NASHVILLE, Tenn. (WTVF) — They are two very important healthcare providers in Nashville.
Nashville General Hospital is the city's safety net hospital and treats Nashville's poor and uninsured while Meharry Medical College has a long history of teaching the nation's next generation of doctors.
The hospital and college have been partners for nearly 30 years. But there's a growing rift between the two now that's threatening this decades-long partnership.
The head of Nashville General Hospital and the head of Meharry Medical College are now clearly at odds with each other.
"So Dr. Webb sent you a letter, the next day you send a letter. What’s going on?" NewsChannel 5 Investigates asked Dr. James Hildreth, the president and CEO of Meharry.
"If commitments are not being honored, and if transparency is not there, it makes it a very challenging situation," Hildreth said.
The partnership between Meharry and Nashville General goes back nearly 30 years when the city closed its own hospital and moved into Meharry's existing facility.
Under the agreement between Metro and Meharry, this would become the city's safety net hospital while Meharry Medical College would train its students and residents there.
"We just want to get back to that commitment that the city made," Hildreth said.
He believes Nashville General is no longer holding up the city's side of the deal.
And after Dr. Joseph Webb, Hildreth's counterpart at Nashville General, sent a letter to Hildreth asking for a "face-to-face" meeting, a letter that Webb also forwarded to local, state, and community leaders, Hildreth's frustration was apparent in his strongly worded response.
"When I assumed this position, I believed you and I had a shared vision," Hildreth wrote.
"What’s changed? What’s different?" we asked Hildreth.
"The hospital administration leaders started a separate entity, a practice group for Middle Tennessee, that has nothing to do with taking care of indigent patients."
Hildreth suggested that Nashville General is trying to change to a for-profit model and pointed to several off-site clinics Nashville General has opened that cater to patients with private insurance.
"The uninsured patients — who should have benefitted from those funds, and the Meharry physicians and residents who care for them — must make do with substandard facilities and equipment," Hildreth wrote in his letter to Webb.
Meanwhile, Nashville General is now hiring its own doctors which Hildreth maintained is not the way it's supposed to work.
"The overarching principle is that the medical school hires the physicians because they’re going to be responsible for teaching the learners, and if you don’t have that, it’s a very challenging situation," Hildreth stated.
"So you’re saying that the doctors Nashville General is bringing in are not training your students?" we asked Hildreth.
"That is correct," he replied.
Additionally, he said there are typically only 30 to 50 patients per night in the 150-bed facility.
"We have 430 medical students. We have about 150 residents. You cannot provide adequate learning for those students and residents with that low of a census," Hildreth said.
But perhaps the biggest point of contention right now is the professional services agreement or PSA, the contract that lays out Meharry physicians' responsibilities and how much Nashville General pays them. That agreement expired nearly two years ago. Hildreth said Nashville General has refused to sign a new one.
Webb, through his public relations team, refused to talk with NewsChannel 5 Investigates, but in a statement to us, insisted the PSA is still in place.
And at the Metro Hospital Authority meeting last week, Webb repeatedly assured board members it was.
"And that (the PSA) is still in place now?" one board member asked.
"Absolutely," Webb replied. "The contract does exist. We are providing remuneration to Meharry for the services that they perform and that is ongoing."
But we discovered in a letter we obtained that Metro Legal recently warned the Hospital Authority Board that the PSA had in fact expired in March of 2023 and cautioned the regulatory and legal problems that can arise without one.
When further pressed by the board, Webb assured them he was working on it.
"We’ve had numerous meetings discussing opportunities to move forward, and we are still having those meetings," Webb told the board.
"Dr. Webb says negotiations have been ongoing and regular meetings?" we asked Dr. Hildreth.
Our camera captured Hildreth's initial look of surprise and disagreement on his face after our question.
"Well, I really can’t... I don’t want to comment on that. I don’t have any animosity towards Dr. Webb."
We pressed.
"But the look on your face there when I asked you that question was like, 'No, that’s not right?'"
But Hildreth declined to comment further.
Webb told us in his statement that "Nashville's healthcare future is too important to be overshadowed by distractions or infighting."
And in that same statement, Webb also insisted that "Nashville General does not owe Meharry Medical College millions of dollars."
Yet, we obtained a billing statement that appears to show the hospital does owe Meharry more than $7 million for unpaid physician salaries, utilities and parking charges.
"We (Meharry) are not going anywhere. We intend to be here for a long time," Hildreth told NewsChannel 5 Investigates.
But he added that in order to fulfill their mission of treating Nashville's poor and training future doctors, Meharry needs a partner that’s willing to work with them.
"So let me ask you what have you heard from Dr. Webb since you sent that letter?" I asked Hildreth.
"Nothing. I don’t expect to. I don’t expect to hear from Dr. Webb," he told me.
After we talked with Dr. Hildreth, he did get a response from Dr. Webb. It was another letter with dates and times that Dr. Webb said he's available to meet with Dr. Hildreth.
No word yet on when or if that meeting will happen.
Now this is the city's hospital. And in the last week, Mayor Freddie O'Connell has repeatedly voiced strong support for Dr. Hildreth as well as the work that Meharry is doing. However, he has also questioned whether Dr. Webb and his team are truly on board with this partnership.
This all comes as Webb is pushing for a new $700 million hospital, which would clearly need support from the city.
Mayor O'Connell has said that unless a new professional services agreement is signed, and it's clear that everyone is on the same page, there’s no reason to pursue a new hospital.
