Physicians seek solution to HRMC-ER dispute

The Haywood County medical community was expected to voice its disatisfaction Tuesday night with a move by Haywood Regional Medical Center CEO David Rice to oust a long-time group of emergency room physicians and turn over the ER to a corporate physician staffing agency.


A countywide meeting of doctors was held Tuesday night (Dec. 12). The Smoky Mountain News had already gone to press when the meeting concluded. In interviews with several doctors prior to the meeting, however, it appeared the medical community would call for the hospital administration to reconsider its decision.

“We feel like for the betterment of the community we need to come together and find a better solution,” said Dr. Stephen Wall, a pediatrician and member of the medical executive committee. “I think it still can be done. I don’t think it is too late.”

The hospital board voted unanimously two weeks ago to replace Haywood Emergency Physicians even though there were 18 months remaining on the group’s contract. The board was acting on the advice of hospital CEO Rice, who has been engaged in a power struggle with the ER doctors for some time.

Hospital board members said the move to cancel the contract was not a reflection on the quality of care the current ER doctors provide. Instead, most in the medical community see the move as a result of ongoing personality conflicts between Rice and a couple of outspoken ER doctors.

“We get a sense that there is hurt feelings and confrontation and anger on both sides of the issue,” Wall said. “We really want to try to bring people together and diffuse the situation. I think the hospital board has a tremendous responsibility to step up and continue to look into the situation and try to find a solution that really makes this a win-win instead of a lose-lose.”

The medical community is largely unified in its call for the hospital board to restore its contract with the current ER doctors.

“I think the administration has made an awful mistake,” said Dr. Joyce Hooley, a pediatrician.“I can’t imagine anything short of patient care that would justify this, and they’ve said that patient care is not the issue. They have let some other issue cloud their judgement on this. They have gotten into some kind of power struggle rather than thinking about what is good for the whole community.”

The hospital board has been stuck in the middle of a conflict between Rice and the ER doctors for the past year and a half (see related article). While the hospital board has attempted to sort out conflicting information from Rice and the ER doctors, most in the medical community see this move as hasty.

The medical community approves of the quality of care provided by the ER doctors, according to nearly a dozen doctors interviewed for this article.

“The medical staff by and large is very satisfied and respects our current emergency department physicians. They are group of excellent doctors providing excellent care,” said Dr. Henry Nathan, a gastroenterologist.

“Quality of care is absolutely the most imporant issue there is. That’s paramount, and the quality of care is not at all an issue, so it seems a fairly drastic step to take,” said Nathan.

That sentiment was echoed several times over.

“The internal medicine department is pleased with the care Haywood Emegency Physicians provides to our patients when they are in the emergency department,” said Dr. Craig Linger, the chairman of internal medicine, speaking on behalf of his department. “We’ve relied on them for years and we are hopeful that a settlement can be achieved that will continue to allow them to staff the emergency department.”

Doctors are also concerned that the move will hurt their ability to recruit new doctors to the community. Doctors do not want to come to a hospital where there is a hostile relationship between doctors and the hospital administration, but that’s exactly the perception this incident will likely leave, according to doctors.

“You want to have a harmonious relation with hospitals you work in,” said Dr. Slobodan Jazarevic, a surgeon. “You can’t be adversarial with the hosptials you work in, and hospital administration can’t be adversarial to the physicians. When something like this happens, you wonder are you the next one on the chopping block?”

Wall said the medical community “is depending on a stable, sensible solution.”

“This hospital has come a long way in the past 15 years,” Wall said, crediting Rice’s vision and leadership. “So much positive has happened and it has only happened because this administration has chosen to work carefully and successfully with the medical staff. You can’t have a good hospital without both.”

Several doctors who spoke under condition of anonymity shared similar views and concerns as those expressed by doctors quoted in this article.

The hospital board will meet on Thursday, Dec. 21. No matter what the board does at this point, it will be breeching a contract with someone.

The hospital has already signed a contract with a corporate physician staffing agency called Phoenix to run the ER starting Dec. 28. But the hospital still has 18 months left on its contract with Haywood Emergency Physicians.

Haywood Emergency Physicians has indicated it will sue the hospital for a breach of contract. Chris Lutes, the manager of Phoenix, would not say whether Phoenix would sue the hospital for a breach of contract should the hospital board reverse its decision in light of the outcry from the medical community.

“We have a signed contract,” Lutes said.

Haywood Emergency Physicians also has a signed contract, said Dr. Mark Jaben, who was appointed by Haywood Emergency Physicians to be its spokesman on this issue.

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