The records of the Vice Provost for Medical Affairs document a remarkable decade in the history of the University of Michigan Medical Center. Beginning with the appointment of George Zuidema in 1983, the records document the completion of the massive Replacement Hospital Project, and by the time of his retirement in 1994, provide evidence of the increasing competition brought about by managed health care.
In February 1983 President Harold Shapiro proposed to the Board of Regents the creation of a new position, Vice Provost for Medical Affairs. The position, approved by the Regents, was designed to improve the administrative reporting structure for the Hospital and Medical School on behalf of the university's executive officers and the Vice President for Academic Affairs. The position created a single node of responsibility by having the Executive Director of the Hospitals and the Dean of the Medical School report to the vice provost while also maintaining the Medical School within the university's academic structure. At the same time, the Vice President for Academic Affairs was redesignated as Vice President for Academic Affairs and Provost to include the Vice Provost for Medical Affairs within the Academic Affairs administrative structure.
The origin of the Vice Provost for Medical Affairs position dates back to the administrative reforms called for in the 1968 report of the University Hospital Study and Advisory Committee chaired by Fedele Fauri. Popularly known as the "Fauri Committee," the committee recommended the creation of the Medical Center as an administrative entity consisting of a director and a board in control. The Medical Center was conceived to include the Medical School, School of Nursing, and University Hospital, recognizing the need for coordination of teaching, research, and patient care among these units. The report called for the creation of the position of Director of Medical Center-Dean of the Medical School combining the administration of the Hospital and Medical School under one office. In 1969 the Regents approved the plan provided that a review of the effectiveness of the reorganization would occur within five years. William N. Hubbard continued as Dean of the Medical School and assumed the role of Medical Center Director. He resigned in 1970 and was replaced by John A. Gronvall.
In 1973 The Medical Center Review Committee, chaired by Alfred Conard, studied the administrative effectiveness of the Medical Center. The committee found that having the same individual serve as Dean of the Medical School and Director of the Medical Center created conflict and recommended the creation of the position of Vice President for Health Affairs to have general responsibility for the health science schools (Medicine, Dentistry, Nursing, Public Health, and Pharmacy), and the Hospital in the planning and development of programs and resources in health education research and patient care. The report recommended that the directorship and the Board in Control of the Medical Center be discontinued when a Vice President for Health Affairs was appointed. The Regents did not adopt the creation of a Vice President for Health Affairs, but did vote to abandon the Medical Center administrative structure.
With the dissolution of the Medical Center in 1974, the Medical School and School of Nursing reported to the Vice President for Academic Affairs. The Hospital reported to the President through a newly-constituted Hospital Executive Board consisting of three vice presidents, the deans of the Medical School and School of Nursing, the chief of clinical affairs, the hospital director, and two members from the medical/dental staff. Board was chaired by the Dean of the Medical School and later by the President.
Increasing demands on the President's time and the fact that the Medical School and Hospital were reporting at two different levels, led to further discussions regarding a vice president for health affairs.
In 1978, President Robben Fleming proposed the creation of the position Provost for Medical Affairs to coordinate the activities in the health sciences, particularly the Medical School and the Hospital. The recommendation was placed before the Regents who deferred action on the proposal. The idea of a vice president for medical affairs was revived the following year, and the issue was discussed in 1980 by a subcommittee of executive officers chaired by Billy Frye, Vice President for Academic Affairs. Owing to strong resistance from the health science schools, the proposal finally advanced in 1983 limited direct oversight to the Medical School and Hospital.
After a lengthy search, George D. Zuidema was appointed as Vice Provost for Medical Affairs and professor of surgery, and assumed office on April 1, 1984. Zuidema, an accomplished scholar and medical administrator, received his B.A. from Hope College in 1949. In 1953 he received his M.D. from the Johns Hopkins School of Medicine. From 1960 to 1964 he was an assistant and then associate professor of surgery at the University of Michigan and in 1963 was the recipient of the university's prestigious Henry Russel Award. In 1964, Zuidema returned to Johns Hopkins where he held the dual appointments as professor and director, section of surgical science at the Johns Hopkins University School of Medicine and surgeon-in-chief of the Johns Hopkins Hospital.
Returning to the University of Michigan, Zuidema held responsibility for bringing about integrated planning between the Medical School and the Hospital in response to the rapidly changing nature of the health care industry and the delivery of health care. He oversaw the completion of the Replacement Hospital Project and the subsequent activation of the new Alfred A. Taubman Health Care Center in 1986. He also assumed a leadership position for the development of information systems within the Hospital. As Vice Provost for Medical Affairs, Zuidema developed a strategic planning function leading to the formulation of a mission statement and goals and entry strategies to guide the Medical Center into the 1990s. To help the planning process Zuidema created the Vice Provost Advisory Board (VPAB), consisting of the Medical School Dean, Hospital Director, Chief of Clinical Affairs and other key staff to advise the Vice Provost on issues affecting medical units. The Medical Center Facilities Advisory Committee (MCFAC) was established to oversee Medical School and Hospital facility proposals. The Vice Provost also advised the executive officers on Medical Center issues through a series of monthly briefings.
In 1986 President Shapiro ftirther clarified the objectives of the position and added sign-off responsibility for all Medical Center budgets, including the Medical School, Medical Service Plan, Hospital, and affiliated units such as the M-CARE corporation. To provide a coordinated approach to planning and operations, a reporting line was added to the Vice President and Chief Financial Officer. The position continued to monitor emerging policy issues in the medical care and medical education arena on behalf of the university's executive officers and Regents.
Administratively the Vice Provost for Medical Affairs had oversight of the Medical Center Office of Marketing, Office of Medical Center Development, Office of Health Science Information Technology and Networking, Medical Center Health Sciences Government Relations, Historical Center for the Health Sciences, Substance Abuse Center, the Transplant and Health Policy Center, the Genome Ethics Committee, and the Program in Society and Medicine. The Vice Provost for Medical Affairs Office was staffed by a senior assistant to the vice provost in charge of finance, and two assistants to the vice provost.
On July 1, 1994, George D. Zuidema retired as Vice Provost for Medical Affairs. In 1995 he was honored with the establishment of the George D. Zuidema Professorship of Surizery at the Medical School. The responsibilities of the Vice Provost for Medical Affairs were dispersed and the office disbanded following Zuidema's retirement. A new office, Vice Provost for Health Affairs was created in 1994 and filled by Rhetaugh G. Dumas, former Dean of the School of Nursing. The new position discontinued the direct oversight of the Medical School and Hospital in favor of indirect supervision of all health science schools and units.
