Roy Exum: The Marauders At Erlanger

Saturday, December 22, 2012
Roy Exum
Roy Exum

It is no secret to anyone that our Erlanger Hospital has endured a dismal year and is a pretty sickly place from a fiscal standpoint right now. Leadership is abysmal, equipment needs are huge and the lack of capital expenditures over the past century is appalling. Therefore, it should come as no surprise that the corporate wolves are circling in abundance and that out-of-town marauders are fiercely jockeying for position to hopefully take control of our region’s level 1 trauma hospital.

Face it, a take-over effort of a floundering institution is as natural as life itself; the marauders see a crippled prey and, eager to seize a guaranteed money-maker in today’s complex world of health care, will swoop in like midnight bandits to nobly “rid Chattanooga of a terrible headache” and soon send the profits out of town in much the same way Memorial Hospital channels millions in cash to the Catholic church in Denver.

Yes, it is sad but so predictable -- all you have to do is “follow the money.”

More specifically, the University of Tennessee health system would absolutely relish returning its sound leadership, solid structure, and certain stability to the floundering hospital – so much that there is now a carefully-veiled threat to take the highly-acclaimed and very valuable residency program away from Erlanger and move it to Nashille. The UT system wants Erlanger so badly they’ll bluff like a riverboat gambler but the hitch is Nashville already has a regional Level 1 trauma hospital.

Let’s be careful here … with UT’s proven expertise Erlanger would likely thrive as never before but that comes with a bunch of problems that our city and county leaders should recognize and weigh carefully. Before the current Erlanger board rushes into some ill-advised emergency meeting and gives The Great Lady Baroness away for a dollar before a pitiful washing-of-the-hands, everybody involved must know that never has decision-making been as crucial for Chattanooga’s overall health care as right now.

Private operators, like the Nashville-based HCA and other large hospital corporations, are also drooling over the rumors that Chattanooga’s largest hospital may soon be available. The fact it is a Region 1 trauma center makes its ability to make money a given. When a proven entity can replace the team of “consultants” from Price-Waterhouse who have demonstrated a fourth-quarter turn-around, don’t think for a minute some hospital consortium would dare let this fish get away.

It is being also rumored that if UT follows through on the threat to take away the residency program, which insiders say is a serious consideration due to Erlanger’s lax leadership and poor results, Vanderbilt has quietly let it be known their health system would leap at the chance to turn Erlanger into “Vanderbilt South.” Vanderbilt Medical Center in Nashville is easily one of the best in the country and today, with its very deep pockets, the Vandy medical campus has already spread over Middle Tennessee.

Now you know why Gerald McCormick wrote a letter earlier this week to the existing Erlanger Board of Trustees imploring them to wait before naming a new chief executive officer. The deep thought is the Chattanooga delegation can – and will – replace the current governance of Erlanger with a more modern and sleek form of 501(c)(3) set-up, making the hospital a not-for-profit organization by February at the latest.

Under a 501(c)(3), a totally different form of governance would replace the current trustees and such a body would, quite candidly, be a Godsend. If the 501(c)(3) rules are followed properly, there would be no political appointments, no alleged racism or despicable favoritism, and the new board – which could include some very worthy people on the present board – would demand more discipline, more executive accountability, set firm goals and function in much the same way as any successful corporation.

The best model for the 501(c)(3) plan is said to be the “new” UT Hospital in Knoxville, which was horribly inferior some years ago until its leaders embraced the same type of management plan, assembled an all-star board, and today is bright, efficient, and – rather bluntly – is regarded by many as the best Level 1 trauma center in the state.

The Chattanooga delegation, now rushing to draft new legislation that will almost certainly be approved by the entire state body, believes that the hiring of a new chief executive officer should include input from the all-star group of leaders resulting from the 501(c)(3) structure. That makes enormous sense, particularly when there are now calls that the selection committee overlooked some wonderful applicants in a hurried quest for the three finalists just presented. Several trustees are quite upset over the flimsy process.

Under current Board Chairman Ron Loving, the Erlanger Board of Trustees has been accused of making some highly-questionable decisions – most recently a deplorable effort to keep his close friend and acting CEO Charlesetta Woodard-Thomson in place –  and the somewhat disgusted legislators know the public’s confidence in the legendary hospital has waned considerably in the past year.

With the fear that an impromptu decision on the finalists for CEO would be more harmful than helpful, the greater goal is to put a new governing body over the hospital. Let’s be real honest, with the 501 (c)(3) now eminent, the existing board would be less than forthright to hire a CEO who would almost immediately answer to a new governing group. Further, only a madman would accept such a job.

Chattanooga’s elected delegation did the exact right thing in calling for Erlanger’s Board to suspend its hiring process. While a delay will call on the Price-Waterhouse consultants to stay in place a bit longer, the reward of a more modern and efficient type of leadership far outweighs any cost. More, the delegation’s sense of urgency to fix Erlanger lends to the belief the Grand Ole Dame is not for sale.

Gerald McCormick and our other public servants are dedicated to finally fixing Erlanger the right way. They know about the wolves and the marauders but they, above all others, want what is best for the people who trust them. We need to fix our hospital and this is exactly how to do it.

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