Roy Exum: Erlanger's Still A Mess

Tuesday, February 12, 2013
Roy Exum
Roy Exum

The news that our local delegation has finally spurred a new governance structure for Chattanooga's Erlanger Hospital towards acceptance in the Tennessee legislature is heartening, but I am among those who believe there is still some tweaking left to be done.

The revisions on what will be called House Bill 0107, for example, call for the hospital's Chief of Staff to be among the nine new trustees who will serve three-year terms. That's silly math. The hospital's Chief of Staff rotates yearly, you see, and given such a mathematical trap we'll soon have a board overloaded with former Chiefs of Staff, especially if each is given a three-year tenure that can be extended two additional times.

Candidly, placing the hospital's Chief of Staff as an "automatic" of the governing board of our region's Level 1 trauma center is well-meaning in theory but terrible in fact. The job of Chief of Staff, elected by the attending physicians, is a heavy one for a doctor who is also maintaining a private practice. It is time consuming and -- if done properly -- a noble and serious part in the daily doings of a huge hospital.

I maintain the Chief of Staff may well be the worst candidate for Erlanger's board but that the immediate past Chief may be one of the best. Better yet, I would amend the bill to simply include "at least one" physician and be done with it. When the new board is chosen, I suspect to see two or more physicians placed by our local political leaders. That's a "no-brainer" and should worry no one.

The more immediate hurdle is for the existing board to hire one of the three finalists that have been interviewed. I am told by several legislators that they will accept and support whoever is chosen and the longer we wait the worse matters will become. Erlanger has already lost $2.5 million in the first half of this fiscal year and the present board, now universally recognized as "dysfunctional," has only itself to blame.

Board chairman Ron Loving has called a special meeting of the current board for Monday, which will hopefully include a vote and result in an offer immediately. This will initiate what all of us pray will be a rebirth of our region's most valuable medical asset. The last year and a half have been admittedly terrible in the hospital's vaunted history. The universal lack of leadership, coupled with some bone-headed decisions, has cost the hospital dearly and the consequences are amplified by each day that inaction on a new CEO goes by. Why wait any longer?

Simultaneously, our local legislators -- presumably with the help of Hamilton County Mayor Jim Coppinger -- should quickly establish a "short list" of top-notch candidates for the nine positions the new board will demand. For simplicity sake, the initial selections should include three persons to serve initial three-year terms, three for two-year terms and three for just one year. Remember, under the new bill the terms can be renewed up to three times.

The perpetuity, with the seated board solely responsible for nominations, is the only difference in the existing board. But the new board should quickly steer towards a 501(c)(3) not-for-profit charter, or similar set-up, that would further eliminate the blundering "good ole boy" fiasco that, in candor, can no longer be blamed on ousted CEO Jim Brexler, who has now been gone 15 months.

A new CEO could be seated quickly and make crucial hires in an effort to untangle a virtual plethora of problems. One hardly needs a microscope, any machete will do. Everything from our crucial relationship with the UT College of Medicine to an earnest effort in retaining a once-brilliant physicians' base is imperative. With the IT department said to be in near shambles, the physical plant in woeful neglect and the competition for patient dollars keen, each new day matters.

Believe it or not, the existing board offers some of the best candidates as new trustees. Donnie Hutcherson, now serving as vice chairman, is a proven gem and is well-acquainted with on-going efforts where we can ill-afford a glitch. Erlanger physician Nita Shumaker and Jennifer Stanley are two others who would be hard to match, according to insiders who cringe at the unfair thought of an "all rookie" cast.

House Bill 0107, and its companion SB 0139 in the Senate, also calls for a representative from "academia," which is a thinly-guised effort to appease the UT College of Medicine, and it is hardly necessary. Everybody at Erlanger is well-acquainted and protective of the College of Medicine's involvement at the hospital so this "restriction" would seem to hamper the new board rather than enhance it.

It was also unfortunate that, in the midst of the legislators forming the new governance board void of political influence, one hospital trustee -- ever "opportunistic" Russell King -- was surprisingly appointed by Hamilton County Chancellors Frank Brown and Jeff Atherton to a new four-year term on the Erlanger board. All three should have known better -- given the spirit and earnestness of the local legislators -- and such folly will hopefully be rescinded.

Yet the regrettable act by the Chancellors -- quite unwelcome in the medical community -- vividly illustrates why the current model of governance at Erlanger is no longer viable and why, the longer we wait, the worse things will continue to be. When the new state legislation is approved within several weeks, the new Board of Trustees should be seated at the very same time and -- at long last -- Erlanger Hospital should move forward.

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