What's a department to think?

First the Utah attorney general's office is all over the University of Utah's department of pediatrics for possible violations of federal and state antitrust laws.Then the Ambulatory Pediatric Association is all over it for creating an outstanding pediatric residency program worthy of the association's 1991 teaching award.

Hospital officials found the latter attention gratifying.

"I feel fantastic. Proud," said Dr. Richard A. Molteni, acting chairman of the U.'s department of pediatrics and acting medical director at Primary Children's Medical Center. "That pride is shared by every member of our faculty."

Fantastic feelings have been scarce in the pediatric department lately. The attorney general began investigating the department last October as part of a nationwide crack down on antitrust violations by members of the medical community.

Part of the local investigation focuses on the very activities that may have helped the department win its recent award: the funneling of the U.'s pediatric residents into the Primary Children's Medical Center, owned by Intermountain Health Care, a private health-care company.

After sending its residents to Primary, the U. Hospital also sent some of its newborn and pediatric patients there as well because it didn't have enough residents at the U. Hospital to care for the tiny patients.

Dr. Michael A. Simmons, then chairman of the pediatric residency program, assigned the program's residents to Primary. Among other things, this forced the U. to staff its newborn intensive care unit with attending physicians, raising patient-care costs.

The problem was corrected when some U. pediatric residents were reassigned to the U. Hospital.

Hospital spokesman John Dwan said pediatric residents now work in the U. Hospital's adolescent unit and in the well-baby nursery. One is assigned to the newborn intensive care center and medical students and pediatric residents also see patients in the U.'s outpatient pediatric clinic, he said.

Department officials credit the marriage between the U. and Primary for playing a large role in the creation of an award-winning pediatric resident program.

Department officials completely revamped the program after Primary's new hospital was completed. The new program offers its 37 residents more responsibility for patient care, said Dr. Lucy M Osborn, department co-chairman and director of the residency program.

"This award recognizes the program's unique aspects, its excellence and the balance of education which it provides," she said. (see box.)

The Ambulatory Pediatrics Association, a professional organization for academic general pediatricians, doesn't give out kudos annually. The award only is presented when it deems a program worthy.

Co-winner this year is the Uniformed Services University of the Health Sciences, Bethesda, Md., for its program for third-year medical students.

Despite the national honor, the state's antitrust investigation still dogs the U.

U. physicians receive "ongoing antitrust counsel" to help them negotiate the murky waters of antitrust law, said hospital attorney Jonathan A. Dibble. "And we are still having ongoing discussions with the attorney general." But department officials themselves said they haven't heard from state investigators for several months. "We have been getting on with what we are supposed to be doing - winning national awards for teaching," Molteni said.


(Additional information)

How the award was won

- University of Utah pediatric residents have the opportunity to train at Primary Children's Medical Center, a private children's hospital adjacent to the state-owned hospital.

- Residents are assigned to faculty members for subspecialty rotations in such areas as cardiology, neurology, hematology and nephrology.

- Residents are involved with patients from outpatient visit, through hospital stay, and in follow-up after discharge.

- Residents are paired with practicing physicians for three years, working twice a week with them in private offices, community-based clinics and the University Hospital's pediatrics clinic.

- In addition to its usual 3-year general pediatrics training program, the U. is one of five medical schools in the country offering a 5-year track leading to triple-board eligibility in pediatrics, psychiatry and child psychiatry.