Roy Exum: Include MDs At Erlanger

Sunday, January 27, 2013 - by Roy Exum
Roy Exum
Roy Exum

There are times when we human beings don’t give one another enough credit and Saturday’s lead headline in the Chattanooga Times-Free Press was a classic example. It read, “Doctors guaranteed Erlanger board seat, but not vote.” If there are any among us who feels a MD should not be included on the board of our city’s largest medical center then we all need to start over in Kindergarten at the School of Common Sense.

But if there is any responsible physician in our region who is going to spend the time and diligence to serve on a revamped hospital board with the prior knowledge that he or she cannot vote, I’ll show you a doctor who is wasting their time. Of course, none of us really knows what the local delegation of our state legislators hopes to accomplish with a new governance structure that is promised this week but the early signs are troubling.

It was hoped that a complete make-over of our region’s Level 1 trauma complex would include provisions for a non-profit, 501(c)(3) type of operating structure that would cast away the shadow of politics and any “guaranteed seats.” Now the Chattanooga-Hamilton County Medical Society is clamoring for a permanent seat and such petty nonsense is one reason the current hospital board is considered to be dysfunctional.

This is obviously a moot point and a waste of the newspaper’s ink. No group or special-interest parties should have guaranteed seats, no matter how big or how small the board will be. To do so creates a mess where other groups, such as minorities or health-related entities, can stir similar havoc. The Medical Society is out of line asking for special consideration and the legislators have been poorly counseled with the flaky notion doctors shouldn’t have the right to vote. My heavens!

At present there are four MDs on the 12-person Erlanger board who are each laudable and to envision any hospital in America where medical professionals are not represented is nearly impossible. At UT Medical Center, the Level 1 trauma center in Knoxville, there are four MDs on a glittering all-star board of 17 people and, in Atlanta where Grady Hospital is one of the biggest public hospitals in the nation, there are two MDs on a 17-person board.

In Nashville, where Vanderbilt is the Level 1 center, things are set up differently. The VU Medical Center is run exclusively by 17 physicians, with Chattanooga’s Cliff Cleaveland as the president-elect, but it operates under the university’s Board of Trust, where two MDs sit on that panel.

In Chattanooga, Erlanger is in direct competition with the privately-operated Memorial Hospital, where there are five physicians on a 26-member board of directors. So for the Chattanooga-Hamilton County Medical Society to grandstand for a “guaranteed” seat on Erlanger’s new board appears to be a solution for a problem that doesn’t exist.

Face it, in no way does the pending legislation bar one or more doctors from being an integral part of Erlanger’s new group but whoever came up with the idea of non-voting participants has badly missed the mark. The belief is that a small, nine-person board will be chosen – each member limited to three terms – and after the initial group is selected, the board itself will now chose its successors each year.

Under the outdated framework, board members were appointed by various groups, as well as the city and county mayors, and the result was predictable and disappointing. Now the new board can guide itself to a professional balance where cronyism and other diminishing factors will no longer affect key decisions at the 4,000-employee institution.

Unfortunately, the existing board of trustees and the Hamilton County delegation have failed to communicate as the new legislation has been drafted and Erlanger leaders are worried that key elements may be missing or omitted when the hurried bill is presented for vote. There is also valid concern that some very worthy people already serving as Erlanger trustees could be overlooked as superb candidates in the new governance arrangement.

The current board has met with three CEO finalists and could name one before the legislation becomes official. Every member of the Hamilton Country delegation has asked Erlanger’s board to wait but if the new governance is merely a rubber stamp where the only thing that changes are the trustees’ faces, there is no valid reason for the existing board to move forward.

The three finalists are said to have been impressive and, with $2.5 million in losses the first half of the fiscal year, the legislators have offered no reason to stall the process. Of the finalists, it is believed that Kevin M. Spiegel, who currently works for Methodist University Hospital in Memphis and also is an assistant professor at the UT College of Medicine, is the front runner.

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