Some of the world's most respected medical specialists work at the UCLA Medical Center. Or at least they used to.

High-profile specialists are fleeing UCLA in favor of fee-for-service hospitals that have promised them state-of-the-art equipment and higher pay.

These physicians, some world-renowned in their fields, say UCLA has made a push to sign more contracts with health maintenance organizations, which means the hospital has been forced to drastically trim costs and cut back on the support given to many specialists' research projects.

"Two or three years ago, UCLA made a conscious effort to get into the managed care medicine game. To be honest, no one goes into managed care to improve the quality of care but to make more money. And the only way you can do that is to cut services," said Dr. Rick Delamarter, an orthopedic surgeon who left UCLA six months ago after 13 years with the institution.

Delamarter is one of a handful of key specialists who have abandoned UCLA. They include world-renowned neurosurgeon Keith Black, urologist Gerhard Fuchs and orthopedic surgeon Matthew Shapiro.

Delamarter was one of UCLA's busiest surgeons. As co-founder of UCLA's Comprehensive Spine Center, he performed 400 to 500 surgeries a year, treating professional athletes and international government leaders. He declined to identify patients by name, but said they have included members of the Oakland Raiders, Denver Broncos, Miami Dolphins, Olympic gold medalists, and heads of state from Canada, France and Saudi Arabia.

The orthopedic surgeon said he decided to leave the renowned medical facility in Westwood because he felt the quality of patient care had declined and that the medical center was no longer interested in buying expensive state-of-the art equipment.

When Delamarter left to set up the Spine Institute at St. John's Health Center in Santa Monica, he took two other spine surgeons with him.

"When you get into a subspecialty and develop an international reputation, 30 to 40 percent of your patients come from out of state or out of the country. They expect a certain level of care," Delamarter said. "With all the cutbacks that UCLA has had to do, they were not able to deliver that quality of care.

"They were not able to support my research programs in a similar way," he added. "I have a busy research lab that is doing cutting-edge things on spinal cord regeneration. The university had a philosophical change (about research) with this whole managed care thing to cut costs."


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