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Rift Widens at Hospital in Ventura

Some say an attempt to block two doctors from medical staff leadership roles is thwarting mediation efforts at Community Memorial.

March 16, 2003|Daryl Kelley | Times Staff Writer

Numerous past and present physician leaders at Community Memorial Hospital are rebelling against what they consider heavy-handed, and perhaps illegal, tactics by top administrators and the board of trustees at the Ventura medical center.

The doctors say executives at the 242-bed hospital have jeopardized patient care and violated physician rights, including the seizure of about $250,000 in medical staff funds, during the last year.

They also say that the hospital's confrontational approach, directed by veteran chief executive Michael Bakst, has poisoned relations with the medical staff and alienated the nonprofit hospital from the community it was founded to serve in 1901.

After months of discontent, a slate of doctors critical of the Community Memorial administration was elected 128 to 82 in November to lead the medical staff in 2004, after the terms of current officers expire. Now, physicians say, the administration is maneuvering to disqualify two of those new physician leaders from holding office or voting in staff elections.

"In my opinion, one reason this is going on has to do with the rather amazing extent to which Mr. Bakst has achieved a kind of fiefdom and believes he has unfettered authority and control to do whatever he wants," said Pasadena attorney Tom Curtis, hired recently by the hospital medical staff's executive committee. "He is accustomed to bullying his way through things.

"A second reason is the national phenomenon of hospitals attempting to limit the authority and power of medical staffs," Curtis said.

Bakst, the hospital's chief executive since 1979, would not comment Friday.

But other hospital executives and some physician leaders who have not joined the rebellion say that the current unrest is little more than a family argument and that Bakst should be credited with managing a strong hospital, not attacked personally.

They say that patient care has not been jeopardized and that dissident doctors have dwindled to a small minority as most physicians have tired of the argument. And they say the hospital has attempted to address staff concerns by hiring a mediator, former state appellate Justice Stephen Stone, only to have that process undermined by dissident physicians.

"Like any family, we're having a squabble that we're going to have to work out," said Dr. Richard Reisman, hospital medical director. But the hospital has done nothing that would harm patient care, he said.

Nor has the administration attempted to limit the role or authority of the medical staff, Reisman said. Rather, physicians have insisted on rights they don't have, he said. "I think certain dissident physicians were attempting to limit the role of the board of trustees."

The bitter internal conflict is only the latest controversy in the recent history of Community Memorial, which set records for local campaigns by spending more than $4 million combined in 1996 and 2000 to sponsor Ventura County ballot initiatives that divided the local health care community.

The current conflict reflects tensions that sometimes flare between hospitals and their medical staffs in this age of highly competitive managed-care medicine, as hospitals try to tighten controls over programs and costs and physicians bristle at any erosion of their rights as a self-governing branch of the hospital.

But a California Medical Assn. spokesman said the Community Memorial quarrel stands out and gives physicians cause for grave concern.

"When relations break down like this, the implications for the future of the hospital are ominous," said Jack Lewin, chief executive for the state physicians group. "This is something the board of trustees of this hospital are going to have to find a way to reconcile, and very soon."

Instead, the conflict escalated last week.

After a Monday mediation session the administration believed was productive, an anonymous Ventura Physician Newsletter critical of the administration was circulated to staff physicians.

That prompted Phillip Drescher, president of the board of trustees, to announce Tuesday the board's imposition of an 18-page Medical Staff Code of Conduct, a document first proposed last year but withdrawn because of protests.

Under the code, a physician may be banned from the medical center "whenever the hospital's Board of Trustees determines that any medical staff member engages in harmful or disruptive behavior ... "

At the same time, Drescher announced a new hospital policy declaring any doctor with a financial interest in a facility or service that competes with Community Memorial services ineligible to vote as a medical staff member or to hold office as a representative of the staff.

A letter Tuesday from hospital attorney Peter Goldenring gave current members of the medical staff executive committee 24 hours to sign a "statement of compliance" declaring any such purported conflict of interest.

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