Doctors at a medical staff meeting at Eastern Maine Medical Center voted overwhelmingly Tuesday night to support a nine-point petition formulated by a group of physicians unhappy with administrative decision-making at the Bangor hospital.

Only one or two of the 197 doctors present did not vote for the resolution, according to three doctors in attendance. EMMC has 324 full-time physicians with staff privileges.

“I think the myth of 31 disgruntled physicians has been exploded,” said Dr. Richard Smith, an anesthesiologist and former medical staff president who is part of the smaller group that drafted the resolution.

The petition states, “We believe that due to the over-extension of services, Eastern Maine Healthcare, EMMC and all their clinical affiliate organizations have drifted from [the mission of serving the well-being of peoples of Maine through excellent care] and this threatens their ability to provide health care services. The executive administration and physicians no longer work cooperatively. This failing has eroded the quality of patient care.”

The nine points ask for systematic changes to force the administration to share more timely information with doctors, and to give physicians additional decision-making authority in areas such as referrals from other hospitals. They ask for changes in administrative approaches to physician recruitment practices to ensure enough specialists are available for hospital duty. The letter was printed in its entirety in the Nov. 16 issue of the Bangor Daily News.

The elected head of the medical staff, Dr. James Raczek, said he is pleased with progress to resolve the issues, citing several committees that have been established to investigate doctors’ complaints.

“I think we’ve made some steps to start the process of looking at these issues,” he said.

Smith said he’s pleased that new lines of communication have been opened to allow physicians to present information directly to trustees and other leaders without being forced to go through the filter of EMH CEO Norman Ledwin. He said he thought the information might change the opinions of some trustees who have been insulated from doctors’ views.

“There are huge problems that are going to surface,” he said. These will relate primarily to the ability of the hospital to man subspecialty and surgical care, he said.

Smith said several groups are now working on the problems at the hospital. These include the medical staff, a separate medical committee chaired by Dr. John Adams, the hospital’s medical executive committee, and a joint committee of EMMC trustees and physicians.

Tuesday night, Ledwin sent out an e-mail listing the members of the joint trustee-physician committee, which has been convened under hospital bylaws for the first time in nearly 20 years. Trustee members are Arthur Comstock, Peter Hoff, Irving Kagan, Esther Rauch, Richard J. Warren, John Woodcock and Ledwin. Physician members are Daniel Cassidy, Irwin Gross, Mark Lingenfelter, John Long, James Raczek, William Sturrock and John West.

The committee will meet regularly to investigate the issues, EMMC Chairman John Woodcock said in an earlier interview.

At the medical staff meeting Tuesday, one of the two doctors not voting to endorse the nine-point petition was Erik Steele, administrator for cardiac services. He said he abstained because he wants to see what the investigations turn up.

“First of all, I think the issues need further explorations before we endorse them,” Steele said. “It will be a long, difficult process, and the issues are complex.”

Steele also said that because he is a member of a committee chaired by Dr. John Adams to investigate physician complaints, he wanted to maintain an objective position.

Because EMMC serves 500,000 people across a large region, he said that everyone must remember the hospital’s responsibilities. “That makes these issues more important for us to think through carefully,” he said.

Asked about changes at the hospital aimed at expediting care in the emergency room, Steele confirmed that the hospital has begun to use a new, more active means of screening patients. The system, called green light-red light, has yet to be formally approved, he said.

A green light means treatment rooms and beds are available. The beds are full in a red light situation, and new patients are accepted based on decisions related to their condition.

More changes at the hospital are being contemplated. Raczek, the medical staff’s elected president, has produced a draft proposal for a variety of changes to EMMC’s staffing and decision-making system. The effort won Raczek a round of applause at Tuesday night’s staff meeting, Smith said.

Doctors have complained that Ledwin has been making budget cuts over recent years that had begun to harm the depth of medical coverage at EMMC. Raczek’s possible solutions would expand the number of physicians to staff key areas, and allow for contracting with private practice doctors and hiring part-time help at hospital expense.

Smith said a key feature of one proposal would expand decision-making power of doctors and nurses into areas controlled by Ledwin.

“This [would] expand the number of physicians that are available to care for patients and empower individuals at a lower level to make things run smoothly,” he said.

Raczek said the proposals were ideas that will be considered by the committees investigating the complaints.