The chairman of the family medicine residency program at Harbor-UCLA Medical Center will remain in charge for at least nine more months and a contract detailing the relationship between the program's clinic and the county-run medical center will be established.
Those are the results of a Los Angeles County Health Department study of the beleaguered 16-year-old residency program. The study was conducted after UCLA Medical School Dean Dr. Kenneth Shine sought to replace the program's director in June.
Los Angeles County Supervisor Deane Dana had requested the study July 10 after the program's faculty doctors complained that removing Dr. Fred Matthies as chairman of the program and head of the Harbor-UCLA Family Health Clinic could be the first step toward the elimination of the program and the clinic.
The county runs physician residency programs at Harbor-UCLA, on Carson Street just west of the Harbor Freeway in Dana's district, and is affiliated with UCLA to meet academic requirements for accreditation. The clinic is in a small shopping center across the street from the medical center.
Michael Pohndorff, a deputy to Dana, said formal action by the entire board of supervisors is not needed to implement the study's recommendations.
Matthies' problems with the university began in 1981, when he successfully fought to get UCLA to pay the salaries of the program's faculty when county budget cuts threatened its future.
Three years later, the program, which trains doctors in a variety of specialties while providing low-cost medical care to thousands of the South Bay's poor and elderly, was threatened again when UCLA said it could no longer pay the salaries and the county said the clinic would have to become self-supporting.
The clinic raised nearly $150,000 in state funding and private donations, but the county said it was not enough. However, Supervisor Dana intervened and the county and UCLA agreed to continue the program. To save money, the university made family medicine part of its internal medicine department, which critics said put the program in competition with others for limited resources.
A UCLA academic review of Matthies in 1984 said he had alienated colleagues in other departments, and last year the program was placed on probation by the Accreditation Council for Graduate Medical Education in Chicago. The council cited the program's financial instability and the unsatisfactory educational environment created by the dispute between Matthies and university officials.
The program was reviewed again in May and the status of the accreditation will be announced next month.
The county report also criticized Matthies' administrative abilities, saying he had developed a "very defensive, aggressive and independent posture in his management of program activities, and on a number of occasions has disregarded the chain of command, as well as established administrative processes, to accomplish his objectives."
However, the report added that it was difficult to assess the program's leadership because of its "tenuous funding situation and uncertainties of program continuance" that have existed since 1981. The report said Matthies' attention to "programmatic and administrative details has been diluted for an extended period of time by fund-raising and lobbying activities."
After the nine-month probation period, Matthies will be evaluated by a team of independent family medicine experts and the county. The report said Matthies should be advised now as to the expectations of the county and UCLA, and informed that future violations of administrative procedures may be grounds for his removal.
The report also said that the county should continue its financial support of the program and clinic, and that a formal contract outlining their relationship with the university and the county medical center should be established.
Shine, the medical school dean, said the university will cooperate with the county and keep an "open mind" about Matthies staying on as chairman of the program.
"The school concurs with the conclusions of the report, which emphasizes the continued support of the family medicine program, and the conclusion that Dr. Matthies 'continued disregard for institutional procedures is inappropriate,' " Shine said, quoting from the report. "Our principal difference of opinion with the county is that, in fact, we believe there was a two-year period in which there was an attempt to do something about that. Our conclusion was that there was a need for a change."
Matthies said he welcomes the evaluation and explained his deviation from established procedures by saying, "The only time I left the chain of command was when I constantly got my requests denied. I'm happy to work with anyone who is willing to work with us fairly in the allocation of resources.
"I consider the report supportive. They hired me in 1979, and only recently has there been any question of my abilities."