Conflicts of Interest

The potential for conflicts of interest arise regularly with corporate governance, all the more so in smaller communities, so it was not surprising that the directors of Eastern Maine Medical Center and the trustees of its parent company Eastern Maine Healthcare were concerned recently about a potential conflict of an EMMC board member, Dr. Ted Silver, a cardiologist with his own practice.

What was deeply troubling, however, was the resolution of the issue: Dr. Silver was removed from the board after serving on it for 10 years even as the board members voting him off said the doctor’s work on the board had been superb and that there had been no hint of impropriety.

The board lost not only a skilled and dedicated health care practitioner but also a valuable point of view that it needs to appreciate the concerns of the medical community. And it not only lost Dr. Silver; much-respected Bangor physician Thomas Palmer resigned from the EMH board in protest. Moreover, several area physicians responded, with a half-dozen writing of Dr. Silver’s removal, “The problem stems from the excessive focus of the current administration and board upon the business aspect of the hospital.”

Certainly, were the board to scrub itself clean of any potential conflict of interest it would lose other members, from doctors to developers, who do excellent work, properly recuse themselves when appropriate but still contribute significantly.

In a community-owned institution, the potential for a conflict of interest grows from the question of what interest should be served. Is the board’s interest the well-being of the medical center or the health of the community? The two, of course, should be aligned and often are, but when they are not, the board has a choice of adapting its policies or allowing either the medical center or the community to take precedence. The more often the medical center takes precedence, the farther the board moves from the realities of the community.

This should not be acceptable to anyone; good health care governance requires cooperation and compromise, a sense that those providing the care, directly and indirectly, have strong, positive ties with each other and with the community. Were those ties to break, the result would be a medical center that became defensive and autocratic. No one wants that.