Breathing New Life into Meharry

The 125-year-old historically Black medical school was on the brink of closing down, but through new leadership and partnerships, the school is financially healthy, and its students' board scores are the highest in the school's history.

By David Hefner

NASHVILLE, Tenn.

On a late July afternoon in 1994, Dr. John E. Maupin Jr. stood outside his new office building, looked over the campus of Meharry Medical College and became a bit emotional.
Things had changed since his days as a dental student at Meharry in the early 1970s. And though change was inevitable, in this case it was frightening.
"I just couldn't believe that this wonderful place that had nurtured me could have deteriorated so badly with so many good people," recalls Maupin, who, just a week prior, had been named president of the Nashville, Tenn., medical school.
What Maupin saw that afternoon were deteriorating buildings with leaking roofs, a once-thriving campus hospital in a state of crippling deficits and low patient counts, and a laundry list of
academic and financial woes — the types of problems that threaten the very existence of historically Black institutions. Meharry was at the cusp of
closing.
For whatever reason, Dr. David Satcher, now U.S. Surgeon General, had acute problems in steering Meharry away from this abyss during his tenure as president from 1982 to 1993. Paramount among Satcher's challenges was the college's hospital, which for roughly 10 years was costing the school about $5 million a year, say Maupin and school finance officials.
Struck by Meharry's condition, Maupin, 54, set out on a course of presidential action that would eventually breathe new life into the school.
And after seven years, Maupin has not only stabilized Meharry; he has nursed it back to health, due in large part to a merger with Nashville's city hospital, an unprecedented partnership with Vanderbilt University and the recruitment of some stellar faculty members. But along the way, Maupin has made some unpopular decisions. Further, he has spent so much time keeping the sinking ship afloat that he has at times neglected at times his loyal crew — the
faculty and staff.
"We had good faculty, but morale was low," observes Dr. Ruben J. Pamies, one of Maupin's key recruits hired last October as chairman of the department of internal medicine. Before joining Meharry, Pamies was dean of students at Case Western Reserve University School of Medicine in Cleveland, the first African American to hold that position.
"We were having difficulty keeping good faculty (in internal medicine department) and recruiting new faculty," Pamies continues. "Many of them wanted to leave for the prospects of better income and support in terms of computers and other basic needs. They felt they were working so hard and killing themselves and no one was recognizing it. ...I met with every one of them and said, ‘Give me a few months, and if you don't see a change, I'll help secure you another job.' Needless to say, none of them has left."
At the Brink of Death
Though Meharry was still breathing in 1993, it was obvious that if things didn't change quickly it would only be a matter of time before the critically injured medical school flat-lined and ended a storied tradition of producing Black doctors, dentists and scientists since 1876.
The school's injuries were severe: a $49 million deficit; an audit that showed the college had a "questionable" ability to pay debts; a 28-page management letter listing internal control, management and fiscal problems; a steady decline of student performance for the past 10 years, with at times less than a 50 percent passing rate on Step I of the boards and only a 39 percent passing rate on Step II. And, as Maupin says, "Every single building on this campus had a leak. I probably knew more than anyone else here how close to closing we were," Maupin says. "I had to lead a resurrection with no money."
In fact, the efforts had begun as early as 1989. At that time, then-President Satcher was given the green light by Meharry's board of trustees to begin negotiations with the City of Nashville. The plan was to close Meharry's hospital, relocate Nashville's declining city hospital to Meharry's campus, charge the city to lease and renovate the facility, while Meharry provided the medical care.
It wasn't an easy sell, but it was the college's only hope for survival.
"The underlying problem was that Meharry, through its hospital, had the responsibility of providing health care to the indigent population of metropolitan Nashville without receiving any
financial support to cover the related cost," says Donnetta Butler, senior vice president of finance and administration at Meharry, who served as treasurer from 1985 to 1991.
Before integration, Butler says, Meharry's Hubbard Hospital was turning over marginal profits because well-off Blacks who could pay for medical care offset the losses caused by those who could not. With integration, that balance ended.
"And as a result, what had been at least a marginal operation turned into a deficit operation," Butler says.
By 1989, it was clear that Hubbard Hospital was the college's Achilles' heel. And over the next four years, Satcher persuaded the city to go along with the deal as long as Meharry agreed to staff the city hospital with all board-certified physicians. By 1994, Satcher and Meharry's Dr. Henry Foster, (President Bill Clinton's 1995 surgeon general nominee), had recruited all board-certified physicians for the hospital, taking care of Meharry's end of the bargain.
But by that time, Meharry had borrowed $22 million from its endowment and $11 million from banks. Plus, it owed another $15 million to hospital vendors. And academic standards and campus upgrades had begun to give way to fiscal necessity.
"(The accrediting bodies) were very concerned about the product: the students," says Dr. A. Cherrie Epps, who Maupin hired in 1994 as a consultant to evaluate Meharry's academic program.
"Students were not demonstrating that their education was sufficient for them to be certified for timely movement. The second thing was that there were fewer students graduating than there were entering the class," says Epps who later became dean of the School of
Medicine.