Erlanger physicians still reeling over chief of staff removal

Staff Photo by Robin Rudd / Former Erlanger Chief of Staff Dr. Chris Young praises the medical staff's performance at a hospital board meeting on June 24, while CEO Dr. Will Jackson, left, listens.

Medical staff officers at Erlanger Health System are frustrated by what they believe was a lack of due process and transparency behind the public hospital board's vote to remove the medical staff's elected leader last month.

During an October board meeting, trustees voted 6-3 to remove chief of staff and fellow trustee Dr. Chris Young, an anesthesiologist, from both his chief and board member roles over allegations he shared unspecified confidential information. Young is a past president of the Tennessee Medical Association and longtime advocate for Erlanger who's practiced there for more than 30 years.

"We're upset with how it happened. We still have concerns about the whole process of it. But as far as finding out why this happened there's just some stuff [the board] can't say," immediate past medical staff chief at Erlanger and former trustee Dr. Jim Bolton said. "I understand that. This whole thing is about privacy, so they can't start blabbing everything to everybody, but it's frustrating not to get to the bottom of it."

Young told the medical staff he strongly disagrees with the board's process and decision in a letter he sent to them after the October meeting.

"I never improperly disclosed information I possessed solely by virtue of my duties as a board member. I was never afforded the opportunity to address the board of trustees about this allegation, either in closed or open session, even though I made such request in writing. I truly believe that I have always acted in ways that were in the best interests of the hospital and the medical staff," Young said in the letter.

Though the board ended further public discussion of the matter, a group of doctors attended Erlanger's regularly scheduled November board meeting Thursday to show solidarity against the board's action.

"This isn't all in support of Chris Young. This is also in support of the position of chief of staff," Bolton said. "It's really the position that we're fighting for, and I think the board realizes how seriously we take what's happened and how we hope that we can make some changes."

For example, Bolton said the medical staff may try to revise bylaws to make the board's process for removing chiefs in the future more clear and fair.

Erlanger is governed by an 11-member volunteer board. Six trustees are appointed by the county mayor with approval from the Hamilton County Commission, and the local legislative delegation appoints four trustees by a majority vote. The chief of staff, who is elected by the health system's medical staff, also serves as a trustee.

In addition to the trustee position, the chief of staff is chair of the Medical Executive Committee - a group of top Erlanger physicians that includes the elected officers and chiefs of the hospital's 11 medical departments. The committee oversees key decisions related to medical staff policies and procedures, with an emphasis on patient safety and quality.

A major function of the Medical Executive Committee is to provide checks and balances on the power of hospital administrators in a health care industry that can often incentivize leaders to value profits over patient care.

Members of Erlanger's Medical Executive Committee - led by officers Bolton, new chief Dr. Chris Poole and Dr. Ben Dart - formally requested to speak during the board's November public meeting but were denied that opportunity. Those three officers, who were also prohibited from addressing the board at its October meeting for not following the approval process, instead met with trustees privately Thursday following the open meeting.

photo Staff Photo by Robin Rudd / Chair Linda Moss Mines speaks during an Erlanger board meeting on June 24.

Linda Moss Mines, chair of the board at the time, said the requested meeting had to be closed because "anything that [the medical staff officers] would've asked for clarification on, had we addressed it in our public session, we would have as a board been in violation of privilege."

Therefore, discussion in a public forum would put the hospital at risk, she said.

"We do certainly want to be able to honor Dr. Young for the time that he has served on the board and for the time he's given to Erlanger. No one questions his love and devotion to this hospital. We know that. It's just simply we couldn't talk, because of privilege, about anything that led to any action of the board," Mines said.

Just as the board trusts the Medical Executive Committee when it comes to overseeing patient safety and quality, Mines said she wants the committee to trust that the board made the right decision concerning Young.

"We trust them explicitly and implicitly, and unfortunately, given the nature of how the board has to operate - as fiduciary responsibility, as a privileged board - as awful as it sounds to say, there are times that the community has to trust us," she said. "Decisions we make may not be easy decisions, but they're foremost in our minds. We're always thinking about Erlanger and how critical Erlanger is to the success of the entire region, not just Chattanooga."

Bolton said trustees did "as best they could" to reassure the physicians, saying during the closed session that removing Young was not done in retribution and that the administration took no part in the deliberations.

"That part, I think we feel pretty good about. We're still frustrated that we don't know what happened and why perhaps some intermediate measures might not have been taken," Bolton said, adding that the board seems open to listening and revamping procedures.

"We're not trying to start a war with the board. We have to work with them. I was on the board the past two years. The people on there, I think, are dedicated. They want to do the right thing," he said. "This particular thing has sort of caught us off guard, and I hope it doesn't get us too far off from where we want to go, because they want to go the same place we do - we want a hospital with good quality care."

Contact Elizabeth Fite at or follow her on Twitter @ecfite.