Just minutes after I was told Erlanger Hospital’s new CEO may be among those attending Saturday’s annual Physician’s Appreciation Brunch, I got word that yet another of the beleaguered hospital’s brightest doctors had finally had enough of the bungling mismanagement and perceived incompetency at our Level 1 trauma provider and would soon be hired away by Erlanger’s chief competitor.

Kevin Spiegel, who was just offered the richest contract in the history of Chattanooga’s largest hospital to come here from Memphis and reverse $12 million in losses over the last 19 months, may find the newly-vacated parking space to his liking but the growing despair for a management team “that cares about people” has to be among the top items on his first agenda.

Spiegel will be offered a very lucrative contract - $680,000 a year with yearly incentives up to half of that, plus life insurance and other benefits. His salary scale was set by the outgoing Board of Trustees, the amount said to be determined by national averages, as though Erlanger could be considered as “average” while still in the midst of the most tumultuous storm in its long history.

“National averages” had little to do with the overdue contract that was finally tendered to the outgoing physician who will doubtlessly take a horde of patients to the Memorial office. While confidentially prohibits naming the physician, suffice it to say Memorial’s offer was said to be “a deal you can’t refuse.”

Spiegel would be well-served to quickly study the underlying reasons so many good doctors and key staff have left Erlanger in just the last two years. Some Memorial doctors now laugh that Erlanger is Memorial’s “farm team,” likening those hired to be like a major-league baseball team calling up the best prospects.

Physician unrest at Erlanger has been well-noted during the CEO search and “hot spots” have since developed within the UT College of Medicine unit based at Erlanger, a glaring lack of peer review, and a dysfunctional management team where both the Chief Medical Director and the Chief Operations Office – both part of a five-person “dream team” – have been fired in the last year.

Consultants from PriceWaterhouseCooper are said to be running the day-to-day operations of the hospital but such an arrangement has bogged down time and time again, adding to physicians’ frustrations and anger. The hospital’s Information Technology, having been horribly outsourced, urgently needs “an executive re-boot” and the physical condition of the hospital is faded and hardly polished.

The challenges of renewing Erlanger to good health are many. Spiegel will not only have to assemble an upper-management team that will restore trust and accountability in the hospital, he also must deal with a new Board of Trustees that will demand early results. The local delegation of the State Legislature is in the process of disbanding the current Board of Trustees – for obvious reasons -- and will appoint a new nine-person board in coming weeks.

Speigel, who will reportedly have a buy-out that equals 18 months of his salary, will have an initial three-year contract with automatic one-year renewals to follow. The new board will be appointed in a joint fashion by County Mayor Jim Coppinger and members of the legislative delegation for terms up to three years but, beginning next year, replacement members will now be chosen by the seated board.

It is thought that the board’s first efforts will be to seek some type of 501c3 operating structure, similar to what other hospitals and health care facilities have done across the country. The new governance plan enabling the new board to replace the current one will soon be presented to the Hamilton County Commission, where one member is already whining that the legislators have left the County Commission “out of the loop.”  

“Out of the loop? There is nothing to say,” countered Coppinger not long ago. “The bill has gone through the House and the Senate, just like the state legislators had hoped. The Erlanger board has picked their candidate, as was their duty. This process has been very transparent.”

 There have also been injunctions filed in Circuit Court that Erlanger officials allegedly violated the Sunshine Law in the hiring process of Spiegel, but a number of sources say the allegations are simply not true.

* * *

Today the Erlanger Foundation will honor Dr. Harry Lawrence, Dr. Millard Perrin and Distinguished Physicians and recognize Bob Main, the CEO at Siskin Rehabilitation Hospital, for his 20 years of service to the community. The brunch will be held at 11 a.m. at the Chattanooga Golf and Country Club following a 10 a.m. reception.

royexum@aol.com