Roy Exum: Erlanger Is In Chaos

Thursday, May 21, 2020 - by Roy Exum
Roy Exum
Roy Exum
I have never heard of a “penumbra.” When a senior member of Erlanger’s medical staff used it in a sentence, it made no sense to me. Later, another Erlanger surgeon explained to me that at the onset of a stroke in the brain, that is why every second counts in a race to the emergency room because the “penumbra” is vital in treatment.  A stroke occurs when blood gets access to the brain and a “bleed” is what occurs in a stroke. Blood kills brain cells – and a large bleed usually means the patient will be unable to reproduce new brain cells. But what gives a growing number of stroke victims hope is that the ischemic penumbra – the brain cells unharmed – can be used to not only heal stroke victims, but cause regrowth of dead cells in mankind’s noggins.
I believe it is safe to say Erlanger’s nationally renowned neurologist – Tom Devlin – knows more about brain strokes than any other person alive in the Southern United States.
But on Tuesday it was learned Devlin had severed all ties with Erlanger. I called his cell and sent emails which were not answered – he’s a warm friend – but on Wednesday it was learned that Devlin, and his wife, cardiologist Carol Gruver, are no longer affiliated with Chattanooga’s only Level 1 provider.
It was also learned that Devlin – whose national stature just triggered a tsunami of unwanted attention to Erlanger’s bumbling hospital executives, is just a part of what could be the hospital’s dying breath. As one remaining doctor told me: “The stroke that has most definitely occurred to Erlanger is massive. It began under (Kevin) Spiegel and Jackson is every bit as bad. The only treatment is to enhance the ‘prenumbra,’ the live cells that are left. That begs: who among the board or hospital hierarchy has such courage to do that!
Erlanger’s Board of Trustees, rather than order paid staff off their haunches, has ostrich-ed - head in the sand. Erlanger’s disappointing address to the tragedy inside has made it worse. 
At Erlanger, the “chaos” is beyond belief. According to valid hospital records, guarded conversations with hospital paid staff, and doctors who are not part of approximately 170 physicians who are hospital employees, it is now believed CEO Jackson is “far from having the ability” to guide Erlanger in a frightening storm indeed. The hospital trustees put him in place on Sept. 18 of last year. He has a one-year contract but the evidence on him is so damning it is claimed that Jackson will soon as be terminated for cause. Consider these findings:
* * *
* -- Four primary care physicians have quit.
* -- At least two cardiologists have left and there is a strong belief two more are awaiting performance ‘bonuses’ before they will quit.
* -- The entire University Oncology & Hematology team, which includes renowned doctors like John McCravey, Matt Graham, and surgeon Larry Schlabach, have departed Erlanger to become Associates with Tennessee Oncology. It is believed Tennessee Oncology will rent the current offices and treat patients in Erlanger’s Plaza Building, a requirement for Erlanger’s Level I certification.
* -- 12 medical specialists have quit.
* -- Five hospital administrators have quit.
* -- A surprising uncommonly high number of nurses have quit, many of whom boasted advanced credentials.
* -- According to Erlanger’s staff website, the CEO has been in neglect of the hospital's top tier staff. Right now, it is believed the following offices are vacant at Erlanger, our largest hospital for numerous tri-state emergencies:
     -- Vice President of Quality Control (has not been replaced)
     -- Chief Operating Office: (There may be an interim under Jackson’s rule)
     -- Chief Information Office (There may be an interim under Jackson’s rule.)
     -- Chief Compliance officer (There may be an interim under Jackson’s rule.)
     -- Chief Medical Officer (An interim is in place under Jackson’s rule)
     -- Vice President of Human Resources: (Reports to Jackson in person rather than the chain-of-command)
* -- When Jackson was hired in October, his contract specified three major goals: one being addressing physician relations, another to reorganize the hospital’s management structure. An Erlanger physician observes, “There is absolutely no way he has achieved the goals. He is an ego-driven tyrant who targets certain people every day. I have never seen a successful leader who got anywhere abusing his teammates.”
* -- One longtime specialist said, “If he uses the COVID-19 pandemic as his excuse model, the disease didn’t get here until he had already ruined himself among the doctors and nurses who are the true strength of this hospital. If he submitted a request for a $50,000 bonus, post it in the doctor’s lounge with a stack of confidential replies that only our Board of Trustees might read. Don’t worry, not even Erlanger is that dumb.”
* * *


Retaliation was huge under former CEO Kevin Siegel but has reached even newer heights under Jackson. With the firm promise and sworn friendship, here are some comments from Tuesday and Wednesday. These are from separate MDs and two RNs at Erlanger:
* -- "Erlanger's Medical Staff gets no support from the board, other than (board member) Phil Burns. The board meetings comprise of a report from (CEO Will) Jackson and then a financial report from Britt Tabor. There is no interaction from the board to the medical staff. They are told what Jackson wants them to hear. They do nothing ... really, what have you seen or heard them do? ... except show up next month. I personally believe they are very culpable ..."
* -- Jackson's form of leadership is to separate one certain doctor and make his life miserable. The other house staff sees it -- it's all about power -- and others wonder 'Am I next?'* --
* -- "What confounds those of us who are still here is why the Board hasn't held Jackson accountable. When he was hired, he announced three major goals. There was to be a report on all three in March. Was there? The report was due before COVID-19 disrupted the hospital. This is just one area the medical staff feels is unacceptable.  Phil (Burns) is one of the most respected doctors in our community but for some reason he hasn't challenged Jackson on the real issues. We've got to quit treating symptoms and address the root cause of the disease. That is a principle of sound medicine."
* -- Another doctor, after being assured of anonymity, said the last five years have not been conducive to Chattanooga's health care. "Erlanger is the most necessary entity in Chattanooga. It is the only place that offers indigent care. Today indigent care costs the hospital $135 million yearly. A viable Board of Trustees would be going to Congress for help."
* -- "Ten years ago there was vibrant leadership on the medical staff with legendary doctors -- long established -- who led philanthropic efforts, but now you see the top physicians, one after another, 'practicing with their feet.' They are leaving."
* --"Spiegel did a great amount of damage to Erlanger and what will happen now that there is 'zero confidence' for Jackson. Our nurses are all looking over their shoulders and … the furloughs that deeply hurt the hospital … leave no trust among those being called back."
*-- Rumors are rampant. "There's a connection between Erlanger and Vanderbilt. Could Erlanger soon join the Vanderbilt consortium?" Most doctors who spoke under anonymity said the parade of former CEOs have "flat-lined the hospital. (The University of Tennessee has a phenomenally successful internship and a residence program on the Erlanger campus. UT would adore the chance to lure Chattanoogans to a waltz on lover’s lane.
* * *
“For two to three months I have visited folks at Erlanger and I would see empty rooms, I couldn't believe all I saw. I began to hear that Dr. Morrison, the heart Dr. who they invested in, was not there, it fell through. Then a couple of other doctors were bailing out. I heard that the man in charge now is much worse than the other.  A friend told me they wish the board would get it together and try to save Erlanger before it is too late, and it almost is. Now it has come to light what I was going to say that Dr. Devlin would be leaving soon. Well, he has.  Others have left or are in the process of leaving. Can you not somehow touch on this and hopefully bring to light things that need to be and should have already been addressed? I hate to see this happen, these are good people and jobs need to be saved. The virus thing has not helped it or any of the hospitals as far as that goes. I value your fairness in trying to do the next right thing and am hoping you would for the mess that is unraveling at Erlanger.”

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