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Doctors voice concerns in hospital vote

Community: M.D.s express ‘strained’ relationship with leadership at Newhall

Posted: February 16, 2011 1:55 a.m.
Updated: February 16, 2011 1:55 a.m.
 

After several years working in a “strained” relationship, doctors at Henry Mayo Newhall Memorial Hospital have issued a “vote of no confidence” against its president and chief executive officer, Roger E. Seaver, and its board of directors.

Hospital administrators say they don’t know exactly what the vote means, but regardless they remain unshaken by the vote and committed to ensuring the best possible patient care.

An attorney for the doctors’ group said efforts at dispute mediation were ongoing, but unproductive so far. A doctor identifying himself as the spokesman for the group declined to comment Tuesday.

“I’m not sure I know what it means,” Seaver said of the vote.

Seaver isn’t convinced that the vote is valid.

“The way they’re running their meetings secretly, and how they take votes, are a mystery,” he said. “I wouldn’t say it should be totally dismissed, but. if you follow normal procedures, debate an issue and then at the end of the debate take a vote and that vote is unanimous, then that would be stinging,” Seaver said.

Labor dispute
Pasadena-based heath care attorney Jay D. Christensen represents the hospital’s medical staff. Christensen confirmed that physicians on the Medical Executive Committee voted last month to endorse a vote of no confidence in their hospital leadership.

“We are in the process of trying to engage the board (of directors) in a dispute mediation process to conduct further discussions,” Christensen said. “So far, those discussions have not been fruitful.”

Christensen said the doctors voted as they did to express their concerns over “the conduct of appropriate patient safety investigations.” He didn’t provide details.

The concerns relate to patient protection and safety, he said, and policies and procedures.

The relationship between hospital administrators and their medical staff has been “strained” for a number of years, he said.
The hospital board’s chairman said one issue of contention arose six months ago when the hospital hired a chief medical officer.

“The Medical Executive Committee was upset that the board had engaged a CMO,” said James D. Hicken, chairman of the hospital’s board of directors. “A CMO is always retained by the hospital, not the medical staff.”

Hicken agreed that the situation at the hospital is strained.

“This conflict has been going on for many, many, many years,” he said.

“Is the board disappointed in the vote? Yes. What does it mean? We don’t really know,” he said, noting he, too, doubts the vote’s veracity.

“We don’t know from who all it came,” he said. “I have talked to doctors who know nothing about it.

“There’s a lot of confusion centered around (the vote),” Hicken said. “Our mission is to represent the community asset and to uphold our commitment to patient care. And we will not let anything like this deter us.”

In an effort to smooth growing tensions between administrators and medical staff, Hicken is inviting the entire medical staff general membership to attend one of a series of group meetings with members of the board.

Point counterpoint

Dr. Gene Dorio, who identified himself in an e-mail as the spokesman for the Medical Executive Committee, could not be reached for comment despite several phone messages left Tuesday.

In his e-mail to The Signal, he declined to comment due to “the legal details and the shroud of confidentiality that hovers over these problems”

Dorio revealed more of his group’s concerns, however, in a recently posted Internet blog.

On Tuesday, Seaver and hospital staff hammered out a point-by-point response to the committee’s concerns expressed by the group’s lawyer, Christensen, and articulated in Dorio’s blog.

* In the blog, Dorio maintains that the vote was in response to multiple attacks against the medical staff, including “resolutions” passed by the board disabling and nullifying involvement of physicians in hospital decision-making.

Seaver said the hospital board’s suggested policy changes are “positive” ones.

He wrote: “The board has asked the Medical Executive Committee to change some of their policies and procedures, and the board has contracted with a nationally known expert in medical staff leadership best practice to provide the committee with support and counsel on making positive changes that will support quality of care and be in the best interests of the community.”

Citing specific changes undertaken by the board, Seaver noted that it reduced the application fee, for example, for new doctors from $2,200 to a more competitive market rate of $500.

In turn, he said in his prepared response: “The board has asked the (committee) to reduce the amount of time it takes for medical staff members to gain voting rights. These changes are intended to help attract additional high quality providers to our local medical community and increase participation in decision-making.”

* Dorio wrote in his blog that the vote calls for removal of the deputy chief of staff from the board of directors.
Hicken said Tuesday no one has been removed from the board.

* Dorio claimed in his blog that some board members hold a financial conflict of interest that affects voting decisions.

Seaver in his written response said: “The board’s goal is to provide high-quality health care to our community, and in all instances to look out for the best interests of our community rather than the individual interests of the board, admin(istration) or (committee) members.”

* Dorio said that the recent appointment of a chief medical officer, which he said violates medical staff governing documents, put the hospital in jeopardy of confidentiality violations and of the Health Insurance Portability & Accountability Act, or HIPAA, which protects health insurance coverage for workers and their families.
Hicken said: “Around the country, the hospitals with the best patient-care statistics are those which hire chief medical officers.”
* Dorio said in his blog that a trusted, decorated veteran and longtime community doctor from the medical staff was removed without due process.

Hicken said reports that Dr. Frank Yusuf — one of the physicians on the hospital board of directors — had been removed were not true, and that Yusuf had attended a board meeting two weeks ago.

* Dorio alleges hospital administrators are trying to “financially affect the medical staff from having legal representation.”

Seaver replied: “The board is concerned that the attorney for the (medical committee) may be protecting his own interests and providing advice to the (committee) that is not in the best interests of the (committee), its general membership and most importantly the community.”

* Dorio said administrators have tried to undermine the credibility of “many honorable physicians” through personal attacks.

Seaver responded: “It’s the board’s belief that the local medical community is committed to their patients, desires to work with Henry Mayo and wants to participate in the decision making around the multiple and varied changes under way. Because of that, the board is reaching out to the entire general membership to meet directly with members of the board.”

* Dorio, in his blog, wrote: “Roger Seaver’s own words against doctors who are ‘not honorable’ insinuated cheating during medical staff elections and false Code of Conduct accusations.”

Seaver said: “The board values and respects the right of the (committee) to perform its duties and depends heavily on their collaboration to continue the advancements and progress already in motion at Henry Mayo.”

* Lastly, Dorio cited “acrimonious behavior targeted at a medical staff.”

Seaver replied: “The (committee) has consequently provided the board with their feedback and both groups are recalibrating their relationship to work better together for the benefit of our patients and our community.”

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