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The story of one of the most public failures in healthcare consolidation

Merger Games

The Medical College of Pennsylvania, Hahnemann University, and the Rise and Fall of the Allegheny Health Care System

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With the research collaboration of Carla M. Messikomer and the assistant of Vicki Leeman Hall and Judith C. Watkins

Judith P. Swazey

"Merger Games is a fascinating account of one of the most ambitious efforts to merge several hospital systems and two academic health centers into a major organization, Allegheny Health, Education and Research Foundation. Dr. Swazey’s riveting description is unique, as it is based on her contemporaneous access to the principals involved in these dramatic events. This book reads like a novel and holds one’s interest from beginning to end."
Arthur H. Rubenstein, MBBCh, Professor of Medicine, Raymond and Ruth Perelman School of Medicine, University of Pennsylvania

With deepening financial problems, Allegheny Heath, Education and Research Foundation filed for bankruptcy in 1998—in the midst of its landmark merger of the Medical College of Pennsylvania and Hahnemann University. What resulted was another dire event in an escalating disaster. As civil and criminal investigations probed Allegheny's collapse, the survival of the medical school and other health sciences university schools, and the operation of the hospitals hung in the balance. Fortunately, a savior arrived in the form of Drexel University who used this opportunity to create its own medical school.

Merger Games is Judith Swazey's gripping account of this historic transaction. Based on extraordinarily detailed first-hand research and continuous inside access to the developments, this book clearly delineates who the players were and what this merger means for the future of medical education and institutional healthcare.

Merger Games is a definitive history of one of the most important academic medicine mergers in Philadelphia and the United States, which happened at a time when medical care was becoming commodified in almost every state.

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Excerpt

Read the Prologue (pdf).

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Reviews

"This is a superb book—a scholarly yet engrossing study of one of the most lurid and revealing events in the history of American medicine. More significant is what the episode reveals about the recent and current trajectory of American medicine, including its pervasion by commercialism, its abandonment of its core principle of service to the public, and its vulnerability to corruption and ‘takeover’. Through rigorous methodology and engaging and powerful storytelling, Swazey succeeds in relating this graphic tale in an engrossing way and at the same time portraying the larger context and meaning of the story."
Kenneth M. Ludmerer, MD, Mabel Dorn Reeder Distinguished Professor of the History of Medicine, Professor of Medicine, and Professor of History, Washington University in St. Louis

"This is an extraordinarily rich, sophisticated, and engaging insider’s view of the birth, complicated life, and financial death spiral of the Allegheny Health Care System. Swazey puts special emphasis on the acquisition and merger of two Philadelphia medical schools and their ultimate takeover by an unrelated university (Drexel). Merger Games will be of special interest to everyone in the academic medicine business in the U.S. The story is intrinsically fascinating, and no other researcher has had the continuous access to the principals involved in the story that the author has had."
George J. Annas, William Fairfield Warren Distinguished Professor, Chair of the Department of Health, Law, Bioethics and Human Rights at Boston University School of Public Health, and author of The Rights of Patients

"Swazey writes a detailed history.... [She] reveals the difficulty of merging the nonprofit, for-profit, and medical education cultures of American health care. She shows how a combination of corporate hubris, ambitious vision, and the sheer complexity of the merger—with its many players and multiple allegiances—doomed it to fail. The book demonstrates on a micro level the complexity of American health care, showing how on-the-ground considerations are driven by larger policy goals. VERDICT...an informative read."
Library Journal

"[A] well-written and highly detailed book that often becomes a real page-turner—and that constitutes a cautionary tale as we enter another era of frenzied buying, selling, and consolidation of health systems....Readers...will undoubtedly appreciate Merger Games’ attention to attributed quotes, detail, and extensive documentation on the perils of health system mergers and acquisitions. Anyone who focuses on medical education will be especially interested in Swazey’s recounting of how the communities of the Medical College of Pennsylvania and Hahnemann University met, gossiped, struggled, downsized, and adapted to a new business climate that no longer valued medical education in the way it had."
Health Affairs

"This is a powerful human drama of pride, overreach, and fall and Swazey tells it well. While ostensibly an 'ethnographic' study, that seeks to understand the Allegheny story through the lens of social systems theory, what elevates the volume above the merely academic is a powerful narrative drive. It’s the mystery of human character, and our desire to learn what happens and why, that holds our interest.... [I]t’s a bit of a page-turner."
Society

"[A] most thorough analysis of a major debacle in the U.S. hospital world and the medical school world.... fascinating."
Care Management Journals

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Contents

Preface
Acknowledgements
Prologue. "Honoring the Past, Creating the Future.": The Last Commencements of the HU and MCP Schools of Medicine and the First Commencement of the MCP&HU School of Medicine

Part I. Let the Games Begin
1. Setting the Stage: Hahnemann, MCP, and Allegheny
2. Entering the Merger Arena
3. If At First You Don’t Succeed: The Acquisition of Hahnemann
4. "Our Maximum Leader": Sherif S. Abdelhak

Part II. Merger Landscapes
5. Corporate, Higher Education, and Teaching-Hospital Merger Arenas
6. Merger Patterns: Human and Organizational Upheavals

Part III. Merger Games
7. Who and What We Are: Creating an Organizational Image and Identity
8. Consolidation Calendar: Tasks and Timetables
9. "Merger Guinea Pigs": The Medical Students
10. Upsizings: Institutional Expansions
11. And Downsizings: Institutional Contractions

Part IV. End Games
12.AHERF, AHERF Sat on A Wall, AHERF, AHERF Had a Great Fall (with Apologies to Humpty Dumpty)
13. Saving the University
14. No One Could Put AHERF Together Again
15. End Games: 2002-2003

Appendix. The Players: People and Organizations
References
Index

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About the Author(s)

Judith Swazey is an independent scholar and an Adjunct Professor of Social and Behavioral Sciences at Boston University Schools of Medicine and Public Health. Her publications, which have focused on social, ethical, and policy issues in biomedical research, health care, and professional education, include In Sickness and in Health: Social Dimensions of Medical Care (with Ralph Hingson, Norman Scotch, and James Sorenson); Social Controls and the Medical Profession (edited with Stephen Scher); and, with Renée C. Fox, The Courage to Fail: A Social View of Organ Transplants and Dialysis, Spare Parts: Organ Replacement in American Society, and Observing Bioethics.

Subject Categories

Health and Health Policy
Philadelphia Region
Business/Economics

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