Thursday, January 25, 2001

Cancer center aim: top-flight status

New director faces bureaucratic web

By Tim Bonfield
The Cincinnati Enquirer

        University of Cincinnati officials are hoping a new director for the Barrett Cancer Center will pave the way for developing the kind of full-scale cancer research and treatment center that many other cities already have.

        But putting the center on the map will require overcoming a history of fits, starts and unrealized dreams.

        “There is a credibility gap. I'm aware of that,” said Dr. Cecilia Fenoglio-Preiser, the Barrett Center's new director. “But there are more signs of hope now compared to three years ago.”

        Having a cancer center in Cincinnati is important because it can provide patients quicker access to world-class experts, more of the latest medical technology, and more clinical trials that test new treatments years before reaching market.

        The Barrett Center has never lived up to predictions made when it opened in 1988 that it would become the place in Cincinnati to get cutting-edge care.

        Before Dr. Kenneth Foon becoming director in April 1999, the center had been running for five years with a part-time director.

        UC's cancer research, which includes millions in grants and about 120 ongoing clinical trials, remains scattered among several departments that don't work closely together. Cancer patients can get high-end care at several hospitals. Cancer doctors linked to the Barrett Center work in a world of tangled lines of authority.

        Officially, the Barrett Center is part of the private, nonprofit Health Alliance of Greater Cincinnati, which includes the privatized University Hospital along with the Christ, Jewish, St. Luke and Fort Hamilton hospitals.

        However, the University of Cincinnati College of Medicine names the Barrett Center's director and controls most cancer research in town.

        For years the goal has been to improve the links between research at UC and local patient care. But progress has been stymied by many factions, said Dr. Foon, who stepped down as Barrett Center director after 18 months in the job.

        Health Alliance executives have a say. UC's top leaders and several different medical department heads have a say. Two physician groups have a say.

        “I was caught in the middle,” Dr. Foon said. “When I came here things needed to change, but people weren't quite ready to make those changes. I think they're more ready to make some of those changes now.”

        Dr. Fenoglio-Preiser described local cancer research and treatment as a series of small organizations with no direction. A city the size of Cincinnati, with its history of high cancer rates, should expect more.

        “Nobody has ever articulated a vision before,” she said.

        UC has developed a “millennium plan” for cancer care that calls for more integrated care, improved cancer control and preven tion, more study of clinical outcomes, and more basic and clinical research.

        An early and controversial part of the restructuring, however, includes ending a five-year contract with a private group of 30 cancer doctors called Oncology Hematology Care Inc.

        UC officials say business disagreements with the group have slowed efforts to link research with clinical care, an important part of developing a true cancer center.

        “We are very disappointed that our plans for involving the excellent community physicians in providing leading-edge medical oncology and clinical trials to all patients in Greater Cincinnati have not been successful,” said Dr. Donald Harrison, senior vice president and provost for health affairs at UC in a prepared statement.

        “Their analysis is that it's our fault. There's frustration on both sides,” said Dr. Richard L. Levy, a radiation oncologist and a senior partner in the OHCI group.


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