Los Angeles County health director Dr. Thomas Garthwaite resigned Tuesday, ending a tumultuous tenure of nearly four years marked by unrelenting budget woes and a deadly scandal at Martin Luther King Jr./Drew Medical Center.
The departure leaves leaderless a county Department of Health Services that oversees four general hospitals and a network of clinics that together treat about 715,000 patients a year, the vast majority uninsured. It also raises questions about who would want to replace Garthwaite.
"This is a thankless job. You could be the perfect person for this job and be under attack," said Linda Rosenstock, dean of UCLA's School of Public Health. "He's been beaten up in public for a very long time."
Garthwaite, 58, told the county Board of Supervisors in closed session that he had accepted a position as chief medical officer of Pennsylvania-based Catholic Health East, which has 31 general hospitals from Maine to Miami. He starts his new job in mid-January.
The mild-mannered physician who faced regular tongue-lashings from his bosses and endured repeated calls for his ouster, had been looking for a new job for months. He said he wanted to be closer to his family on the East Coast and focus primarily on his passion for improving patient care.
But he also suggested that he had tired of being publicly second-guessed.
"Hindsight is 20/20 and Monday morning is a great time to be quarterback, but I have to play them on Sunday," he said in an interview. When decisions "don't work, I get the blame and if they work, I don't get much of the credit."
Garthwaite, who has served in the post since February 2002, is the third health chief to leave in a little more than a decade. All have had uneasy -- and at times rancorous -- relationships with their bosses, the county Board of Supervisors.
Although he was handpicked by the supervisors after a nine-month search, Garthwaite turned out to be, by many accounts, less than ideal for the job. He arrived in Los Angeles after serving as the top medical officer for the U.S. Department of Veterans Affairs, a low-key administrator who brightened when discussing the implications of healthcare data. But the new job demanded political savvy and a thick skin.
Still, he racked up some successes, especially early on.
For instance, he helped craft a 2002 county ballot initiative that raised taxes to support an unraveling trauma care system. More recently, he earned praise for hiring a team of senior executives to help run his department, including a new administrator for King/Drew.
