Contributed by George H. Kamp, M.D.—November 30, 2001
The choices made by a county medical society’s staff and physician leadership impact the success of the group profoundly. Just as an individual’s choices all have consequences, the group’s collective decisions may result in growth and strength, or bring about the decline of the organization. Nowhere is this better illustrated than when a medical organization decides to become involved in a broad community issue. Also, even after such a choice is made, there is a fine balance between the enthusiasm of the physician leaders and the judgement and resources of the professional staff. The Tulsa County Medical Society has done well historically in making choices and has indeed been fortunate to have remarkable wisdom and stability in its staff.
One man’s personal conversation with God led to the Tulsa County Medical Society ‘s involvement in a controversy of national interest in 1977. The man to whom God spoke directly was Reverend Oral Roberts, president of Oral Roberts University in Tulsa. As reported by Oral Roberts soon after the conversation, God was quite clear in His command that Reverend Roberts should solicit donations from his “prayer partners” to build a 777 bed hospital in Tulsa. The complex should include a 60 story physicians office building, a 30 story hospital, a water course called “the river of life”, and an entrance marked by a multi-story sculpture of two praying hands. It was to be named the City of Faith, and was to combine the healing benefits of prayer and medicine.
Public announcement of this project in the fall of 1977 was followed immediately by a great deal of spirited discussion among the members of Tulsa County Medical Society, as well as hospital officials and the general public. Both the television stations and local newspapers began covering the issue extensively. At this time, Oklahoma law required any new hospital construction in the state to go through a certificate of need review process. This consisted of review and comment by a local Health Systems Agency and final decision by the Oklahoma Health Planning Commission. This commission had three members, all of whom were employees of the state. The two physician members were the state Commissioner of Health and the Director of the Department of Mental Health. The third member was the Director of the Department of Human Services, Mr. Loyd Rader. The Commissioner of Health was Joan K. Leavitt, M.D. and the Director of the Department of Mental Health was Hayden Donahue, M.D.
Physician members of the Tulsa County Medical Society served as board members of several Tulsa hospitals and thus had a direct interest in the potential impact of construction of new hospital beds. Although the three largest hospitals in Tulsa had an average occupancy of approximately eighty per cent, the Tulsa Hospital Council reported an excess bed capacity of 1000 beds, comparing actual occupancy with licensed bed capacity. Oral Roberts officials, including Dr. James Winslow, Oral Roberts vice provost for health affairs, countered these statistics with their belief that most City of Faith patients would come from outside the Tulsa area.
Another area of major concern for members of Tulsa County Medical Society was the effect on medical education. At the time of the City of Faith announcement, the University of Oklahoma College of Medicine at Tulsa had been educating junior and senior medical students in Tulsa hospitals for two years. Affiliation agreements between the medical school and the hospitals were required for the medical school to be accredited. These agreements were in place for the University of Oklahoma. Additionally, Oral Roberts himself had previously announced plans for a four year medical school at his University, and he was actively negotiating for the required hospital affiliation agreements prior to announcing the City of Faith project. A second medical school, the Oklahoma College of Osteopathic Medicine and Surgery, also was in Tulsa and there was considerable debate as to whether the community could support three medical schools.
This particular aspect of the debate was resolved immediately with the announcement of the City of Faith project. Negotiations between Oral Roberts and the existing hospitals for the affiliation agreements ceased. The attorney for the Tulsa Hospital Council, Mr. Earl Sneed, stated “When Oral Roberts announced this new facility, the Tulsa hospitals withdrew in shock.” The prospect of a new competing hospital united the other hospitals in their opposition to the proposal and indicated the powerful nature of the struggle. Members of the Tulsa County Medical Society were concerned about potential oversupply of both physicians and hospital beds.
At the final meeting of the Tulsa County Medical Society in late 1977, there was discussion of the far-reaching effects of the Oral Roberts project, but no formal action was taken. After the meeting adjourned, the outgoing president of the society, Dr. E.N. Lubin, asked Dr. George Kamp, the incoming president, what his plans were in the matter. Dr. Kamp responded that he believed the society should be involved in the issue, and in some rational way communicate to the general public the informed opinion of its membership. Additionally, he believed the society must be involved in the state’s Certificate of Need review process. Dr. Kamp also told Dr. Lubin he didn’t really have any idea how to do these things. This appealed to Dr. Lubin’s sense of humor, and the discussion ended with this very loose plan. Fortunately, the executive director of the society, Mr. Jack Spears, was a master of shaping loose plans into workable and logical actions, which reflected well on the society.
Emotional arguments about the City of Faith project were widespread in Tulsa in late 1977 and early 1978. Some members of Tulsa County Medical Society supported the project and contributed to it. Others were opposed, but none of the approximately 645 members were unaware of the issue. Publicity was heavy, and the Oral Roberts fund raising organization was actively soliciting donations with considerable success. When these efforts faltered briefly Oral Roberts had a vision of a 900-foot tall Jesus, and donations again increased. Many community leaders offered their opinions publicly, including a prominent surgeon who observed in the Tulsa World that having a direct conversation with God was often taken as a sign of mental instability. In this atmosphere, potential certainly existed for the Tulsa County Medical Society to be drawn into a position which would be internally divisive. Part of the challenge was for the group to take a meaningful position without alienating significant numbers of its own membership.
Written requests for the Society to take a position reached the Board of Directors in early January, 1978. Initially, the board considered calling a general membership meeting for discussion, debate, and drafting an official position. Concerns were expressed by several board members that this approach might worsen controversies and not lead to a well thought out or even representative opinion. Additionally, it was noted that opportunities for verbal presentations and spontaneous interaction for Tulsa physicians existed at the public hearings scheduled by the Oklahoma Health systems Agency and the Oklahoma Health planning Commission.
After lengthy consideration, the Tulsa County Medical Society board on January 23, 1978 decided to perform a written survey of its membership. The many complex issues involved precluded a survey of every aspect of the matter, and the board chose to proceed with a single question, attempting to reach the core issue. The survey ballot which was developed asked very directly and simply if the physician member believed the City of Faith Hospital was needed and if he favored its construction. The ballot was promptly mailed to all 645 members of the Society. A remarkably high number were returned, a total of 488 ballots were returned in a timely manner, reflecting the opinion of 76% of the membership. Of the ballots returned, 78% opposed the project and 22% favored it.
The officers and staff of the Society now had the opinion of the membership and proceeded to share this. This was received with considerable interest by local television stations and newspapers, as well as the agencies involved in the Certificate of Need process. By late February 1978, the Oklahoma Health Systems Agency had completed its public hearings, consideration by board and staff, and had recommended rejection of the City of Faith project. This recommendation then went to the three person Oklahoma Health Planning Commission for final decision.
This decisive meeting was held in Oklahoma City on April 26, 1978. The stage was set for a major media event. Oral Roberts had appealed to his followers to contact the three members of the Health Planning Commission; they received approximately 310,000 pieces of mail and nearly 3000 telephone calls. Both houses of the Oklahoma legislature passed resolutions urging the Commission to approve Roberts’ application.
The hearing room for this meeting was completely packed. Dr. Kamp presented the opinion survey opposing the project. He was one of many who testified during the three-hour hearing. A member of the Oklahoma Legislature, Representative Guy Davis, cited scripture in favor of Roberts. Roberts himself presented an emotional plea; his attorney also testified. Dr. Winslow testified that 506,000 prayer partners had contributed more than 27 million dollars to the project. The executive director of the Commission, Mr. Jack Boyd testified that there was no need for new hospital beds in Tulsa. After brief deliberation, the commission voted 3 to 0 to approve the project. Oral Roberts rejoiced, and announced that construction would begin that afternoon.
The Certificate of Need granted allowed the opening of 294 beds of the proposed 777-bed facility. Construction was completed in 1981, and the facility received its first patients on November 2, 1981. It opened with 71 regular care beds and 8 intensive care beds. President Roberts stated the facility opened debt free and cost approximately $250 million.
The large numbers of patients hoped for never came, however. Both the hospital and the medical school ultimately were closed, and the praying hands statue moved to another location on the university’s campus. Given the perspective of time, it appears that the Tulsa County Medical Society was appropriately involved and grew stronger through this interesting chapter in its history.