UI Hospitals and Clinics history

University Hospital opened its doors to the public in January 1898. But the beginnings of patient service at The University of Iowa date to about 1873, when the fledgling Medical Department opened a hospital operated jointly with the Sisters of Mercy.

The eight-member medical faculty, headed by Davenport surgeon Washington Freeman Peck, had raised some $5,000 to refurbish an 1842-vintage school building known as the Mechanics Academy into a 20-bed hospital with two open wards (one each for men and women), four private rooms, and a surgical amphitheater.

To run the hospital, Peck persuaded the mother superior of the Sisters' Davenport house to send a group of nuns to Iowa City to feed and care for patients at the hospital at no cost to the University. The medical faculty, for its part, provided medical services to patients and served as the hospital's board.

Most patients at the hospital were poor because at that time, hospitals were seen as charitable institutions serving unfortunate "paupers" without means or family of their own. Counties paid for such care out of charity funds, and indeed, the Medical Department had a standing agreement by which Johnson County paid for six patients a week throughout the year at the rate of $4 per patient.

In 1885, the Sisters of Mercy relocated to a vacant mansion a few blocks away and opened an independent Mercy Hospital in 1886.

New hospital needed
Standards of medical practice and education were improving. Scientific medicine, with its increasingly sophisticated understanding of diseases (the germ theory was by then commonly accepted), replaced other medical sects The hospital was fast outgrowing its antiquated beginnings. UI officials decided The University of Iowa had to build its own hospital.

Charles A. Schaeffer, president of the University from 1887 to 1898, led the effort to gain legislative approval for the necessary appropriation. Proposing a millage tax to support construction of a new hospital and other buildings at the University, Schaeffer argued the hospital would serve hundreds of indigent Iowans who could not afford the medical and surgical care they needed.

The tax gained approval in 1896, and in less than two years the new 65-bed University Hospital was built where Seashore Hall is now located. Designed with clinical instruction in mind, the hospital boasted a 200-seat amphitheater in addition to its wards, clinics, and private rooms; steam heat and electric lights made it thoroughly modern.

University Hospital would appear quite modest by today’s standards, but then it represented a new era of patient service and medical education for Iowa.

At the time, the hospital was considered part of the College of Medicine. The organizational framework governing University Hospital reflected the focus on teaching. The hospital superintendent, charged with responsibility for the nursing and dietary care of patients, as well as the many operational details of running the hospital on a day-to-day basis, reported to the dean of medicine.

By 1914, hospital administration was increasingly recognized as a distinct profession, and the College of Medicine hired a Des Moines physician to become superintendent of University Hospital.

Working partnership
Not until 1928 did University Hospitals' own identity as a service institution begin to emerge. That's when a new medical dean, Henry S. Houghton, and a new hospital administrator, Robert E. Neff, forged a working partnership that de-emphasized the administrative lines of authority between them. Neff, who was not a physician, reported to the dean, but he enjoyed broad authority over all hospital operations except medical care.

This new attitude stemmed in large measure from the patient service obligations imposed by Iowa's indigent care program, which began in 1915, assuming statewide importance for its service aspect.

University Hospital was used until 1928 when, following passage of Iowa’s indigent care laws, patient admissions increased dramatically. This growth led to the opening of a new 735-bed General Hospital on the west campus in 1928.

Other trends continued to give University Hospitals a stronger independent identity. Gerhard Hartman, who succeeded Robert Neff in 1946, focused on patient service in the hospital's mission. Also, scientific advances made medicine more effective, spurring consumer demand that increased as hospitalization insurance became more common.

Hospital licensing and accreditation, beginning in the 1950s, made University Hospitals accountable to authorities outside the University and even the state. Indeed, it was the Joint Commission on Accreditation of Hospitals, the national accrediting body, which prompted a significant organizational change for UI Hospitals and Clinics in 1976. To address a requirement that hospitals have written bylaws and clear oversight by governing boards, the Board of Regents, State of Iowa, became UI Hospitals and Clinics’ governing body.

Independence
This gave the hospitals full independence to pursue its statewide patient care mission. Under the leadership of director John W. Colloton, the hospitals carried out an ambitious program of capital development and instituted organizational strategies to meet the profound challenges of a fast-changing health care market. What remained was to forge a new partnership with the College of Medicine that integrated UI Hospitals and Clinics’ teaching and service missions.

In 1994, a new hospitals director/CEO–R. Edward Howell–and new College of Medicine dean–Robert P. Kelch, M.D.–began working collaboratively to achieve such a balance. Howell and Kelch consulted extensively and developed the Clinical Enterprise, an innovative structure for joint oversight of all clinical initiatives of UI Hospitals and Clinics and the College of Medicine. Sharing the financial stakes and institutional responsibilities of this initiative, the partners are committed to providing aspiring physicians with top-flight educational opportunities at the College of Medicine, and providing the people of Iowa with quality health care services delivered in an efficient, cost-effective manner.

This partnership is known as UI Health Care.