The Erlanger Health System Board held a special called meeting on Thursday afternoon before a packed room of doctors and other health professionals on the future of president Kevin Spiegel.
Trustees indicated that Mr. Spiegel had come under fire after the Medical Review Committee cast a no confidence vote in the hospital leadership.
At the start of the meeting, trustee Gerald Webb made a motion to table the discussion, saying all 11 trustees were not present. Chairman Mike Griffin said eight of the 11 were present and two were taking part by phone.
It was agreed, however, that the board would not take a vote on whether to retain Mr. Spiegel at the meeting.
Trustee Jim Sattler said the board's executive committee met with Mr. Spiegel recently. He said afterward a physician texted him saying he had heard the panel had asked Mr. Spiegel to step down. He said that doctor and another said it "would be very disruptive" for Mr. Spiegel to be terminated at this time.
Mr. Sattler said, "The trustees are sworn to confidentiality. I am very upset that this leaked out."
He read a list of accomplishments during the Spiegel administration, going from a Class C hospital to a Class B, cutting the mortality rate, and upping share of market. He said Mr. Spiegel spearheaded the outpatient center for Children's Hospital and is poised to lead in a drive to build a medical tower nearby.
Saying he favors keeping Mr. Spiegel, Mr. Sattler said it would be very difficult to get another CEO "with all this negativity going on." He said, "Nobody is going to want to come here."
Mr. Griffin said the scrutiny on Mr. Spiegel began with the action by the medical panel. He said hospital staff afterward had gotten into two separate camps. He said, "I hope we can start reaching across that divide." He said after the vote meetings were held to hear concerns of the medical committee.
Mr. Spiegel said Erlanger faces challenges, including soaring indigent care expenses, but he said there have been many successes, including its public perception. He said there is "a lot of talk about the Emergency Department, but the patients are saying that is the place they want to go."
He said, "We've more than doubled access to care" and he said a strong orthopedics unit has been built as well as in stroke care and urology.
Mr. Spiegel said Erlanger is at an all-time market share of 45 percent.
He said Erlanger has gone from 30 primary care doctors to 121, making "referrals the strongest they ever have been." Another improvement he said is setting up urgent care centers to relieve stress on the emergency room.
The Gunbarrel Road medical facility because cash positive within 90 days of opening, he told the trustees.
Mr. Spiegel said Erlanger has $225 million in the bank - "the most we have ever had." He added, "The financial position of Erlanger has never been stronger."
He said he has recruited numerous top physicians to Erlanger and there is "a trust level" with them.
Mr. Spiegel said other local hospitals are having trouble recruiting nurses, "but Erlanger is not."
He said, "We need to continue investing in our infrastructure, including our kitchen which has been in the same place since 1938."
He said he pledges to continue meeting with medical staff and hearing and responding to their concerns.
He stated, "I'm prepared to take this hospital to the next level."
After Mr. Spiegel spoke, Mr. Webb said there are a ton of positives, but "We've got serious foundational issues that we need to address. There are cracks starting to show. A person who runs too fast, they topple over."
He said some relationships at the hospital "have been fractured beyond repair."
Mr. Webb said, "We need to get to a position where we can address these foundational issues to see if we can get a resolution. It doesn't do any of us any good to say those issues don't exist."
Dr. David Bruce spoke in Mr. Spiegel's behalf, saying he had helped build a strong orthopedic department, been very active in Ironman, and helped provide athletic trainers throughout the county schools. He said, "I am 100 percent behind Kevin Spiegel. It is the right thing to do to keep him."
A urologist said, "We may need to fire a special teams coach, but we don't need to fire the head coach. You may go from a 7-4 team to a 1-10 team."
Another doctor said, "We are black and white supporting Kevin Spiegel." He said, "Do we have issues, yes, but let us address them."
Dr. Jody Miller said, "I came here because of a vision of a hospital that is experiencing amazing growth and taking great care of members of our community."
A veteran pediatric physician, Joannie Jack, said of the situation. "The real issue is politics and greed." She added, "It has taken us forever to get here. Don't mess it up."
Another pediatric doctor said, "We have leapfrogged in the department of pediatrics in so many ways that a change in leadership would set us way back." She said, "Mr. Spiegel sees me on the street, he knows my name, he knows my family." She said he helped "make us the first Baby Friendly hospital in the state of Tennessee." She said, "I ask you to really think hard before you make a decision that sets this hospital back 10 steps."
However, a trauma surgeon said he seldom sees Mr. Spiegel in the hallways any more and "there is an ingrained lack of trust. There are a lot of things we need to fix. There is a distrust that underlies everything around here that needs to be fixed."
Mr. Sattler said at the end of the meeting, "I make a motion that every one of us leave out of here as one big Erlanger family."