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USF Doctors' Program Loses Accreditation

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By LINDSAY PETERSON

lpeterson@tampatrib.com

Published: February 21, 2009

TAMPA - A fellowship program at the University of South Florida for doctors specializing in risky pregnancies has lost its national accreditation.

USF officials are appealing the findings of the American Board of Obstetrics and Gynecology. They said the problems have been exaggerated because of conflicts between two doctors in the program, but the university is making changes to deal with the board's concerns.

The program provides specialty training to visiting doctors. They spend one year doing clinical work and two years in research and scholarly development. The purpose of the program is to enable doctors who have completed four-year residencies in obstetrics and gynecology to enhance their skills, said Peter Fabri, associate dean for graduate medical education.

The obstetrics and gynecology board had particular concerns about the clinical portion, saying after an October site visit that the fellows were seeing too many patients without proper supervision.

The doctors see patients at Genesis Clinic, which is owned by Tampa General Hospital and treats low-income women dealing with high-risk pregnancies.

A letter Feb. 6 from the obstetrics board's executive director, Norman Gant, states that past problems with the supervision of doctors in the program seemed to have worsened.

David Keefe, chairman of the USF obstetrics and gynecology department, said he didn't understand the complaint because an attending doctor is present in the clinic. "The notion that they're unsupervised is just false. There's always an attending there."

Previously the fellowship doctors saw patients at a clinic in Manatee County, where they were not always supervised. A supervisor was available by telephone, but after a doctor complained about the "telemedicine" arrangement, the accrediting board told USF it had to stop.

Keefe said that a long-simmering conflict between two doctors involved with the fellowship is at the core of the accreditation problem.

The fellowship was placed on probation in 2005 but regained its accreditation in 2007 under Ruben Quintero, a recognized fetal surgeon and acquaintance of Keefe's who came to USF in 2006. About the same time Quintero was hired, another doctor that Keefe knew, Adam Urato, came to USF and asked to work with the fellowship doctors at the Manatee clinic.

Conflicts soon developed between the two doctors, Keefe said. Many of the problems revolved around difficulties getting attending doctors to the Manatee clinic to cover for Urato when he was not there. That led to the telemedicine arrangement, Keefe said.

But Urato complained about the fellowship doctors working without supervision and ultimately took his complaints to the accrediting board. When the Manatee program was discontinued, he said the supervisory problems were continuing at Genesis.

Keefe said Urato wanted to take over the fellowship program. Animosity between Urato and Quintero grew, and Urato eventually left to become an assistant professor at Tufts University in Boston. Quintero is leaving to join the faculty at the University of Miami's medical school.

"We had huge personality conflicts playing out," Keefe said. "It's unfortunate because I think we have a superb training program."

Urato disagreed that the problems were personal. "It's very unfortunate that he continues to try to spin it this way. ... From the beginning our concern has been about the care of poor high-risk women. The supervision was not adequate."

Valerie Whiteman will take over the program, which is being brought under the graduate medical education program. That program has supervision, monitoring and evaluation systems in place, Fabri said.

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