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The main Erlanger campus is seen on Thursday, June 27, 2019 in Chattanooga, Tenn.

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Erlanger board meeting

A dozen physicians who are employed by Erlanger Health System have written a letter to the hospital's board of trustees expressing support for CEO Kevin Spiegel.

That letter, dated June 24, was in response to an article in the Times Free Press about another letter sent on May 9 to the board from a separate group of doctors tasked with overseeing the quality and safety of medical care at Erlanger.

The contents of the May letter are privileged under Tennessee law, but a copy was obtained by the Times Free Press.

The June letter was signed by 12 doctors from the Erlanger Medical Group, several of whom attended Erlanger's regularly scheduled board meeting on Thursday evening. Board Chairman Mike Griffin opened the meeting by acknowledging what he called the "elephant in the room."

"I'm disappointed that 'the letter' was ... leaked or shared with the newspaper," Griffin said, adding that although it wasn't a pleasant article, it was "very fair."

The May letter was sent to trustees from the Medical Executive Committee and outlined concerns about chronic operational issues, such as inefficiency, understaffing, poor morale and policies that cause overcrowding in the emergency department and operating rooms.

Dr. James Bolton's statement

Dr. James Bolton's statement on behalf of the Medical Executive Committee:

"The Erlanger Board of Trustees has delegated to the Medical Staff the responsibility for the quality of patient care. Consistent with the bylaws, the Medical Executive Committee is specifically charged with evaluating areas of risk in the clinical aspects of patient care and safety, and proposing plans and recommendations for reducing those risks. This was the basis for the MEC letter dated May 9, 2019. It is beyond the delegated responsibility of the MEC to represent all the views of the general medical staff with regards to hospital management. The reference to "no confidence" in the letter referred to the current structure of Executive Leadership in addressing the patient care issues identified in the letter."

It went on to say, "despite over 3 years of complaints and concerns by patients and physicians, hospital management has been ineffective in addressing these issues," leading the committee to say it has "no confidence in the structure of the current Executive Leadership to ensure quality and safety of patient care."

The doctors from Erlanger Medical Group who signed the June letter say they believe the press misinterpreted the Medical Executive Committee's intent and they felt "compelled to express our opinion and state that we wholeheartedly support Mr. Spiegel and his team."

That letter says that the medical group is "grossly underrepresented" on the Medical Executive Committee and that "Erlanger had shown amazing growth" during Spiegel's tenure.

The Medical Executive Committee is comprised of the hospital's 11 department chiefs, who serve two-year terms. Members are elected by their respective departments except for contracted departments, which are appointed by the committee but typically nominated by their department. Officers are elected by the entire medical staff.

The dean of the University of Tennessee College of Medicine at Chattanooga and Erlanger's chief medical officer also serve as voting members on the committee, and the chief executive officer is an ex-officio non-voting member.

Griffin said Thursday the board is there to "do what's best for this hospital," and since trustees are volunteers who primarily work outside the hospital, they welcome information from the medical staff and have taken action.

Dr. Will Jackson, chief medical officer, said a new committee is in place to handle "everything across the spectrum," from how and when patients are accepted to appropriate staffing and investing in areas to alleviate overcrowding in the emergency department.

Erlanger-employed physicians supporting CEO

Erlanger-employed physicians who signed a letter to trustees in support of CEO Kevin Spiegel:

Dr. Argil Wheelock

Dr. Bill Moore Smith

Dr. Amar Singh

Dr. Stephen DePasquale

Dr. Jeremy Bruce

Dr. Larry Shears

Dr. Jeffrey Poynter

Dr. Charles Wood

Dr. Peter Boehm

Dr. Jody Miller

Dr. Daniel Kueter

Dr. Jesse Doty

"Rest assured these are things that have been addressed," Jackson said. "This is at the top of the agenda."

Chief of Staff and Trustee Dr. James Bolton recited a statement on behalf of the Medical Executive Committee.

"The Medical Executive Committee is specifically charged with evaluating areas of risk in the clinical aspects of patient care and safety, and proposing plans and recommendations for reducing those risks," Bolton said, adding that the committee doesn't represent the views of the general medical staff in regard to hospital management.

"The reference to 'no confidence' in the letter referred to the current structure of executive leadership in addressing the patient care issues identified in the letter," Bolton said.

Griffin, a nearly eight-year veteran of Erlanger's board, said Spiegel has both "tremendous support in the hospital" and "some people that aren't fans."

"That's not unusual in hospital administration, but this board is together, and we're going to work this out," he said.

One of those fans, Dr. Argil Wheelock, attended Thursday's meeting and was one of the doctors who signed the medical group's June letter. As a Chattanooga resident of 40 years and an Erlanger urologist of 31 years, Wheelock has watched the hospital weather many ups and downs but says the quality of care under Spiegel is "better than ever."

"His accomplishments over the last six years or so that he's been here have been amazing," Wheelock said. "The letter was written because we care. We care about Erlanger, we care about our patients and we care about administration."

Trustees also approved Erlanger's new budget, which focuses heavily on "throughput," or the efficient movement of patients through the hospital. Other priority areas include expanding primary care and improving infrastructure.

In his CEO's report, Spiegel focused on Erlanger's positives: improvements in readmissions, patient experience, market share and revenue.

"In the emergency department, we know it's really crowded," Spiegel said, citing publicly available patient experience survey data. "The patients, after everything, they are improving their experience, and that is a positive thing. So we're doing something really right."

Contact Elizabeth Fite at efite@timesfreepress.com or 423-757-6673.

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Letter from Erlanger-employed physicians

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