Letter from physicians to EMH, EMMC boards

Editor’s Note: The following draft petition was presented to the Medical Staff Executive Committee and to the chairman of the Eastern Maine Medical Center’s board of trustees Wednesday night. It was addressed to the trustees of both Eastern Maine Healthcare and EMMC.

Ladies and Gentlemen:

As physicians of this community, we have committed our careers, our talent, our ongoing concern, and our creative efforts to make Eastern Maine Medical Center (EMMC) an outstanding hospital. On a daily basis we live EMMC’s mission, “to provide excellent, compassionate, primary and specialty health care services, and to cooperate with others to promote the well being of the peoples of Maine.”

We believe that due to the overextension of services, Eastern Maine Healthcare (EMH), EMMC, and all their clinical affiliate organizations have drifted from this mission and that this threatens their ability to provide optimal health care services. The executive administration and physicians no longer work cooperatively. This failing has eroded the quality of patient care.

The Board of Trustees of EMMC and EMH need to understand and address these concerns. We are willing to work through the Medical Executive Committee, but the solution will require the concerted action of the Board of Trustees, executive administration, and physicians. We are committed to structural change so that this impasse will not arise again.

Communication and Control of Information:

Physicians need more effective channels of communication with the administration and Board of Trustees to resolve problems. The Medical Staff, through its leaders, needs timely access to planning and financial information generated by and available to the administration when this information pertains to patient care. The Medical Staff must be an equal partner with the administration in decision making that affects patient care.

Chief Medical Officer:

Physicians must have a physician administrator who will serve at the direction of both the Board of Trustees and the Medical Staff. This individual must have access to all committees of EMH/EMMC and any affiliate providing clinical service, including finance and planning, and have a voting seat on the EMMC Board of Trustees and the EMH Board of Trustees. A mechanism must exist to reevaluate the appointment of the physician administrator at the discretion of the Medical Staff and the Board of Trustees.

Medical Executive Committee:

The Medical Executive Committee needs adequate background information, and financial and logistical support provided in a timely fashion to allow it to participate in decisions affecting patient care at EMMC.

Community Care:

The development of referral medical services at EMMC must occur in collaboration with all the specialties involved and its impact on the outpatient medical needs of our community and medical staffing assessed before new programs are implemented. Before expanding referral services, resources need to be available to maintain our current level of outpatient care.

Partnering with Physicians:

EMMC needs to work cooperatively with physicians, regardless of whether independent, in groups, or in the employ of EMMC/EMH.

Recruitment:

Our community needs to be able to attract and retain qualified medical practitioners. The current crisis is about broader and more profound issues than individual physician or specialty remuneration. EMMC/EMH executive administration needs to change its behavior which has eroded the local working climate, resulting in loss of physician services.

Leadership Support:

The stipends of section chiefs and Medical Staff officers need to be sufficient to allow any qualified physician to serve in these positions.

(8) Capital Expenditures:

The Strata Committee is charged with reviewing all expenditures greater than $50,000 that relate to patient care. The Committee needs to be utilized, not circumvented, and have access to the Board of Trustees when items are in question.

(9) Referrals:

Patients accepted for care at EMMC must have the approval of the physician assuming responsibility for their definitive care. They need to be assured that physician and institutional resources are available to meet their needs.

In summary, we remain deeply committed to the mission of EMMC. We believe that this mission is in serious jeopardy unless there is a change in the current climate of exclusion of the physicians from meaningful input. With the present financial and political challenges facing our society, it is more critical than ever that EMMC partner effectively and work collaboratively with us, the physicians of this community. Over the years, we have tried repeatedly to address these issues through the present executive administrative, and Medical Staff structures without success. It has now become imperative that the Board of EMMC understand and address our concerns.