This story was updated Thursday, Aug. 29, 2019, at 9:40 p.m. with more information.
The Erlanger Health System Board of Trustees called a special public meeting Thursday to discuss ongoing issues within the hospital and the future of President and CEO Kevin Spiegel.
Board Chairman Mike Griffin opened by saying "the heaviest thing on my heart right now is that I love Erlanger," but physician backlash that came after a letter from the Medical Executive Committee surfaced in June still needed to be addressed.
Chronic operational problems outlined in that letter, such as inefficiency, understaffing, poor morale and policies that cause overcrowding in the emergency department, have improved, Griffin said. However, some doctors are still unhappy with Erlanger's executive leadership.
"I've gotten a lot of feedback from both sides of the house, and let me speak to that. There shouldn't be two sides of this house. We're on the same team," Griffin said. "Our question of the hour now is: where do we go now with our leadership?"
Before anyone else spoke, trustee Gerald Webb made a motion to table that discussion. Webb said not enough trustees were present, although eight of the 11 were in the room and two others, Linda Moss Mines and new trustee John F. Germ, participated by phone. Dr. Blaise Baxter was the only absent trustee.
The board then agreed no vote would be taken Thursday regarding Spiegel's future, and Griffin opened the floor for others to speak.
Trustee Jim Sattler, whose health issues left him unable to attend the latest board meeting, expressed his disappointment in how information has leaked out of closed meetings and fueled rumors of Spiegel's looming resignation.
"We signed a confidentiality agreement, and we have a responsibly for that, and I'm just totally upset how anything leaked. We all know in today's environment negative things do fester," Sattler said, adding he was opposed to replacing the CEO.
Spiegel took over executive leadership of Chattanooga's only public hospital — the largest regional provider of care for indigent patients — in April 2013 after serving as CEO at Methodist Healthcare in Memphis for five years.
He oversees operations of six acute-care hospitals, a behavioral health hospital, a multi-specialty physician group practice and academic teaching program affiliated with the University of Tennessee College of Medicine. The health system also includes the only children's hospital within 100 miles, the fourth largest interventional stroke program in the United States, the country's seventh busiest emergency department and the region's only Level 1 trauma center, which treats the most severe injuries.
Spiegel addressed the packed room Thursday and emphasized the system's success over his tenure.
"The financial position at Erlanger has never been healthier and never been stronger," he said. Highlights in his role at the helm of what has become the nation's 10th largest public hospital include a 92% increase in net patient revenue, dramatic market share growth and improved bond ratings.
Those achievements, combined with new philanthropic initiatives, allowed Erlanger to take on major capital projects. Some of those include Erlanger East Hospital, a $100-million electronic health record system and a new children's outpatient center — the first phase of a new children's hospital and 14-story medical tower. In the process, Erlanger became the largest employer in Chattanooga and the fastest-growing health care organization in Tennessee.
"We want to see Erlanger go to the next level, and I'm prepared to lead that, and I want to see everybody here join me," Spiegel said.
Webb said the board was "thankful" for those positive changes, but that there are serious foundational issues that need to be addressed.
"The reality is, we're not here this evening because everything is going well," he said. "Sometimes, the honest truth about what is actually taking place is what is needed. Those conversations have to take place."
Webb said Erlanger needs to repair relationships within the system, but based on some conversations he's had fears some "have been fractured beyond repair."
Others from the audience began to chime in and express their support for Spiegel and his vision for Erlanger.
Many of the people who spoke were physicians, such as orthopedic surgeon David Bruce, who fear losing Spiegel would also mean losing the momentum that occurred under his leadership.
"Since that time, we've been able to grow our department to what I think it the finest orthopedic group in this area," Bruce said, pleading with the board not to make a "drastic" decision. "We now have every school in Hamilton County and three in North Georgia covered by athletic trainers and that's because Mr. Spiegel had that vision."
Dr. Richard Moore, a longtime colorectal surgeon, said no matter what Erlanger achieves, "the focus still needs to be on the patients."
Dr. Joani Jack, a pediatrician, challenged those leading the charge against Spiegel to question their motives.
"If you look in the mirror and you can tell yourself there's a little bit of greed involved in this, I want to tell you it's my patients that you're hurting. It's my kids," she said with tears in her eyes, boiling the hospital's issues down to politics and greed.
Trauma surgeon Philip Smith said he likes Spiegel and the other administrators, but trust and transparency could improve.
"There's a distrust that's underlying everything here that needs to be addressed," he said.
Less than a year ago, Erlanger's Board of Trustees rewarded Spiegel for his performance with a $46,000 raise, bringing his base salary up to $964,000.
Last week, Spiegel announced Erlanger's executive vice president and chief operating officer, Rob Brooks, had "separated from the organization."
Contact Elizabeth Fite at firstname.lastname@example.org or 423-757-6673.