This is the second part of a two-part series. Access part one here.
Disputes between physicians and hospitals can come in all sizes and forms.
In what started out as a challenge to management and clinical policy changes at 63-bed Christus Spohn Hospital Beeville (Texas), ended with at least four physicians resigning from the 12-member medical staff and a general surgeon entering into negotiations to acquire the county hospital.
But negotiations to take over the lease from Christus Health, a 17-hospital not-for-profit system based in Dallas, ended in June after surgeon Rodney Schorlemmer, M.D., went public with his complaints to the local newspaper, says Thomas Royer, M.D., Christus president and chief executive officer.
Schorlemmer "proposed to the county to take over the lease of the hospital and turn it into a for-profit entity. We told the county we would be willing to talk about it if that is what they wanted, Royer says. After he went public, we said we were not going to talk anymore.
Royer says the dispute began in March 2005 when Christus began to implement several quality-improvement policy changes at its hospitals. Meetings with physicians and staff were held to explain the process and the rationale. Some of the projects included moving toward national protocols in pain management, myocardial infarction and allowing families in critical-care units, Royer says.
As protocols move through organizations it sometimes causes major pushback by doctors, Royer says. The (hospital administrator) was highly criticized at the time. He had my full support. The implementation was no different than at other facilities.
However, Schorlemmer says his displeasure amounted to more than questions about quality improvement changes. He charges that the hospital altered the minutes of medical staff meetings without doctors knowledge or permission; refused to change a guidebook that promised patients they would have no pain during their stay; and attempted to discipline a physician and terminated a staff member without going through the medical staff.
Schorlemmer also alleges Christus Spohn charges patients much higher prices for tests than other area facilities.
As physicians, we hear patients complain first. I have had numerous patients come in and said, 'Why dont the doctors take over the hospital? We dont like what is going on,' Schorlemmer says.
Schorlemmer, who maintains his office of 21 years across the street from the Beeville hospital, resigned in March 2006. His former partner, Michael Belew, M.D., left in September 2006 but sees patients once a week at Schorlemmers office. Both surgeons hold surgical privileges at other hospitals.
We also lost a family practice doctor and an internist, Schorlemmer says. They just didnt trust (the Beeville) hospital anymore.
The Beeville hospital has since recruited a general surgeon and an obstetrician-gynecologist, Royer says. I am sorry these physicians left, but I understand why they did, he says.
In February, David Wagner, the Beeville administrator, resigned. Jerry Rodriguez was hired to replace Wagner, Royer says. Rodriguez was formerly vice president and chief operating officer of the hospital.
Schorlemmer says a group of physicians, citizens, local investors and hospital companies are still interested in purchasing or leasing the Beeville hospital. A community group is circulating a petition that asks the Bee County Commission to seek out other management for the hospital, he says.