There are two separate articles in our local newspaper concerning Henry Mayo Hospital leaving the reader to connect the dots. They are the front page controversial removal of Dr. Greg Jenkins, Deputy Chief of Staff, as a voting member of the Board of Directors, and tucked away on a back page an announcement of newly appointed Board member, Dr. Richard Corlin.
Why would Dr. Jenkins, who has lived and worked in Santa Clarita for 25 years, be eliminated from our hospital Board of Directors by someone who does not live nor work in our community? Let me bore you with some of the details.
Followers of the West Ranch Beacon “Henry Mayo Hospital Rant and Rave” are aware of the illegal and irresponsible hospital appointment of Chief Medical Officer, Dr. Susan Reynolds. The hospital insists the physician Medical Staff recommended her to the position. Going back to our core problem, The Joint Commission (TJC) sanctioned the hospital for poor communication between the Administration and Medical Executive Committee requiring a Mediator to intervene. Dr. Reynolds was recommended as a Mediator, to be paid jointly by both sides.
Stunningly, within two weeks of her acceptance, the hospital announced appointment of the Mediator as Chief Medical Officer (CMO) for a reported salary of $22,000 per month. Additionally, she was contracted to receive an additional $100,000 to find a permanent CMO. It was obvious the hospital could care less about the TJC sanction, and seemed ready to dangle money to gain influence.
With the hospital now fully paying her salary, it was not surprising Dr. Reynolds, under the guise of her title, ramped up their “game plan” and became a source to propagandize conflict and acrimony against the Medical Staff instead of enhancing communication.
Immediately, a new lengthy and vague “Code of Conduct” was adopted by the hospital Board of Directors supplanting the old one, giving the Administration power to falsely accuse, bully, and intimidate physicians. Nurses, who will testify in court to this, were solicited by Administration to create “incident reports” against doctors to trump up charges! I then had my own ironic experience with this growing outrage which is not so boring.
On February 9th, Roger Seaver, CEO, led an open “State of the Hospital” meeting in the cafeteria informing the public of activity related to nursing, construction, goals, etc. During this presentation, Dr. Reynolds stated a “change in the culture” where there would be no “yelling” tolerated, and “respectful dialog” would now be maintained. Mr. Seaver stated “I want the intimidation factor eliminated from this hospital”, and Board of Director Chair, James Hicken, concurred in his comments. Physicians have always felt this way, being held accountable at every level for our behavior.
Part of Mr. Seaver’s presentation revealed a “Vote of No Confidence” by the Medical Staff against the Administration and Board of Directors. This discussion, although contentious, was a valid exchange of opinions by doctors, Board members, and Administration.
As I turned to address Mr. Hicken seated toward the back of the cafeteria, a hospital Administrator, seated about five feet behind me, chimed in yelling “You called me a crook and a liar!” and continued this haranguing and finger pointing for about 20 seconds. (I believe he was referring to my WRB “Rant and Rave” postings which has not called anyone “a crook and a liar”...yet.)
What was bothersome and disconcerting is Dr. Reynolds, Roger Seaver, and Mr. Hicken observed this behavior without once intervening, even though they had just criticized this type of intimidation. How they expect to have a “change in the culture” when those advocating this change are not impressed to affect those around them presents a difficult slope to climb.
Returning to our original question and trying to connect the dots to the new hospital Board member: Dr. Reynolds is also the President and CEO of The Institute for Medical Leadership, and going to that website
http://www.medleadership.com/faculty.htm you will find on her organization’s faculty Dr. Richard Corlin. Anyone surprised? Not only do we have an outsider now on the Board and your local physicians have lost a vote, but this reminds the community of past dubious indiscretions by Roger Seaver and his involvement with Beverly Hill’s G&L Realty.
Radio personality and columnist Michael Josephson, honorably promotes “character counts”. All of us make mistakes and cross the line, but how we handle these mistakes and accumulated experiences influence the evolving of our character and growth into better people.
The hospital Administration and Board of Directors is crossing the line too often...ignoring sanctions, dangling money, and creating a bullying environment. Connecting the dots exposes them queuing up giving favoritism as they scratch each others back.
We typically reserve the term “bully” to kids and young adults. But does everyone evolve out of this behavior as their character grows? To answer this, one must just look at the Administration and Board of Directors at Henry Mayo Hospital.
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 http://hospitalrantandrave.blogspot.com/
Monday, February 28, 2011
Sunday, February 20, 2011
HMNMH Doctor Vote of No Confidence; What It Means!
Readers of The West Ranch Beacon and the “Henry Mayo Newhall Hospital Rant and Rave” blog are well aware of the continual controversy surrounding our community hospital. A front page article in the local newspaper headlined “Doctors voice concern in hospital vote” on February 16, 2011 expressed the hospital “hammered out, point-by-point” response to my recent guest commentary here at the West Ranch Beacon titled; “No Confidence in CEO Seaver & Board of Directors”.
As most of you know, the physician Medical Staff voted in a confidential meeting on January 11, 2011, “No Confidence” in CEO Roger Seaver and the hospital Board of Directors. This information was not public until Mr. Seaver breeched the Medical Staff confidentiality by publicly criticizing the vote at an open State of the Hospital meeting on February 9th. With this revelation, the Medical Staff requested their issues be put forth in The West Ranch Beacon (WRB), a free daily digital publication serving the Santa Clarita Valley.
I was criticized by the newspaper for the Medical Staff’s lack of response, but in an e-mail to them I wrote “there are legal details and the shroud of confidentiality that hovers over these problems” making it mandatory physicians be precise in their wording.
The Medical Staff understands the financial noose the hospital has on that newspaper, but we also see their recent nominees for "Newsmaker" of the year include: Roger Seaver, Judy Fish, James Hicken, and Elizabeth Hopp (all HMNMH Board members); and "Business of the Year" nominee Bank of Santa Clarita (where Hicken and Hopp are officers). The Medical Staff is therefore apprehensive about the newspaper being "fair and balanced" in their reporting.
Additionally, one must understand the underlying motivation by the hospital is to control the Medical Staff by subverting the Medical Executive Committee (MEC) through false accusations of being “not honorable” and cheaters. This comes from Roger Seaver who controls the Board of Directors and uses “resolutions” to remove physician participation in hospital decision-making.
Returning to that newspaper article, most of our rebuttal is already contained in past postings here on the WRB. It was clear when Mr. Seaver and Mr. Hicken gave their responses, they felt that no one reads the WRB. Having been “scooped” on this story, it was evident the newspaper does.
Questioning that “Seaver isn’t convinced that the vote is valid” brings to mind President Ronald Reagan’s famous remark, “Here we go again!” Previous WRB postings show Mr. Seaver’s attempts to persistently question and dismiss Medical Staff voting as fraudulent. People cheat, but why would all doctors systematically participate in fraud?
The hospital’s appointment of a Chief Medical Officer (CMO) was controversial, but most importantly, not legal. The State of California and the Federal government legally defines how hospitals and physicians interact inculcating governing documents with strokes of authority. Because specific guidelines are important, almost every aspect of function in this relationship is delineated.
Around the country, hospitals that have a CMO have this position defined in their governing documents. The position of CMO was not described in any HMNMH nor Medical Staff document when the position was created. I can only speak from the Medical Staff side that the By-Laws and Rules & Regulations still do not contain any reference to a position of Chief Medical Officer.
Without the duties and responsibilities of this position being defined, our hospital is at risk for sanctions from State and Federal levels that could potentially close our doors.
Mr. Seaver’s response to the alleged “conflict of interest”: “The Board’s goal is to provide high quality health care to our community, and in all instances to look for the best interests of our community rather than the individual interests of the board, administration, or committee members.” Really?
No influence on your Board members that have: millions of hospital dollars in their bank; million dollar contracts for hospital construction projects; six or seven figure contracts with Board physicians? Too bad some Board members get drunk at the trough!
There are now 14 Board members instead of 15, since a recent “Resolution” removed our Deputy Chief of Staff, Dr. Greg Jenkins, from the Board. The “trusted, decorated veteran and community physician” I alluded to was not Dr. Frank Yusuf as suggested. That suspended doctor, Dr. John Cocco, has been a “target” like Dr. Yusuf.
The Board “Resolution” reducing the physician application fee is an attempt to financially affect the Medical Staff access to moneys they need to fight the multiple hospital lawyers, lobbyists, and PR people. Our battle to protect ourselves and the community is predicated on our ability to retain an attorney, who the hospital attempts to belittle and deprecate.
Throughout the newspaper article, there is a persistent attempt by Seaver and Hicken to raise their banner of “best interest of the community” and “patient care” above that of the doctors. But as rapper Jay-Z wisely observes: “You can say what you say, but you are what you are”.
When the CEO and Board President of our hospital state they “don’t know exactly what a physician ‘Vote of No Confidence’ means” is exactly why we should not have confidence! Let me translate what it means: WE DON’T TRUST YOUR HEALTHCARE DECISIONS!!
Now as I raise our banner, the doctors at Henry Mayo Hospital promise to fight for an improved hospital and better healthcare for the people of our community. So when others line up at the Board trough to join them with their straws, we will be there to put a kink in them!
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 http://hospitalrantandrave.blogspot.com/
As most of you know, the physician Medical Staff voted in a confidential meeting on January 11, 2011, “No Confidence” in CEO Roger Seaver and the hospital Board of Directors. This information was not public until Mr. Seaver breeched the Medical Staff confidentiality by publicly criticizing the vote at an open State of the Hospital meeting on February 9th. With this revelation, the Medical Staff requested their issues be put forth in The West Ranch Beacon (WRB), a free daily digital publication serving the Santa Clarita Valley.
I was criticized by the newspaper for the Medical Staff’s lack of response, but in an e-mail to them I wrote “there are legal details and the shroud of confidentiality that hovers over these problems” making it mandatory physicians be precise in their wording.
The Medical Staff understands the financial noose the hospital has on that newspaper, but we also see their recent nominees for "Newsmaker" of the year include: Roger Seaver, Judy Fish, James Hicken, and Elizabeth Hopp (all HMNMH Board members); and "Business of the Year" nominee Bank of Santa Clarita (where Hicken and Hopp are officers). The Medical Staff is therefore apprehensive about the newspaper being "fair and balanced" in their reporting.
Additionally, one must understand the underlying motivation by the hospital is to control the Medical Staff by subverting the Medical Executive Committee (MEC) through false accusations of being “not honorable” and cheaters. This comes from Roger Seaver who controls the Board of Directors and uses “resolutions” to remove physician participation in hospital decision-making.
Returning to that newspaper article, most of our rebuttal is already contained in past postings here on the WRB. It was clear when Mr. Seaver and Mr. Hicken gave their responses, they felt that no one reads the WRB. Having been “scooped” on this story, it was evident the newspaper does.
Questioning that “Seaver isn’t convinced that the vote is valid” brings to mind President Ronald Reagan’s famous remark, “Here we go again!” Previous WRB postings show Mr. Seaver’s attempts to persistently question and dismiss Medical Staff voting as fraudulent. People cheat, but why would all doctors systematically participate in fraud?
The hospital’s appointment of a Chief Medical Officer (CMO) was controversial, but most importantly, not legal. The State of California and the Federal government legally defines how hospitals and physicians interact inculcating governing documents with strokes of authority. Because specific guidelines are important, almost every aspect of function in this relationship is delineated.
Around the country, hospitals that have a CMO have this position defined in their governing documents. The position of CMO was not described in any HMNMH nor Medical Staff document when the position was created. I can only speak from the Medical Staff side that the By-Laws and Rules & Regulations still do not contain any reference to a position of Chief Medical Officer.
Without the duties and responsibilities of this position being defined, our hospital is at risk for sanctions from State and Federal levels that could potentially close our doors.
Mr. Seaver’s response to the alleged “conflict of interest”: “The Board’s goal is to provide high quality health care to our community, and in all instances to look for the best interests of our community rather than the individual interests of the board, administration, or committee members.” Really?
No influence on your Board members that have: millions of hospital dollars in their bank; million dollar contracts for hospital construction projects; six or seven figure contracts with Board physicians? Too bad some Board members get drunk at the trough!
There are now 14 Board members instead of 15, since a recent “Resolution” removed our Deputy Chief of Staff, Dr. Greg Jenkins, from the Board. The “trusted, decorated veteran and community physician” I alluded to was not Dr. Frank Yusuf as suggested. That suspended doctor, Dr. John Cocco, has been a “target” like Dr. Yusuf.
The Board “Resolution” reducing the physician application fee is an attempt to financially affect the Medical Staff access to moneys they need to fight the multiple hospital lawyers, lobbyists, and PR people. Our battle to protect ourselves and the community is predicated on our ability to retain an attorney, who the hospital attempts to belittle and deprecate.
Throughout the newspaper article, there is a persistent attempt by Seaver and Hicken to raise their banner of “best interest of the community” and “patient care” above that of the doctors. But as rapper Jay-Z wisely observes: “You can say what you say, but you are what you are”.
When the CEO and Board President of our hospital state they “don’t know exactly what a physician ‘Vote of No Confidence’ means” is exactly why we should not have confidence! Let me translate what it means: WE DON’T TRUST YOUR HEALTHCARE DECISIONS!!
Now as I raise our banner, the doctors at Henry Mayo Hospital promise to fight for an improved hospital and better healthcare for the people of our community. So when others line up at the Board trough to join them with their straws, we will be there to put a kink in them!
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 http://hospitalrantandrave.blogspot.com/
Sunday, February 13, 2011
HMNMH Doctors: No Confidence in CEO Seaver & Board of Directors
It was revealed by HMNMH Roger Seaver at a State of the Hospital meeting on February 9th that doctors passed a “Vote of No Confidence” against the CEO and the Board of Directors at their quarterly Medical Staff meeting on January 11, 2011. his vote was in response to multiple attacks against the Medical Staff including “Resolutions” passed by the Board disabling and nullifying involvement of physicians in hospital decision-making.
Specific grounds for this vote included removal of the Deputy Chief of Staff from the Board of Directors (one of two physicians elected by the Medical Staff to represent them on the Board); Board member financial conflict of interest affecting voting decisions; appointment of a Chief Medical Officer which violates Medical Staff governing documents putting the hospital in jeopardy of HIPAA and confidentiality violations; removal of a trusted, decorated veteran, and longtime community doctor from the Medical Staff without due process; and attempting to financially affect the Medical Staff from having legal representation.
Not mentioned were personal attacks against many honorable physicians to undermine their credibility. Roger Seaver’s own words against doctors who are “not honorable” insinuated cheating during Medical Staff elections and false Code of Conduct accusations. My colleagues at other hospitals nor I have ever seen such acrimonious behavior targeted at a Medical Staff.
We are a Medical Staff as diverse as this nation. With over 27 countries represented, we are an ethnic, cultural, and political blending of diversity, yet we stand together when providing our experience, knowledge, and talents to our hospital and this community.
A few noteworthy accomplishments by our Medical Staff: Doctors John Cocco, Art Garfinkel, Doug Gadowski, James Mackabee, Tony Panasci, Larry Leiter, Karl Stein, and the late Patsy Desimone are Vietnam era veterans; 28 doctors signed up for involvement in Second Opinion Specialist (SOS) with the Samuel Dixon Clinic; donation of a defibrillator, recommended by cardiologist Dr. Kenneth Tam, to the SCV Senior Center; and sponsorship of their “5th in the Nation” Wii Bowling team.
Doctors Peter Kim and Garrett Sutter medically assisted the injured after the earthquake in Haiti, with Dr. Kim also aiding children after Katrina five years ago. Recently, Dr. Darrin Privett helped Haitians during their cholera epidemic.
Trauma physicians, like Dr. Ranbir Singh, and emergency room doctors, like Dr. Raymond Henry, are saving lives every day; and intensivist Dr. Charanjit Saroa and Dr. Himanshu Wickramasinghe burn the nightly candle in the ICU.
Doctors Sum Tran and Chand Khanna will travel to Vietnam at the end of April to operate on children who are disfigured by clef palate, and everyday many of our orthopedists, ENTs, and neurosurgeons save lives, knowing some patients have no insurance and are unable to pay.
We are raising our families in Santa Clarita, participating in community activities, and fund raising for non-profit organizations. Many of us teach at medical schools and sit on Boards that serve children, seniors, and the poor.
The doctors on the Medical Staff hold true to the hospital mission statement “To improve the health of our community through compassion and excellence in healthcare services” and are proud of our colleague’s dedication, integrity, and involvement.
Medically, our contribution and role in governing HMNMH has been hijacked by a CEO and Board whose healthcare expertise lags far below those of the Medical Staff. Legitimate criticism to challenge what is wrong is a right and responsibility that must be heard to protect our hospital.
Therefore, the “Vote of No Confidence” against Roger Seaver and the Board of Directors by the doctors of the HMNMH Medical Staff is a vote for our Santa Clarita Valley community.
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 http://hospitalrantandrave.blogspot.com/
Addendum:
The following is a posted list of the Medical Executive Committee, duly elected physicians from the Medical Staff who have been chosen to represent them:
Frank Yusuf, M.D. – Chief of Staff; (In practice: 39 years, 30 years at HMNMH)
Gregory Jenkins, M.D. – Deputy Chief of Staff; (In practice: 28 years, 25 years at HMNMH)
Floyd Katske, M.D. – Secretary; (In practice: 35 years, 30 years at HMNMH)
Gene Dorio, M.D. – Treasurer (newly elected); (In practice: 30 years, 23 years at HMNMH)
Larry Leiter, M.D.; (In practice: 50 years, 35 years at HMNMH)
Parvez Galdjie, M.D.; (In practice: 42 years, 30 years at HMNMH)
Harold Quan, M.D.; (In practice: 39 years, 32 years at HMNMH)
Mark Sender, M.D.; (In practice: 30 years, 26 years at HMNMH)
Cecelia Hann, M.D.; (In practice: 28 years, 23 years at HMNMH)
Lakhbinder Dhanda, M.D.; (In practice: 24 years, 14 years at HMNMH)
Joseph Terrazzino, M.D. (newly elected); (In practice: 22 years, 12 years at HMNMH)
The eleven member Medical Executive Committee average 33.4 year in practice and 25.5 years at HMNMH. For any level of profession, this experience and expertise is an undisputed qualification afforded to patient care at our hospital, but has been aggressively marginalized and denounced by Roger Seaver and the Board of Directors.
Gene Dorio, M.D.
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 http://hospitalrantandrave.blogspot.com/
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: http://www.the-signal.com/section/37/article/38809/. 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 http://hospitalrantandrave.blogspot.com/
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: http://www.the-signal.com/section/37/article/38809/. 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 http://hospitalrantandrave.blogspot.com/
Tuesday, December 21, 2010
The Battle to Demand a Better Hospital
Every year, the Henry Mayo Medical Staff has a duty to elect physicians to their Medical Executive Committee (MEC). This election took place in early December and was the most contentious battle in my 23 years on Staff.Unsubstantiated and unwritten allegations of previous voting impropriety were made by CEO, Roger Seaver, in an apparent attempt by Administration to affect the outcome of this election. Even the hospital Board of Directors, which was handpicked by Mr. Seaver, passed a “resolution” to appoint a retired Judge to oversee the election proceedings.
The Henry Mayo Medical Staff, as at any hospital in California, is an autonomous organization which has legal, ethical, and fiduciary responsibility to the citizens of this Valley. Our role is to maintain and enhance the healthcare at Henry Mayo Hospital without outside influence. Knowing the MEC might be the last bastion against special interest, 93% of the voting physicians turned out to cast their ballot and overwhelmingly defeated Mr. Seaver’s attempted takeover.
Unsettled and angry, Mr. Seaver lashed out at the Medical Staff after the voting stating members were “not honorable”. This was witnessed by a Judge and captured on videotape. Accusations like this against doctors have been presented in the past to the Board of Directors, hospital Foundation, and public in order to manipulate and create bias against the MEC and the Medical Staff.
Borne out of this, an outside physician consultant was asked earlier this year to assist and improve communication amongst doctors and hospital staff. As these meetings progressed, I continually asked why the Administration’s role in lack of communication was not delineated. To no ones surprise, it became apparent in the consultant’s final assessment that blame was to be made solely against members of the MEC, disregarding any role of the Administration. So, who paid the consultant?
A Chief Medical Officer (CMO) was hired and immediately, not only were accusations made about elections, but false “Code of Conduct” allegations were being made against physicians. Recently I queried hospital nurses and they told me they were appalled when asked by Administration to report doctors for “anything” (and would testify to this in Court). So, who pays the CMO?
Finally, the Board of Directors has passed multiple “Resolutions” against the Medical Staff and the MEC. So, who pays the Board of Directors? They aren’t paid...but please read on.
As a 501(c)3 non-profit hospital, Henry Mayo Hospital must file a 990 form to the IRS concerning financial conflict of interest from Board members. Anyone can ask for this document and obtain it. Not reported on their form is the millions of dollars Henry Mayo has in the Bank of Santa Clarita where James Hicken is the President & Chief Executive Officer and Elizabeth Hopp is the Senior Vice President/Director of Client Services...both of whom are on the Board of Directors of Henry Mayo Hospital. Were any other Board members left off the form that might have financial conflict of interest? Certainly, their exclusion from this 990 form must be known to the accountants and attorneys of Bank of Santa Clarita and Henry Mayo Hospital, but what does the IRS and the California Attorney General think about this? (Please see: Is the Henry Mayo Newhall Hospital board too cozy?)
Even with the Medical Staff and MEC under a barrage of deprecating allegations, they are fiercely defending their role in protecting patient care at our hospital. Apparently questionable and threatening decision making by Roger Seaver and the Board of Directors jeopardizes the viability of Henry Mayo Hospital.
As alluded to previously on this site, the hospital knowingly has appointed a CMO whose duties and responsibilities are not listed nor defined by Henry Mayo governing documents, making us liable for sanctions from The Joint Commission (TJC) and Centers for Medicare & Medicaid Services (CMS). Not addressing recent sanctions by TJC puts the hospital at further risk, as do violation of HIPAA, “sentinel events”, and the above mentioned financial conflict of interest.
The Medical Staff, some of whom are your physicians, and the MEC need your support in their efforts to maintain quality and high standards at our hospital. We must demand honesty and transparency from Henry Mayo Hospital, and not the defaming and demeaning rhetoric we’ve seen from them in the past. Should the physicians and the public not have their demands met by Roger Seaver and Board of Directors, then maybe we will get justice from the IRS, California Attorney General, CMS, and TMJ.
As contentious as this battle is, it is one we cannot afford to lose.
Gene Dorio, M.D.
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.
Monday, November 29, 2010
Commentary: Is the Henry Mayo Newhall Hospital board too cozy?
Lately I have been thinking about boards of directors and corporate executive pay because for the last several years it has been increasingly in the news. Corporate executives being arrested for stock option backdating or swindling of funds; boards of directors asleep at the wheel or just rubberstamping whatever the Chief Executive Officer wants, and more.
It’s interesting to see that Warren Buffet, one of the richest men in the world, gets paid by his company Berkshire Hathaway about $100,000 a year plus some perks. Or how about Steve Jobs the CEO of Apple getting a dollar a year. Obviously both men are billionaires and don’t need the money but it is an example of responsible corporate leadership.
There are plenty of other examples where corporate chiefs get a base salary and their bonuses are tied to performance. If the company does well and the owners (shareholders) are happy with the returns on their investment, then the CEO is rewarded and if the company doesn’t do well then that is reflected in the compensation too.
Good corporate boards should be made of individuals that bring some expertise or experience to the table and are active in the governance of the company. These are professionals that should not have conflicts of interest either by doing business with that company or have relatives working for the company.
That’s one of the reasons why it’s rather odd to me to see the Henry Mayo Newhall Memorial Hospital (HMNMH) board of directors appear to be so cozy. Especially with all the controversy that has surrounded the hospital over the years it would seem prudent to have a board of directors that are as independent as possible.
The HMNMH Board Chair is James Hicken, President & Chief Executive Officer of Bank of Santa Clarita and Elizabeth Hopp, Sr. Vice President/Director of Client Services for Bank of Santa Clarita, is also on the hospital Board of Directors. What’s interesting about this is that the hospital apparently has millions of dollars in the Bank of Santa Clarita. That makes me ponder if these board members are looking out for the best interests of the hospital or of the bank? If the hospital decided to put its’ money in another bank would these board members still invest their time on the hospital board?
I also wondered why several doctors that are on the HMNMH board apparently have million dollar contracts with the hospital? Wouldn’t it be better to have medical doctors or experts on the hospital Board of Directors that don’t have any monetary affiliation with the facility; doesn’t that make them more objective and impartial?
There is an awful lot of construction going on at the hospital campus with more to come over the next few years and one of the owners of a construction company that appears to have a multi-million dollar contract with the hospital is on the board of directors. I would think having a construction expert on your board during a major facilities expansion and upgrade is a great idea but it would seem more sensible to have an independent expert, one with no business connection, on the board to add to the checks and balances of overseeing the construction work at the hospital. Wouldn’t that seem better?
The other thing that I thought was peculiar is that Roger Seaver the President/CEO of Henry Mayo Newhall Memorial Hospital getting a total compensation package of $631,540.00. Gee, that’s more than six times what Warren Buffett makes and more than 50% higher then the $400,000 that President Obama makes. It might be better to have a more performance based compensation structure in place, one that rewards for significant improvements in health care to patients.
Now let’s face it, the hospital can pay what it wants and have whomever it wants on its board of directors. But it does raise eyebrows when you do see some of the activity described above going on and continually hear about quality of care issues. Those quality issues have been around for a long time and it may mean that the hospital facility has to go above and beyond to shake that negative stigma. Even starting at the board level with having more transparency and less perceived conflicts.
I discussed it with a few folks and one of them said to me; “That’s just how they do things in the Santa Clarita Valley; there is a lot of back slapping going on, that’s just the way it is.” But that doesn’t make it right or appropriate, does it?
It’s not hard to get the impression from some of this information that quite possibly there may be more interest in business and “back slapping” then in the administering of quality health care. That is certainly the view of some local doctors and former hospital patients.
Dave Bossert- Commentary
Dave Bossert is a community volunteer who serves on a number of boards and councils. His commentaries represent his own opinions and not necessarily the views of any organization he may be affiliated with or those of the West Ranch Beacon.
It’s interesting to see that Warren Buffet, one of the richest men in the world, gets paid by his company Berkshire Hathaway about $100,000 a year plus some perks. Or how about Steve Jobs the CEO of Apple getting a dollar a year. Obviously both men are billionaires and don’t need the money but it is an example of responsible corporate leadership.
There are plenty of other examples where corporate chiefs get a base salary and their bonuses are tied to performance. If the company does well and the owners (shareholders) are happy with the returns on their investment, then the CEO is rewarded and if the company doesn’t do well then that is reflected in the compensation too.
Good corporate boards should be made of individuals that bring some expertise or experience to the table and are active in the governance of the company. These are professionals that should not have conflicts of interest either by doing business with that company or have relatives working for the company.
That’s one of the reasons why it’s rather odd to me to see the Henry Mayo Newhall Memorial Hospital (HMNMH) board of directors appear to be so cozy. Especially with all the controversy that has surrounded the hospital over the years it would seem prudent to have a board of directors that are as independent as possible.
The HMNMH Board Chair is James Hicken, President & Chief Executive Officer of Bank of Santa Clarita and Elizabeth Hopp, Sr. Vice President/Director of Client Services for Bank of Santa Clarita, is also on the hospital Board of Directors. What’s interesting about this is that the hospital apparently has millions of dollars in the Bank of Santa Clarita. That makes me ponder if these board members are looking out for the best interests of the hospital or of the bank? If the hospital decided to put its’ money in another bank would these board members still invest their time on the hospital board?
I also wondered why several doctors that are on the HMNMH board apparently have million dollar contracts with the hospital? Wouldn’t it be better to have medical doctors or experts on the hospital Board of Directors that don’t have any monetary affiliation with the facility; doesn’t that make them more objective and impartial?
There is an awful lot of construction going on at the hospital campus with more to come over the next few years and one of the owners of a construction company that appears to have a multi-million dollar contract with the hospital is on the board of directors. I would think having a construction expert on your board during a major facilities expansion and upgrade is a great idea but it would seem more sensible to have an independent expert, one with no business connection, on the board to add to the checks and balances of overseeing the construction work at the hospital. Wouldn’t that seem better?
The other thing that I thought was peculiar is that Roger Seaver the President/CEO of Henry Mayo Newhall Memorial Hospital getting a total compensation package of $631,540.00. Gee, that’s more than six times what Warren Buffett makes and more than 50% higher then the $400,000 that President Obama makes. It might be better to have a more performance based compensation structure in place, one that rewards for significant improvements in health care to patients.
Now let’s face it, the hospital can pay what it wants and have whomever it wants on its board of directors. But it does raise eyebrows when you do see some of the activity described above going on and continually hear about quality of care issues. Those quality issues have been around for a long time and it may mean that the hospital facility has to go above and beyond to shake that negative stigma. Even starting at the board level with having more transparency and less perceived conflicts.
I discussed it with a few folks and one of them said to me; “That’s just how they do things in the Santa Clarita Valley; there is a lot of back slapping going on, that’s just the way it is.” But that doesn’t make it right or appropriate, does it?
It’s not hard to get the impression from some of this information that quite possibly there may be more interest in business and “back slapping” then in the administering of quality health care. That is certainly the view of some local doctors and former hospital patients.
Dave Bossert- Commentary
Dave Bossert is a community volunteer who serves on a number of boards and councils. His commentaries represent his own opinions and not necessarily the views of any organization he may be affiliated with or those of the West Ranch Beacon.
Sunday, November 21, 2010
From “OUR” Hospital to “THEIR” Hospital
Your loved one is ill and has been hospitalized for several days. Typically, the physician decides on a treatment plan and when they can return home. Would it bother you if the hospital CEO made these decisions based on bottomline finances instead of educated and reliable medical reasoning? This scenario is occurring across the country, and presently entangles our Henry Mayo Hospital.
Let’s face it, big business has taken over Wall Street and the banks, and little business and people like us have been hurt. A decade ago, plans were launched to take over hospitals...why?...because that’s where the money is! According to an article in one of our medical journals, the hospital industry is “out to decimate the independence of medical staffs and take away physicians’ rights. Their objective is clear: they want to place unfettered power and economic control over doctors in the hands of hospital administrators.”
Admittedly, doctors are not good business people, and they tend to have quirks of arrogance and self-righteousness that continually divide them. Taking advantage of these faults, big business swooped in and used physician medical licenses to make big profits. Yes, we’ve heard of some mismanaged hospitals going bankrupt, but most are now doing exceptionally well. Certainly, it would be generous if these hospital business people were interested in streamlining the system, saving money, and improving healthcare. But the massive profits are instead deceitfully funneled into huge administrative salaries, bonuses, pensions, and golden parachutes. Sound familiar?
A game plan by well-financed hospital business associations have lobbied many states to allow hospitals to “corporately practice medicine.” California does not. Because of this, there is an attempt to circumvent State law, which ultimately will be tested in California courts. Prime example is The City of Hope Medical Staff trying to thwart efforts by the hospital to use the position of Chief Medical Officer (CMO) and a foundation to hire outside physicians. (Please refer to my October 12, 2010, commentary on this blog surrounding the controversial appointment of a CMO at Henry Mayo. Are they “setting the table”?)
These physicians are paid and under the authority of the hospital, who therefore dictates the degree and extent of care hospitalized patients receive. I’d love to cry “What about the Hippocratic Oath?!” these physicians have taken. Doctors are intelligent, and a rare breed, but sadly some are not so principled to bite the hand that feeds them.
As I’ve discussed previously in the West Ranch Beacon, Henry Mayo Hospital is governed by three entities: Medical Executive Committee (MEC), Administration, and Board of Directors. The MEC is elected by the physicians of the Medical Staff and follows By-Laws, and Rules & Regulations in maintaining State-law protected self-governance, which separates authority between doctors and the Administration. This is why physicians currently make all decisions about care of our hospitalized patients.
What if though the MEC is “majorilized” by physicians who vote to change the By-Laws, and Rules & Regulations in favor of the hospital Administration? Will patient control and decision making then be in the hands of the Administration? Of course. There are some physicians paid by Henry Mayo Hospital because they have contracts and directorships, and we have seen them financially coerced into speaking for the hospital (City Council Hospital Master Plan meetings). I wonder how they will vote if they are a member of the MEC? Conversely, physicians presently on the MEC who have attempted to maintain autonomy and self-governance have been bullied, degraded, defamed, and threatened by the Administration.
One truly needs to ask a critical question: Where is Henry Mayo’s Board of Directors in all of this? Unfortunately, they have already laid their cards on the table by passing multiple “Resolutions” condemning the MEC efforts to protect themselves. One can only look at the role the Administration plays in this influence and wonder when the public will ask for a conflict of interest investigation of certain Board members.
There is an attempt to make the MEC and Medical Staff at Henry Mayo Hospital be the “bad guys” as this has been propagated and propagandized to the Board of Directors, Foundation, hospital medical personnel, and even to the Medical Staff. As an involved Medical Staff member and not on the MEC, my view of these problems are clear and precise: the problem does not lie with the MEC nor Medical Staff; this bullying and hostility comes directly from the Administration, in conjunction with their plan to take over all financial control and influence of our hospital.
In life, we have only a few intimate relationships: with our spouse, our clergyperson, and our physician. Once thought to be sacred ground, the relationship with our doctor is in jeopardy and threatened. Preservation of this sacrosanct relationship is critical, and from this my hope is “our” hospital will never be called “their” hospital.
Gene Dorio, M.D.
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.
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