TRMC: “Latest episode […] set to vilify and destroy Tulare’s hospital”

We have to be frank here. The questions you have asked center around the latest episode of the vicious attempts by a few disgruntled doctors set to vilify and destroy Tulare’s hospital. The problems with the medical staff started many years ago, way before HCCA or the current Board were in place.   There was no meaningful representation on the MEC, and doctors felt bullied by the MEC members who controlled patient referrals.  If a doctor stood up to them, he or she faced peer review.  Many fine doctors were turned away at the credentialing stage for pretextual reasons, or they walked away out of frustration with the process, with the result that the staff could not become independent of these tyrants.  No MEC elections were held for years.  The hospital census dwindled, while these same doctors who exerted their control over the medical staff referred their patients to other hospitals.

Ten years ago when the OIG came in and slapped the hospital with a multi-million dollar fine for illegal physician contracts, the abuse of power came to a screeching halt.  These few doctors, unable to come to terms that their golden days had ended, began to boycott the hospital until their demands were met.  The result?  The hospital went through six CEOs in 7 years, as many CFOs, and board after board suffering from the antics of this same group.

When the District finally entered into a long-term partnership with HCCA and these same doctors realized that the days of simply switching the administration when it did not yield to their selfish demands were over, they changed tactics.  In addition to the boycott, the sole pediatric group serving the hospital resigned on short notice leaving the hospital with no pediatric coverage.  The next destructive tactic was to start filing complaint after complaint with federal and state surveying agencies.  In the last year alone, more than 20 complaints were filed – all of which either were completely unfounded or fully corrected.  As you know, governmental surveyors are obligated to investigate every complaint received.  There is no cost to the complainant to file a frivolous complaint, but it costs the hospital a great deal in terms of time and resources to respond.

Which brings us to the episode to which you are referring. We do not necessarily agree with the survey report that you base your questions on.  However, we did offer a plan of correction because we are always seeking to improve the hospital’s procedures and practices.  That was hardly an admission of any wrongdoing by the hospital.  Beyond that, we decline to comment because the matters are (or are expected to be) in litigation.  Any speculation by anyone as to the responsibility of any doctors or the hospital for the unfortunate events that led to deaths in the hospital are nothing but that – speculation.

It is ridiculous and wholly inconsistent with what we have done to date to suggest that the hospital’s administration would ever delay implementation of a safety or quality measure (personnel, equipment, or otherwise), especially if there was any concern by any staff member.

As is the case in virtually all other hospitals in the United States, peer review actions are confidential and unlike the people that may be providing you with this false information, we respect the process and do not reveal privileged committee work product.  To be clear, this is not an affirmation or a denial of any action taken or not taken relating to any other physician in the medical staff.  Suffice it to say, that both federal and state regulators have formally confirmed that the affiliation with the new Professional Medical Staff was the appropriate plan of correction to fix the hospital’s failed previous medical staff issues.

It is also important to note that, unlike with the previous medical staff, decisions are made by the Medical Executive Committee as a whole and not by specific individuals.  To be clear, no one physician member of the MEC has more than one vote.  Unlike the past, no individual physician member has the informal power to enact a direction regarding action for or against another physician even if s/he wanted to.

In closing, we would like to remind you that while others continue to degrade the good that is happening at our hospital, the staff and physicians take great pride in the quality care given at Tulare’s hospital, as is evidenced by multiple quality awards received over the past three years. Even with needless distractions such as this, we will continue doing what is right for our community.