More than 250 Summa Health System doctors voted “no confidence” in President and CEO Thomas Malone and his leadership team in a standing-room-only meeting Thursday night and have called for the leaders’ resignations.
The vote came amid growing controversy surrounding the decision to replace Summa’s longtime emergency room physicians on New Year’s Day with little notice.
The doctors also voted in favor of an outside investigation and the reinstatement of the replaced ER doctors, Summa Emergency Associates (SEA).
Dr. Dale Murphy, an internal medicine physician who was president of the Summa medical staff until Dec. 31, said more than 200 doctors lined up in a hospital auditorium Thursday night to sign the letter, which will be delivered to the board of directors.
Murphy said an online survey also will be sent to all voting doctors who were not in attendance. The medical staff totals about 1,100, he said.
The doctors first took a hand vote, and about four people didn’t raise their hands, but “the rest enthusiastically voted yes,” he said.
“It’s a strong message to the board and administration,” Murphy said. “The hope is they will listen to it and move to bring a sense of normalcy to our institution.”
Summa spokesman Mike Bernstein said the board issued this statement when asked to respond to the doctors’ vote: “The board supported the need to bring in the new emergency medicine provider. We will do whatever is necessary to ensure quality patient care and solidification of a strong environment during this important transition.”
Bernstein said the board met Wednesday night and discussed its position on the issue. He said Malone was unavailable Thursday night for comment and there were no immediate plans for a board meeting.
Dr. Rodney Ison, a primary-care physician who leads Community Healthcare, which includes 15 offices in the region, called the no-confidence vote “ridiculous” and said many of the doctors who signed the letter “had an ax to grind.”
“Not once were patients and patient care and what’s in the best interest of our patients in the room tonight,” Ison said after the vote on Thursday. “We can’t have political wars and political battles of ‘what’s in my best interest and what’s in your best interest.’ We’re physicians.”
Dr. Thomas Mark, chair of Summa’s department of anesthesiology, said he did not sign the no-confidence letter because “I don’t think it represents the current reality. I didn’t sign it because I support Tom Malone and the current administration and what they’re trying to do with Summa’s vision.
Mark also said there were conflicts of interest with doctors in the room.
Mark estimated that at least 50 doctors did not sign the letter, or left the meeting early, not knowing there was going to be a vote.
“A lot of people who were there to either support administration or were trying to learn information left. The meeting got late. ... There was a lot of strong-arm pressure to sign the letter,” he said.
Mark confirmed his anesthesiology group recently signed a one-year extension with Summa and is negotiating a multiyear contract.
But Dr. Hitesh Makkar, vice president of the Summa medical staff, said the doctors “didn’t take this lightly. We have never had a meeting like this. This is more turnout than we’ve had in any medical staff meeting in the past.”
Makkar, a pulmonary critical care and sleep doctor, is part of another independent physician group whose contract was not renewed as of Thursday.
Makkar said doctors hope the board takes their vote seriously.
“I would hope they would take a look at this and say, ‘You know, we get the message loud and clear,’ ” he said. “... There’s been a pattern from the current administration. It appears to us that they don’t value physician relationships.”
Contentious meeting
The vote came after a two-hour contentious meeting, in which sources said Malone received no applause, Dr. Cynthia Kelley, who leads medical education at Summa, was loudly booed and heckled and a standing ovation was given to Dr. Jeff Wright, who leads SEA, an independent physician corporation that’s separate from Summa.
Malone and other nonvoting members of the staff were asked to leave the room before the vote.
The decision — with four days’ notice — to replace the group of doctors who had staffed Summa emergency rooms for 40 years with a group of doctors paid by Canton-based US Acute Care Solutions (USACS) on New Year’s Day has created a firestorm in the medical community and Greater Akron community.
Adding fuel to the medical community’s ire about the SEA decision is what many say is the potential conflict of interest between the head of the new ER doctors’ group and a high-powered Summa executive.
USACS works with hospitals across the country to provide similar groups of physician services. The company’s chief executive officer, Dr. Dominic Bagnoli, is the husband of Dr. Vivian von Gruenigen, Summa’s chief medical officer, one of the most powerful administrative positions at the health system.
Summa officials have said that von Gruenigen was not involved in the selection process and that she would not affect the relationship between Summa and USACS.
Controversial switch
The changeover surfaced publicly late last week and affected staffing at Akron City Hospital and Summa facilities in Barberton, Green, Medina and Wadsworth.
Forty-eight hours before the no-confidence vote, a dozen Summa department chairs signed a letter that was posted on an internal Summa blog on Wednesday urging medical staff to support the system. It is unknown whether any of those doctors have since changed their minds and voted with their colleagues in the no-confidence vote.
In the letter, they said “the rapid series of events” surrounding the ER change “have stirred a variety of emotions and promoted misinformation that does little to serve our patients or promote a positive working or learning environment.
“We accept that this happened due to a negotiating process that went awry and forced a difficult decision to change Emergency Department providers.”
The leaders said it was in the best interest to move forward with the decision.
“While we realize there are powerful emotional responses to this situation, we, the Chairs, want to place the focus on our patients and on supporting the Emergency Medical Department to serve those patients,” the letter 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