For example, in 1996, Alan Hevesi (then Comptroller of the City of New York) cited Columbia University with “widespread fiscal mismanagement” in a major financial audit of the University’s 56 million dollar affiliation contract to staff and operate Harlem Hospital.  The allegations of fiscal mismanagement were quietly settled with the University returning 2 million dollars to New York City’s Health and Hospitals Corporation. The detailed text of this audit was never released to the public, and for good reason.
     We were able to obtain a copy of the 110 page document.  Pages 8-10 are asummary of the findings of the Hevesi audit.  In addition to the recitation of the allegations of serious financial fraud, this summary exposes the fact that patient care had been seriously compromised as a consequence of what the report refers to as a “fiscal theft” of service.  Pages 17-19 document instances of “double dipping” in which Columbia Presbyterian Hospital attending physicians with part time assignments at Harlem Hospital received salaries from both the City of New York as well as Columbia University for overlapping hours. That is, they were supposed to be working at one facility when they were actually at the other. They were paid twice for working at two facilities at the same time (p.8)  This meant that one or the other facility and its patients were being defrauded of the scheduled time the fully trained physician was supposed to be present.  Clearly the community had been put at risk or harmed by the absence of these attending physicians.  These physicians were neither present to supervise house staff nor to deliver patient care.

         The Hevesi report dealt with Columbia University’s fraud of Harlem Hospital and consequently the health of the African American community of Harlem in New York City.  Pages 52-55 document specifically how the AWOL “double dipping” Columbia physicians had a direct impact on patient care at Harlem Hospital.
            As noted in the Hevesi report, it is an accepted standard of graduate medical education that medical trainee house staff who read x-rays in an emergency room are to have these x-rays re-read by fully trained radiologists within 24 hours. Serious and consequential decisions are made on the basis of these x-rays and safe practice demands that a fully trained physician be required to check the work of the trainee. There were numerous indications in the Hevesi audit that this practice was being ignored, most likely
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