Erlanger finalist explains loyalty

photo The Erlanger Medical Center is seen in this aerial photo.

NASHVILLE - A finalist for troubled Erlanger Health System's top job sought to reassure Hamilton County legislators Wednesday that if hired, his duty is to the hospital and not the University of Tennessee's College of Medicine.

Memphis-based Methodist University Hospital CEO Kevin Spiegel is an assistant professor at the UT Tennessee Health Science Center College of Medicine, where he said he teaches about "anything to do with the structure and function of a hospital."

"I get a very large sum of money from that. It's zero," Spiegel joked. "I've never received any money from the state of Tennessee for doing that. You do it because you love it."

Spiegel is one of three finalists to become CEO of Erlanger. The public hospital is beset with financial problems, strife on its governing board of trustees, physician factions and no permanent CEO to run it since the board fired its last one 18 months.

One of the fears is about a perceived power play by the UT College of Medicine (UTCOM), whose doctors practice and teach at Erlanger, to take over the board. The seven-member legislative delegation rejected UTCOM's request last year to get four seats on the board. Now the delegation is preparing to overhaul the hospital's governance structure.

House Majority Leader Gerald McCormick, R-Chattanooga, told colleagues he took the unusual step of inviting Spiegel to meet with the delegation after talking to him about his concerns over Spiegel's ties to UTCOM.

"I was reassured after our telephone conversation that you don't have 'evil designs' on our community hospital and I wanted you to get a chance to reassure others of the same thing," McCormick said.

Spiegel told lawmakers that Methodist has a similar relationship with UTCOM, a situation pointed out by his critics.

"I have a fiduciary responsibility for Methodist Healthcare, not to the University of Tennessee," Spiegel said. If named Erlanger's CEO, his priority would be the hospital, he said.

When he arrived at Methodist nearly four years ago, Spiegel said the hospital was losing money.

"What I did was bring people together -- the University of Tennessee docs, the private doctors and the [hospital] employed doctors. You had these three factions," he said.

Today, Methodist is making money, he said. However, $3 million to $5 million is "not a lot" at a $300 million enterprise, he noted..

Turning around a hospital like Erlanger is "not easy," he told lawmakers.

"And it can't be done without everyone in this room ... to work together. It [Erlanger] needs some fiscal oversight. It needs someone who knows the business. It needs someone who's done it before, and I think I have those talents."

Lawmakers questioned Spiegel about various issues, including whether physicians should be voting members on the board of the new nonprofit entity lawmakers want to create. He said they should. He also said having one or two members from UTCOM also is a good idea. But three or four UTCOM board members would be too much, he said.

Rep. JoAnne Favors, D-Chattanooga, a nurse who once served on Erlanger's board, asked about the value of a proposed "faculty practice plan." Spiegel said he would take a close look at UTCOM's proposed plan, which some fear is an attempt to take more money from Erlanger by shifting management of faculty physician practices from Erlanger.

The plan calls for the creation of a joint hospital-UTCOM corporation that manages practices, from setting appointments to billing.

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