Thursday, January 20, 2011

Guest Commentary: HMNMH Board of Directors: Enriching Administrators and Lowering Standards

Henry Mayo Newhall Memorial Hospital (HMNMH) CEO Roger Seaver’s annual salary is $530,000; Bob Hudson, Chief Financial Officer, receives about $265,000; John Schleif, Chief Operating Officer, $255,000. On top of this, they receive bonuses increasing their salaries 20% -- just like Wall Street executives. Who decides the dollar amounts for salaries and bonuses?...the 14 voting members of the hospital Board of Directors.

Certainly, if it were based on merit, none of us would object. But we now know undue financial conflict of interest with some Board members influences their vote and affects this decision.

Would HMNMH having millions of dollars in the Bank of Santa Clarita affect the vote of two Board members from that bank? Would construction contracts with the hospital affect the Board member’s vote who owns that company? Would two physicians (appointed, not elected by their peers) who have lucrative medical contracts with the hospital be able to avoid affecting their vote when it comes to administrative salaries and bonuses?

I believe in the free market allowing those who provide diligent quality work reap rewards based on their worthiness. When the CEO dangles money and contracts in front of Board members he has personally appointed, is the vote on salaries and bonuses skewed? What if we could all stack the deck when it comes to determining our own salaries?...who among us would maintain a higher level dictated by personal morals and ethics?

Every day we are challenged with right from wrong and good from bad, and our subsequent response to these challenges is a reflection of personal upbringing and character. Growing and maturing is a part of setting our standards and raising the bar to that higher level.

Diverting this conversation for a moment, as a physician at Henry Mayo Hospital I worry how this same Board of Directors is attempting to lower the bar of hospital standards. I give you two examples:

First, the physicians of the Medical Executive Committee (MEC) play a major role in assuring quality patient care at Henry Mayo Hospital. Nationally, The Joint Commission (TJC) oversees standards and accreditation assuring our hospital and others maintain high levels of patient care. Our local newspaper recently noted the hospital’s compliance with these standards: Why then is HMNMH considering a change to a different accrediting agency away from the TJC?

Ninety-seven percent of the hospitals in the US are accredited by TJC. But the new agency, should the Henry Mayo Board of Directors decide to make a change, does not value physician input, nor do they evaluate “sentinel events” - an unanticipated event resulting in death or serious physical or psychological injury. Really? Then who will evaluate these sentinel events?

It might be hard for the public to fathom that there is potential for physicians not to be included in confronting these problems nor informed by the hospital in a timely fashion. Unfortunately, this has occurred resulting in vehement demands by the MEC for the hospital to correct this problem immediately. Without TJC oversight, uninvestigated sentinel events might happen again!

Second, the hospital has used a survey group known as Press-Ganey to evaluate their performance compared to other hospitals in the US. We have not done well in these outpatient post-hospital surveys. Recently, the hospital Board has sent groups of individuals, many who are not involved in patient care, to survey inpatients -- while they are still ill and hospitalized.

With most of my patients being elder seniors and already fearful of their health problems, asking questions in the hospital when they are ill about whether the care is adequate raises their paranoia that a negative response might result in less care. Moreover, since these hospital questioners are not patient care providers, is this a confidentiality or HIPAA violation? Ultimately, it is an attempt by the hospital to “game” the system and affect the Press-Ganey survey responses.

Many of you already knew the outrageous salaries and bonuses the hospital Administrators are making and financial conflict of interest with many Board of Director members. Your concern though should also be the “moving of the goal posts” and lowering of the standards which is compromising patient care at our hospital.

As we try to make life better and improve healthcare in our community, instead of lowering hospital standards, we should call for the lowering of Administrative salaries and bonuses, and greater accountability from the Board of Directors to regain the moral high ground.

Gene Dorio, M.D.- Guest Commentary

Gene Dorio, M.D., is a local physician. His commentary represents his own opinions and not necessarily the views of any organization he may be affiliated with or those of the West Ranch Beacon. You can also see more of Dr. Dorio’s commentaries on Henry Mayo Newhall Memorial Hosipal at