In a surprise resignation, one of the top executives at Johns Hopkins Hospital will leave his position at the end of this week as the result of a disagreement over how Hopkins should reorganize for the future.
Gennaro J. Vasile, who was named executive vice president and chief operating officer in November 1992, will depart his No. 2 job at Hopkins on Friday, according to an announcement by Dr. James Block, chief executive officer of the hospital and the Johns Hopkins Health System.
Dr. Vasile was hired by Dr. Block shortly after Dr. Block came to Baltimore from Cleveland in June 1992. There was no indication yesterday that a replacement for the departing executive had been selected.
The short announcement posted at the hospital and distributed to department heads said simply that Dr. Vasile had resigned and that "differences with respect to system integration were cited as the primary reason."
The announcement said Dr. Vasile would continue his "active work in the health care field, including consulting, and he plans to continue his faculty affiliation with the Johns Hopkins School of Hygiene and Public Health."
Hopkins officials declined to elaborate on the statement.
Efforts last night to contact Dr. Vasile and Dr. Block were unsuccessful.
The Vasile resignation comes at a critical time. Last fall, Hopkins launched a "re-engineering" effort intended to overhaul the way Maryland's pre-eminent health system does business.
Hopkins faces unprecedented challenges from health maintenance organizations and other hospitals. HMOs and other insurers are demanding lower prices and more efficiency from hospitals such as Hopkins.
Acclaimed as one of the nation's best hospitals, Hopkins' rates are higher than those of most of its competitors.
Hopkins officials blame this on the large volume of free care the hospital provides to the uninsured and on the cost of training doctors.
"Insurers may be willing to pay some premium for Hopkins quality," Dr. Vasile explained when the reorganization was announced last year, "but we know we have to lower the differential. Re-engineering is an opportunity to improve our competitive positioning while enhancing quality and service."
Hopkins' problems are compounded by its decision in 1989 to sell an HMO it had formed. Hopkins tried to regain the HMO by suing Prudential Insurance Company of America, which bought the HMO.
But the suit ended this February with an embarrassing apology from Hopkins.
Before he came to Hopkins in 1992, at age 46, Dr. Vasile was president and chief executive of United Health Services in Binghamton, N.Y.