At a recent meeting of the Erlanger Hospital Board of Trustees, its Executive Committee gave hospital CEO Kevin Spiegel the singular power -- in writing -- to sever ties with the University of Tennessee’s College of Health Sciences. Graduates of the medical school in Memphis have been coming to Chattanooga to do their internships and residences for years and it has been the greatest Godsend for the people of our area since Great God Almighty plotted the course of the Tennessee River to flow at our doorstep.
We’ve got far greater doctors than we would normally attract because they can complement their practices with professorships at the Medical College. These same physician instructors can cherry pick the best and the brightest young minds to make Chattanooga their home and “medical availability” – the ability for a patient to be seen -- is greater in Chattanooga than in other cities our size across the United States.
But as Erlanger has now reached heights none of us would have ever dreamed under Spiegel and his team, the reign of success has now triggered a pseudo-medical condition that history has proven time and again can be fatal. It is a form of ear-nose-throat pomposity that causes great leaders to no longer hear others of sound mind, nor possess the vision to study a different view of ideals. The condition is easily diagnosed because the victim’s clothes no longer fit well. Noticeably to the diagnostician, the syndrome “too big for their britches,” it is always obvious, and readily prone to error.
Candidly, Kevin Spiegel is the best thing that has ever happened to our public hospital but, now astride a very high horse with stirrups too long, Kevin should realize the majority of Erlanger “grey beards,” who have weathered many storms with the Baroness, are deeply worried the low-hanging branches will go unnoticed in the senseless fog he has created, and has the house staff genuinely concerned.
A low-hanging branch has knocked many a haughty rider into a muddy ditch. The fear is Spiegel’s recent decisions towards outside medical staff are not in the best interests of anyone save some bloodless accountant and the deadly vice we know as greed.
On the surface Erlanger appears to be thriving, capital projects abound, the construction of a new and improved Children’s Hospital is exciting. But warts that are believed to be personal vendettas, denying able medical residents of the UT model duties at other hospitals, and – in some cases – leaning so hard on a cut-throat business formula that the best healthcare in the region is senselessly and clearly diminished. This is not who we are, not at all.
The hospital’s recent skirmishes with some of the best thoracic surgeons in the South are outright embarrassing. It actually places a public hospital in a position of some loathsome predator instead of as a Level 4 health provider. The hospital’s graduation education committee – some 25-35 top doctors – recently drafted a “no confidence letter” to the board and there is an overwhelming vein of distrust now coursing throughout the county’s medical community. What could be more repulsive to a compassionate society, Mr. Spiegel at its front?
With rural hospitals closing and others being forced to limit services due to lack-of-staff, Erlanger is often over 100 percent occupancy but it is widely being quoted that when a hospital administrator reportedly told hospital officials she was putting the ER on “alert,” the reply to the diligent servant was that person would immediately be terminated, thwarting hospital protocol. “We are borderline in a lot of areas,” according to well-connected sources.
Steve Schwab, the Chancellor of the UT Health Science Center, knows there are bad rumblings yet thus far has chosen to ignore the warning signs. Rather than face the mounting problems and the ominous “Lack of Confidence” letter, it is believed Schwab, somewhat lightly-regarded in leadership circles, will meet with UT Trustees John Foy and Vicki Gregg in Chattanooga sometime this week, along with Spiegel and “other quite concerned individuals."
Schwab has repeatedly warned Spiegel his “popularity” has waned – the two were friends in Memphis before Spiegel came to Erlanger -- and the fact ‘tenure’ has been ominously withheld for highly-regarded Bruce Shack, the dean of the Chattanooga college, has now acquired a certain stench and more disdain for Schwab.
Some question if the Executive Committee can actually give Spiegel the sole authority to kick UT’s lengthy and committed efforts in the face. The Executive Committee has changed dramatically in recent years. It’s milque-toast stance towards the hospital’s executive team is --- let’s be honest – both staged and laughable to some.
Many doctors at Erlanger are now hospital employees, lending to credible charges there is intimidation among the staff, but what is overlooked is that this skirmish with the UT College of Medicine couldn’t come at a worse time. Because of UT’s strong and vibrant affiliation with Erlanger, the best and the brightest medical students seek internships and residencies in Chattanooga every year.
What happens is that shortly before graduation, medical students “pick” where they would most likely to continue their training. The requests are processed by accredited teaching hospitals across the country and Erlanger is always high on the list. If UT and Erlanger are at odds, the top medical students want no part of a squabble. Erlanger could suffer notable losses this spring.
From where I sit, Kevin Spiegel should focus on his wins and learn from his losses. Regardless of missteps in the past, the focus must be on the strength of our alliance with UT College of Medicine rather than on petty and insignificant differences Kevin and UT dean Shack can repair within hours. The best thing about a mistake is that after we recognize it, you can tie a new knot if only you can grasp both ends of the string.
We just need to use a double knot this time.