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Wednesday, 27 December 2006 00:00

It is a sad day, indeed

Written by 

Thursday night, the Haywood Regional Medical Center Board chose to breach the hospital’s contract with Haywood Emergency Physicians rather than consider mediation, as proposed by the medical staff.

They produced an inch-thick document in an attempt to “correct the misinformation.” In doing so, the hospital gives us all an invaluable insight into their way of doing business.

Their timeline documents the many exchanges that occurred in what they call a non-negotiation, beginning in May 2006 when HEP first asked the hospital for help. It is interesting that its sixth entry involves the Meditech Information System. It contains wording that misrepresents the tone and substance of some exchanges, as at the Oct. 6 medical staff meeting, where they refer to HEP’s criticism of the administration rather than acknowledging the broad-based medical staff concerns voiced there.

Over half the packet contains documents dated before May 2006 that were never brought up in the negotiation. At least two five-page documents sent from our lawyer are left out. It quotes our lawyer’s statements out of context. They fail to highlight information that either puts things in its proper context or outright counters their opinions.

For instance, there is a 2005 report from the Emergency Department Medical Director that chronicles the many factors affecting patient turnaround time. The board was impressed with this report. They directed the CEO to convene the ED Oversight Committee to address these issues, including, among others, “identifying barriers which are preventing all departments from working together;” identifying delays in admissions; nurse staffing issues, and doctor staffing issues.

In the Mountaineer on Dec. 20, the vice president of nursing says “there are multiple factors that cause delays in the emergency department.” Three paragraphs later, the CEO says, “The physicians are the problem.”

The adjoining article on Dec. 20 depicts the challenges faced by any emergency department. In comparing national survey data, it shows “that HRMC performs much better than national average.” Through this last three months, the hospital has continued to run ads extolling the rapid, efficient care patients have received in the ED.

When taking care of you, the doctor must consider all the facts and figures, dig for further information, do the appropriate homework and display the necessary curiosity in making the best possible diagnosis. The doctor must then be able to adequately articulate this to you. Only then do we have the best opportunity to be successful in your care. Dismissing valid information that doesn’t support the diagnosis is a recipe for disastrous decision making.

One of many, many examples was the 50 to 1 vote of the medical staff. Based on a reported phone call to a couple board members, the hospital dismissed the vote, believing the medical staff did not act with the best interest of the community and hospital in mind. Their statement that doctors are more concerned with losing business, fortunately, only applies to an obvious few.

Another example is their refusal Thursday night to consider the thoughtful, fact-filled presentations of four doctors, including two previous board members. Valuable insight and information that respectfully challenged the hospital’s claims were off-handedly dismissed. This is a slap in the face to the overwhelming majority of the medical staff, who should be commended for wading into this mess in an attempt to find some reason and reasonableness.

The hospital acknowledges this is not about quality of care, conduct, competence or character. Yet, these are the very issues they retreat to now. Listed in the documents made public by the board are what certainly sound like issues of concern with the ER doctors, until you know that these were undocumented claims elicited by administration’s repeated memos to report any questionable behaviors.

They also fail to indicate that the ED Director’s report appropriately refutes these claims. If there is a so-called nurse/doctor war, then administration should permit nurses to speak out on the issue. If heard, the ED nurses’ message would be clear. Twisting information to conform to one’s agenda leads to historical revisionism at its worst.

This document, titled “The Facts About the Negotiations Between HEP and HRMC,” is, indeed, very revealing in its ability to shed light on the facts and on how business is conducted. The hospital never shared its issues until doing so publicly in the press and in this document, even when we asked repeatedly to understand their concerns.

Despite this breach of contract and loss of trust, we do hope that the hospital board follows through on its offer to repair relationships with the medical staff and the employees. As one letter to the editor said, “personally, no one cares about your issues. We care solely on how we are treated and that the doctors know their business.”

We appreciate the opportunity you have given us over 15 years to participate in your health care. We apologize if each and every interaction was not ideal, but we are gratified by your validation of the excellent care we have provided over this time.

HEP thanks all of you, the medical staff and employees, those in Haywood County and those in surrounding counties and around the country, who have been following this story. We hope you stay tuned and keep an eye open to how these decisions affect health care in this community and in yours.

This has been a struggle for the heart and soul of this hospital and about how decisions are made that affect your care. It is a sad day for Haywood County; it is a sad day for health care.

Haywood Emergeny Physicians:

Tom Sither, MD

Mark Jaben, MD

Jeff Grimes, MD

Edmond Welsh, MD

Ely Zaslow, MD

Mark Morris, MD

Tony Iacovelli, MD

Don Dewhurst, MD

Edson Brock, MD

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