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Wednesday, 20 December 2006 00:00

Public forum shows loss of community confidence in HRMC leadership

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By Becky Johnson • Staff Writer

Community outrage with Haywood Regional Medical Center continues to escalate over a move by hospital administration to oust a long-time group of emergency room doctors.

 

At a town meeting sponsored by Haywood Emergency Physicians Tuesday night, emergency room doctors urged the public to keep supporting the hospital in light of the controversy.

“Don’t abandon the hospital,” Dr. Tom Sither of Haywood Emergency Physicians told an audience of 75 people. “None of us want the hospital to be abandoned even though we disagree. We have been cheerleaders for the hospital for many years, and we don’t want the hospital to suffer.”

Unfortunately, that is a likely outcome. The hospital is slated to turn over ER operations to a corporate physician staffing outfit on Dec. 28. But the new outfit only has one or two doctors lined up at best, according to Haywood Emergency Physicians. The new doctors will be unfamiliar with the ER layout, the computer system, the nurses, the ambulance drivers, and the workflow in general. In addition, no one has talked to the current group of ER doctors yet about how the transition will happen.

“There has been on communication from the hospital about how to manage midnight on Dec. 28,” Dr. Mark Jaben said. “If I have a patient at 11:59 p.m., what do I do at 12:01 a.m. when I’ve been terminated?”

The new corporate staffing outfit, Phoenix, maintains it has an excellent transition plan but would not share the plan with the current ER doctors, Jaben said.

“They said it was proprietary,” Jaben said.

While Phoenix representatives have said they already have some doctors lined up, none have been credentialed by the hospital yet. They had counted on a significant number of the current ER doctors staying on under the new corporate staffing outfit, but that’s not happening. Only one of the 10 is willing to stay.

Audience members asked who in the world Phoenix will find to staff the ER with the change slated to occur just eight days from now.

“The doctors they will manage to bring in the first days or weeks will probably be flown in to do a shift or two at an exorbitant rate that Phoenix is willing to pay to get through these first few weeks,” Dr. Ely Zaslow said. “There is a very consistent pattern to how these groups work.”

Mission Hospital in Asheville is concerned about the Haywood ER upheaval, according to a letter sent by Mission to Haywood Regional this week. Leaders of Mission Hospital fear if the ER changeover goes through as planned, they could be swamped with patients who are avoiding the Haywood Regional ER. Doctors in other specialties fear there will be a trickle-down effect that could affect the entire medical community in Haywood

Members of the audience and the medical community suggested that the ER doctors are the victims of hospital CEO David Rice, who has manipulated the hospital board. Rice controlled the flow of information to the hospital board, sequestering them from information he didn’t want them to have.

“It seems to me there is a lack of communication, a disconnect,” one member of the audience said.

The ER doctors agreed.

“How has the board made its decisions? With what information and from who?” Jaben said. “One of the big issues in all of this is who is hearing what, from whom and when.”

When the doctors were asked if there is anything they would do differently in hindsight, Sither said that while serving as the hospital chief of staff in 2005 he should have done more to open lines of communication between the hospital board and medical community.

“I wish as chief of staff in 2005 I had taken the initiative to have more communication between the board and medical staff so this wall that has been built up for various reasons could been taken down,” Sither said. Sither said the board needs to hear a variety of opinions from the entire medical community, not just hospital administration, in order to make informed decisions.

A couple of times in the forum, audience members spoke poorly of Rice, even calling for his resignation. The ER doctors attempted to diffuse those comments, however.

“We are not advocating for Mr. Rice to lose his job,” Jaben said. Jaben said they just want to keep theirs.

“We have been here a long time and would like to stay and continue to take care of people in this community,” Jaben said.

One audience member said the ER doctors should sue the hospital for a breach of contract.

“Litigation is only thing that would bring this to a head,” said Roscoe Wells.

The ER doctors said they do not want to do that, however.

“We are still hopeful this could be turned around,” Zaslow said.

Jaben said they are putting their faith in the hospital board to reverse or at least delay the contract with Phoenix to give the current ER doctors and the hospital time to mediate a resolution. It is unclear whether the board will reconsider, however.

“The board is being told now to ‘Dig in. It is going to blow over. Don’t back down. We’ll make the change and it will go away,’” Zaslow said. “But it is not going to be over. Just because we are not there on the 28th, just because we are gone doesn’t mean we can’t come back.”

Another audience member said it is up to the public to keep the pressure on the hospital.

“If we sit here and let this happen we have nobody to blame but us,” said Harley Caldwell, an audience member.

(For a more detailed report on the Q&A portion of the forum, go back to the home page and click on “ER doctors hold Q&A”)

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