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In the UCSF-Stanford merger, the busiest health care workers are the doctors of spin

Wednesday, Jun 11 1997
While Stanford University and the University of California at San Francisco move to combine their hospitals into one health care behemoth, the spin doctors are working at a furious pace to win over a largely skeptical medical staff.

The result is nothing less than a deafening dissonance between the post-merger reality of cost-cuts and layoffs and administrators' rosy version of one big happy family. The dissonance is so great that employees have taken to parodying administration communiques, adding a dose of much-needed comedy.

Earlier this spring, UCSF Stanford Health Care (as the merged entity is known, or USHC for short) began publishing the weekly Transition Times, a newsletter designed to "provide quick, timely updates on current merger-related activity, decisions and plans" to employees, a recent issue explains. At least some of those employees responded with their own parody -- the Travesty Times. The identities of the Travesty's authors remain a mystery at both ends of Highway 280, but their work has been widely circulated, according to sources at both institutions.

So far, the Transition Times has reported such valuable information as, "USHC's current thinking" on employment.

The thinking is that 5 percent of the employees are about to be laid off, the remainder may well be placed in different jobs, and the administration is "investigating" benefit options.

One of the biggest issues involved in the merger is that University of California employees will no longer be able to participate in the state public employee retirement system. Transition Times reported the following details on this to employees: "USHC will offer a retirement plan to employees." According to the newsletter, the plan is "anticipated" to be one that involves a defined contribution by employees.

Meanwhile, as the Transition Times was putting its cheerful spin on breaking merger developments, the Academic Senate of UCSF, the campus faculty's governing body, held a special meeting to question whether the merger should even happen. UCSF Professor of Medicine Warren Gold called the meeting "to educate my colleagues and make up for a lack of information that is characteristic of this whole procedure," he told Synapse, the campus newspaper, in a May 1 story.

Maybe Gold and his colleagues just hadn't gotten the message yet. A later issue of Transition Times includes the heading, "Are we reaching you?"

Transition Times also regularly devotes space to legislative action. Specifically, bills authored by Sens. John Burton and Quentin Kopp, and Assembly members Carole Migden and Kevin Shelley, all requiring degrees of public accountability by the newly formed hospital and its use of $350 million in public money and assets. Consider the following excerpt from the May 20 issue:

"As various bills make their way out of committee and through the legislative process, newspaper headlines describe a grave situation. In fact, USHC, Stanford and UCSF officials continue to express confidence that they can work with legislators to satisfy concerns regarding public accountability for the merged organization while protecting the confidentiality of important business matters."

Here's how Stanford and UCSF officials were "working with" the legislators in question: The same day that issue of Transition Times went out to employees, leaders of Stanford and UCSF sent a letter to Burton and Shelley stating that the proposed legislation would "hamper the operations of the new non-profit entity so severely as to make the merger questionable." The "difficulties" of complying, the officials continued, "have led us to conclude that the pending legislation would impair our ability to function in our highly competitive marketplace." Lest any questions remain about their feelings about the bills, they state that "were these bills to become law, it is clear that the constraints would cause this merger to fail."

As a symbolic compromise, the heads of the new entity graciously offered to hold public meetings when they're ready to discuss how USHC will dispose of its public assets.

Both Burton and Shelley remain unmoved; they say they have no intention of backing off from their proposed laws, which continue to progress through the legislative process.

By the June 3 issue, Transition Times' authors were clearly losing patience with dissenters and the media. They responded to a San Francisco Chronicle editorial that backed the proposed public oversight requirements, despite the fact that the newspaper continued to support the merger itself.

"While we were disappointed in the editorial position ... in favor of the public oversight legislation as it has been phrased by Assemblyman Kevin Shelley and by Senator John Burton, we were not really surprised," the Times stated. "Public meetings and access to information are the bread and butter of the news business, and one could hardly expect an editorial position supporting restrictions on such requirements, no matter how inappropriate."

In the same issue, the Times answered an e-mail message from someone asking how to buy stock in the new company. Apparently, amid all the spin, some staffers still don't understand that USHC was formed as a nonprofit, "public benefit" corporation. The public can't participate by buying stock, only by "donating" University of California assets.

A welcome antidote to the paternalistic groupspeak of the Transition Times is the Travesty Times, which debuted May 12. Under a logo remarkably similar to its target's, it carries the following defining statement: "Providing administrative spin and demoralizing blather .... [A] publication from the UCSF Stanford Health Care transition team currently working to convince you that the UCSF-Stanford merger is as much a fact as income taxes and mass murder." The Travesty Times has a point. The Board of Regents has yet to hold its final vote on the deal, and employee groups have filed suit challenging the merger's legality on a number of grounds. That suit could take a year or more to resolve.

Tongue in cheek, the Travesty Times provides a crafty satire of USHC officials' thinking and their use of the fait accompli as a rhetorical weapon: "Oh sure, there are a few annoying legislators, caregivers, and interested members of the citizenry who keep tugging at our trouser legs about their petty concerns. You know, abandonment of the public trust, giveaway of an institution that belongs to (because it's funded by) the people of this state, refusal to speak openly about our dealings, things like that. But there are bound to be malcontents who do their little bit to impede the doings of their betters [sic] whenever any great endeavor is afoot.

"Ok, so that's fait accompli as a technique of rhetoric and propaganda. Look for it in our future announcements, publications, press conferences, and the like: we'll be giving you lots more examples. Cheap, effective, and a perfect reflection of our estimate of your intelligence."

Transition Times has thus far chosen to ignore its ridiculing. However, perhaps coincidentally, the May 20 issue, the first to appear after the parody debuted, included the heading "We listen and learn."

Merger opponents wouldn't agree.

About The Author

Lisa Davis


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