and students, as well as other caregivers a grave injustice in publishing articles such as those in Sunday’s paper. Parkland should be viewed locally as it is nationally: as one of the biggest, busiest, and best public hospitals in the country.

In an effort to uncover problems — and with a strikingly absent concern for context — Dallas Morning News reporters have been publicly seeking via their blog to hear from Parkland patients who experienced complications in their care. If the reporters were to ask the opposite question, I have no doubt that they would have been inundated with stories from grateful patients whose lives were saved and transformed by the care they received at Parkland from UT Southwestern faculty working with trainees and students. The Dallas Morning News is not delivering to the people of Dallas the quality of journalism they deserve by looking for exceptions and using them to cast aspersions on the overriding quality of medical care available at Parkland from UT Southwestern attending and resident physicians and all other Parkland employees.

UT Southwestern faculty are proud of their long-standing association with Parkland, and I am proud to be president of an academic medical center whose students, resident physicians, and faculty are providing care to Parkland patients.

Sincerely,

Daniel K. Podolsky, M.D.

President, UT Southwestern Medical Center

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