Hamilton County's highest-paid employee, Medical Examiner Frank King, likely will have his title changed and pay shaved after a vote of the County Commission this week.
King and forensic pathologist Dr. James Metcalfe will be switching roles ahead of a looming deadline on a state law that first took effect in 2008.
King, a pathologist who makes about $195,000 a year, has been the county's medical examiner since 1986. Metcalfe, who's been with the county since 2007, makes $144,000 annually.
Hamilton County Mayor Jim Coppinger briefly described the move to the County Commission's finance committee as a "cost neutral" change of titles. The commission is expected to vote on the mayor's recommended change Wednesday, but King has been pushing for action for almost four years.
Under the 2008 law, for the county's medical examiner facility to do autopsies after July 1, it must be accredited by the National Association of Medical Examiners, a nonprofit organization that requires the medical examiner be a board-certified pathologist.
King is not board certified, but Metcalfe is.
"This will be the first step; then we have to have that organization come in and do a review of the facility," Coppinger said Monday. "What we were told by Dr. King and Dr. Metcalfe was that was the only sticking point."
King said he would take his boards if he could.
In the early 1980s, he completed a medical residency in pathology and a one-year fellowship in the specialty but never took and passed his boards.
"When I finished my residency, the American Board of Pathology's policy was, as long as you work full-time in your specialty, you can take your boards at any time," King said Monday.
At first, he wasn't convinced he wanted to stay in forensic pathology, but he slowly began to build the office in Hamilton County, which in the beginning was just him and an assistant.
He didn't consider taking his boards until about 10 years later, after working what he describes as at least one three-year period without a single day off -- not even weekends.
And now he can't pass his board -- at least not without years of repeat training -- because of American Board of Pathology changes.
"I thought at that point, 'If I get another job, I really need to have my boards,'" he said. "Well, they'd changed the rules. They said if you've been out of your training more than five years, you have to repeat it."
King said there's no pathology program at any Chattanooga school and, even if there was, he estimated it would take at least three years of taking classes he has already taken, before he could sit for the test.
STATE LAW CHANGES
Shortly after the new law was passed in 2008, members of the National Association of Medical Examiners came to evaluate Hamilton County's office, King said. The group recommended that King and Metcalfe shift roles.
King said he went to then-County Mayor Claude Ramsey to request the change.
"I wanted to do that, Dr. Metcalfe did, but former County Mayor Claude Ramsey did not," King said.
Ramsey asked the state Legislature to pass a private act to extend the compliance date until July 2012, King said, and each year after, he asked Ramsey to swap him and Metcalfe, but Ramsey didn't make the switch.
According to King, Ramsey told him: "'I've got three years, doc, I like it the way it is.'"
Ramsey acknowledged Monday that he did meet with King about the matter years ago but declined to comment further.
Last January, Ramsey became deputy governor, and commissioners named Coppinger to replace him.
Coppinger and King met before the holidays to discuss the pending problem.
Coppinger proposed that the men swap titles and that King take about a $25,000 salary cut while Metcalfe receive a $25,000 hike.
Coppinger then sought the legally required Chattanooga and Hamilton County Medical Society approval of the swap.
"The fact that there were more stringent requirements in the medical examiner's office is something we had been paying attention to," said Rae Bond, the medical society's executive director. "In this particular case, we thought that was an excellent solution."
National Association of Medical Examiners Executive Director Denise McNally said the accreditation process isn't mandatory for membership, but McNally said she's heard it is now required in Tennessee.
Hamilton County received a preliminary accreditation in 2009-10.
"They're lapsed right now, but I do know that they are working on it," said McNally, who's based in Missouri.
King said getting back in the group's good graces is now harder.
"[National Association of Medical Examiners] now has a different inspection protocol, much more thorough, much more demanding. We missed our chance to be accredited three years ago," King said. "That expired because we didn't correct the ... deficiency."
Even if commissioners vote this week to make the switch, King said much more work must be done to meet National Association of Medical Examiner's 30-page checklist of requirements.