The NCAA is still considering whether or not to shoot Penn State with its biggest bullet – the Death Penalty – in the wake of the horror that pedophile Jerry Sandusky caused in the most explosive tragedy I can ever recall in college sports. Sandusky will almost certainly go to jail for the remainder of his life, but the NCAA is now wrestling with the belief that the recent Freeh Report revealed there was “a culture” so out of control it cannot be ignored.
Closer to home, we have another “culture” so out of control it can no longer be ignored. I believe it is time for the most wise among us to consider “the death penalty” at Erlanger Hospital, our largest health provider and our region’s Level 1 trauma center.
In college sports the “death penalty” abolishes all competition for a number of years. There are no games, no coaches, no athletes, no nothing.
Obviously at Erlanger that can’t happen, but until we kill a cancerous “culture” that today is so prevalent at the hospital that, in the words of one observer, it will drive away “every doctor and nurse who can afford to leave.” Ironically, Erlanger is similar to Penn State in that both “cultures” have killed the institutions from within. My call is simple: Just as they did at PSU, the time has come to totally and completely clean house and I’m talking about using a sharp scalpel and surgical-grade soap.
On Tuesday the state of Tennessee announced Erlanger Hospital’s most noble knight, its greatest advocate, and its top cardiologist is leaving. Dr. Mitch Mutter will become the state’s medical director for special projects. While he will indeed improve the state’s efforts in the war against a prescription-drug epidemic and the impending Obamacare mess, the bitter truth is that Dr. Mutter couldn’t stand “the culture” at Erlanger for another minute.
Forget the press releases, the community involvement, the famed Children’s Nutritional Program of Haiti and all else. Mitch Mutter, who adored every patient and loved his Erlanger family with unabashed enthusiasm and joy, was offered the commissioner of health when Bill Haslam was elected but stayed at Erlanger believing that it would change. Instead, it has just kept getting worse. And worse. So now, as we who own the hospital watch its longtime MVP walk away, it is our latest sorrow and gut-wrenching disappointment. How much more can we take?
Thus far in the fiscal year Erlanger has hemorrhaged over $17 million in losses. Aside from that, it very may well be on the cusp of losing its fabulous UT medical school residency program. UT medical leaders are unhappy and don’t tell me you are surprised; its customer satisfaction ratings are in the tank. My gracious, even Consumer Reports is calling Erlanger just average.Then there is a noted lack of leadership, antiquated equipment, a morale-shaken staff, deplorable housekeeping, an unexplainable information technology system, and a downtrodden core of doctors who just watched former Chief of Staff and 2012 Distinguished Physician Mitch Mutter walk out the door. How are we doing?
In the meanwhile, its primary competition – Catholic-owned Memorial -- has a reported $47 million in profits, a $235 million renovation in the works and just raised $15 million in a capital campaign from individual donors. Parkridge, owned and well-operated by HCA out of Nashville, is also quite healthy.
If Erlanger was an Army installation every officer in uniform would be yelling the historic military word for chaos and alarm – FUBAR! – but even a junior-high student can see our treasured hospital is today “Fouled Up Beyond All Recognition.” And the longer we wait, the worst it is going to get. The question is, how much more disease can we stand before hard-fisted decisions and firm-footed steps are taken to avert a crisis that has been somewhat blindly ignored as we ponder the Bessie Smith Strut, whether to expand Normal Park Elementary enrollment, and why it seems so hot outside this summer.
Erlanger insiders reveal the consultant team is already making good suggestions but not until the fiscal year ends in October can bigger changes take place, this at the demand of the bondholders instead of the hospital’s oft-bumbling trustees. The search for a new CEO, I am told, is moving well but that is still six months to a year away.
Chattanooga’s legislative delegation promises to study how the trustees should be selected sometime after this fall’s election process but the truth is there should never be any more political appointments. Cronyism, as has been best illustrated at Erlanger, is clearly a disease we need to eradicate everywhere. Most thinkers believe the city and county leaders should immediately act to create a 501c3 organization and use the UT Hospital in Knoxville as a template. UT Hospital was almost as bad as Erlanger before the city leaders in Knoxville turned it around using the same logic. Today the UT Hospital makes money, is clean, treats patients exceptionally well and is guided by a glittering cast of knowledgeable trustees and leaders.
The urgency to act now, instead of October, is because the UT Medical School’s residency program – a dazzling asset – is getting ready to bolt if something’s not done and more than “lip service” is not clearly demonstrated. (Hint: Baptist Hospital in Nashville is the whisper and UT Hospital in Knoxville could be a player. Against either, you know the loser.)
The immediate solution is pretty simple. Do what major league baseball does – fire the manager after tonight’s game and send the lousy pitching coach packing too. Give the club owner (us) several days and with – say – armed with a six-month contract package worth $750,000, either Governor Haslam or County Mayor Jim Coppinger can get us a new skipper within a week. If $750 grand makes you gasp, remember we have already tossed over $17 million to the wind and the fiscal year ain’t over. To save Erlanger “the time is now.”
True, no new baseball manager can win the first week but, if we give him an additional $500K and tell him to quickly fetch two or three fastball pitchers who would also enjoy a six-month contract (that could lead to a longer deal), he’ll get ‘em in here by the next Monday. Laugh if you will, but we would have a chance instead of no chance and status quo (FUBAR).
We would tell our new clubhouse managers that we want the hospital clean, we want it welcoming, and we want the highest level of professional service ever before seen here. Two weeks ago one Erlanger doctor ordered an outpatient procedure on a patient and – within three hours of the test – the still somewhat sedated patient called the doctor’s office, demanded his records and vowed he would never return after being treated so badly by the staff. (I’ve got his email.)
My point being that the indignity just happened. Dr. Mitch Mutter – who I’ll guarantee generated handsome revenue for the hospital – just hit the door. Erlanger has bigger problems, too, but I get all the initials messed up. There is the reverse-racism thing – both the Chairman and CEO are black – and when the number of helicopter rides begin to affect the monthly balance sheet, somebody might need to take a long look at what patients are being charged in exorbitant fees.The indigent costs are so incredible that only Congress and the Supreme Court know the answer but increased “patient dumping” needs to be policed. There are security issues, ridiculous out-sourcing, disrespectful supervisors, childish cliques …. The list goes on and on. Veteran nurses are alternately outraged and heartsick.
The “culture” at Erlanger deserves the same fate as the “culture” at Penn State. I personally hope Penn State doesn’t get the “death penalty” because all of those who created the culture are either in prison, headed there or destined to live a life of shame and dishonor. The only ones who have let Erlanger are the very ones the owner (us) can’t afford to lose.
Finally, there is one more line of thought. Let’s sell it. I think that is a valid talking point right now. Any big hospital chain would jump at the chance – duh, fix Erlanger and you’re instantly in the honey -- and that would be the easiest solution. Memorial Hospital is run by people in Denver. Parkridge is HCA in Nashville. But to sell the 4,000-employee, Level I trauma center would take some deep thinking by some smart people.
I am saying Erlanger Hospital has to make a move. The people who own it need to realize it will cost us nothing but more money and heartache until something is done. It is that simple. Mitch Mutter just left. So did all his patients. Soon there will be others. That’s what I’ve been preaching; it is the Death Penalty, flat and simple.