The chair of Haywood Regional Medical Center’s hospital board resigned last week in the face of overwhelming pressure from both the public and medical community to step down.

In a resignation letter, Freeman said she stepped down after much “soul-searching,” adding it was in the best interest of the community and the hospital.

“Let the healing begin,” Freeman wrote.

Freeman was an ardent supporter of former hospital CEO David Rice, who stepped down early in the crisis. The night before Freeman resigned, the hospital board met in closed session and allegedly discussed whether she should stay or go. The meeting was not open to the public, but shouting was heard behind the closed doors and Freeman left the meeting teary-eyed.

The following day, the hospital board came under fire in a report by Compass Consulting group, hired to fix problems flagged by inspectors. The report laid the blame for the crisis on hospital administration and at the feet of the hospital board for its laissez faire attitude. The board placed too much trust in administration and failed to take an active role overseeing hospital operations. (see “Power and control” above)

Some trace the blame back to the Haywood County commissioners, who appoint the hospital board. The hospital board has two doctors on it — the rest are political appointees.

The commissioners promptly replaced Freeman with Dr. Henry Nathan, a gastroenterologist and respected member of the medical community. It’s an odd turn of events, however, since commissioners had the chance to appoint Nathan to the hospital board last year in lieu of Freeman but chose not to. Nathan applied for the hospital board last spring when three of the eight seats on the board came up for appointment.

During the selection process by county commissioners, Nathan raised telling red flags.

“I am afraid the hospital board has taken a direction that is not in the best interest of the welfare of the hospital and its patients,” Nathan told county commissioners. “We should stop to think before each and every decision, ‘Is this going to help patient care, facilitate patient care, improve patient care?’ If it is, then we should. If it doesn’t, then we shouldn’t.”

Nathan told commissioners a rift had formed between the medical community and hospital administration and board due to a lack of communication.

“I think the medical staff has communicated with administration and with the board and they heard us but they didn’t listen,” Nathan said this week. “None of us could understand why they didn’t listen because they made some bad decisions.”

Nathan cited the ousting of a long-time group of ER doctors and their replacement by a national physician staffing outfit in late 2006 despite an outcry from the medical community. Another example: the board’s selection of a computer system for the hospital despite doctors’ warnings it didn’t work well.

Freeman told commissioners a vastly different story. Freeman defended hospital administration and said that only a minority of doctors — maybe 20 percent — didn’t like the administration.

“We have some physicians that butt up against administration, that don’t particularly like administration and it’s been difficult to hammer that out,” Freeman said at that time. Freeman defended the board’s move to oust the ER doctors, who had been labeled troublemakers by administration for voicing concerns.

Commissioners Mary Ann Enloe, Bill Upton and Kirk Kirkpatrick voted for Nathan over one of the incumbents, but he didn’t have enough votes to make it on the board.

Now, the community is putting faith in Nathan to bring a fresh voice to the crisis.

“I know how important it is and I sure hope we make the right decisions,” Nathan said. “I don’t think it will be that hard. I think the right decisions are fairly obvious.”

Nathan said communication between the board, administration and the medical community will be more important now than ever for the crisis to be solved.

“They need to take advantage of the wisdom and knowledge wherever they can get it — the nursing staff, the other employees, the people in the community and the medical staff all have something to contribute and it is really foolish not to take advantage of that,” Nathan said.

Some question whether Freeman’s resignation is enough, citing a loss of confidence in the hospital board.

“The governing board is not asking hard questions,” said Raymond Ezell, who spoke during a public comment session at a county commissioner meeting.

Two seats on the hospital board held by Mike Ray and Steve Sorrells are up for appointment next month. Neither Ray nor Sorrells returned phone calls asking whether they planned to re-apply for the seats.

Anyone who wants to apply can call 828.452.6625 or get an application at www.haywoodnc.net (click on “board of commissioners” on the left hand side). The deadline is March 31.