Summa Health’s decision to abruptly cut ties with its longtime emergency medicine doctors wasn’t the only reason for a no-confidence vote this week by hundreds of area physicians.
But the ER staffing switch was the latest in a series of leadership failures by President and CEO Thomas Malone and his team, according to a letter signed by 230 Akron-area doctors and emailed to the Summa board Friday.
Malone discounted the vote in a memo to staff, calling it a “divisive attempt” by a minority of Summa’s doctors to influence a contract negotiation that has already ended.
“We can no longer remain silent. Recent events demand that the concerns of the interested Medical Staff of Summa Health be heard,” the doctors said in the letter. On Thursday, about 217 doctors signed the no-confidence statement and additional doctors signed on Friday, with requests by more to sign it over the next few days.
Summa has always had professional collegiality and loyal staff, the letter said.
“That culture and mission is being destroyed by a series of poor decisions made by the current administrative team,” said the letter.
As more doctors sign off on the letter, updated signatures will be sent to the Summa board, said Dr. Dale Murphy, an internal medicine physician who was president of the medical staff until his term ended Dec. 31.
Murphy expects 400 to 500 doctors to sign the letter. Additionally, an anonymous survey will be emailed to all 1,100 Summa doctors to allow doctors who may fear repercussions from the administration if they speak out to voice their opinion, he said.
The hospital’s communications department declined to make Malone available for an interview, despite multiple requests over the last several days.
However, in a memo emailed to all Summa staff Friday afternoon, he urged employees and doctors “to remain focused on our shared priority, to keep the health of our patients and our community first.”
Dr. Michael Bage, a Summa cardiologist and former medical staff president who penned the letter that the physicians lined up to sign Thursday, said although there are 1,100 physicians on the medical staff, about half of those doctors are not active on the Summa campuses and have privileges to see patients, if needed. So about half of the active staff “showed up on a couple days’ notice, in the snow and at an awkward time and sat through a long meeting,” said Bage, an investor in Western Reserve Hospital, which is in a protracted legal battle with Summa.
Murphy said Malone’s memo makes it sound like “this is a bunch of yahoos who signed it. It’s not a minority; those are the most active at the hospital.”
On Thursday night, after a contentious two-hour, standing-room-only meeting, doctors first successfully took a hand vote on three issues: the no-confidence vote and request for resignation, a request for an outside investigation and the reinstatement of the Summa Emergency Associates (SEA), which had staffed Summa’s emergency rooms for four decades. When negotiations broke down between Summa and SEA, the health system contracted with Canton-based U.S. Acute Care Solutions to take over staffing the five ERs on New Year’s Day with two days’ notice, raising concerns locally and nationwide.
In his memo to staff, Malone defended Summa’s decision to switch providers and said “we do not have the ability or the inclination to revisit that decision.”
Dr. Thomas Mark, chair of Summa’s department of anesthesiology, said he feels Thursday’s meeting was “unprofessional.”
“I don’t think it’s a fair representation of our medical staff,” said Mark, whose group is in contract negotiations with Summa.
Bage said doctors stood in line, some for 40 minutes, to sign the letter. And there were some doctors, who are often known for their poor penmanship and signatures, “who went out of their way to do their best second grade penmanship just to make sure. Some people went so far as to block letter their name after [their signature],” he said.
Other letters
Three other letters were also presented to the staff at the meeting. Two of those letters of “no confidence” from independent physician groups were submitted by the groups to the board on Friday, their leaders confirmed.
“Hopefully, the board makes the right decision,” said Dr. Gary Pinta, an internal medicine physician who is president of Pioneer Physician Network, a group of 39 doctors.
Pinta, an investor in Western Reserve, said the SEA debacle was bad, but it was also not the reason for the no-confidence votes by his group and other physicians.
“The ER was the last straw, but that’s a huge straw,” said Pinta, whose group is independent and does not have a contract with Summa, but refers its patients to the hospital. Over the last several years, Pinta said he and his colleagues have been troubled by the decisions made by Malone and his administration.
“It’s really been a trade of give up quality and lose control. If anyone speaks up over the years, you’ve seen them fired or they’re gone,” said Pinta, calling the culture “tyrannical.”
Pinta said as a primary care physician, he doesn’t know the new ER doctors.
When an ER doctor calls him about one of his patients, he said, “I have to trust them.”
Another physician group, Unity Health Network, the parent group of the critical care doctors whose contract with Summa expired Thursday after it was not renewed this summer, also sent a letter of no-confidence.
Dr. Kevin Mineo, an internist and chairman of the board for Unity, said his 120 doctors and medical providers have seen “the decay” in the relationships with the physician groups by Malone. “While we understand that one must be concerned with cost and viability, we are concerned when patient safety and quality care may be sacrificed in that name,” Mineo wrote in his letter.
Summa spokesman Mike Bernstein could not confirm whether the letters had been received by the board and said the board has not issued any new statements since Wednesday when it reiterated that it supported Malone and the decision regarding SEA and USACS.
In a meeting with the Beacon Journal on Friday, Valerie Gibson, Summa chief operating officer and president of the hospitals, said there was “no merit to a no-confidence vote of a limited number of physicians.”
When asked how the health system will move forward after the no-confidence vote by more than 200 of its doctors, Gibson said, “You build your relationships with those physicians who continue to align themselves with our organization, with the mission, vision and value we’re trying to get to and our mission toward population health.”
Mineo and other doctors acknowledged that Thursday night’s meeting and interactions among some colleagues have become strained.
Mineo said it was uncomfortable being in the meeting with colleagues and people who trained him who may now disagree with him.
“There were some doctors who turned away from you when they saw you,” he said.
Betty Lin-Fisher can be reached at 330-996-3724 or blinfisher@thebeaconjournal.com. Follow her @blinfisherABJ on Twitter or www.facebook.com/BettyLinFisherABJ and see all her stories at www.ohio.com/betty