A new, more detailed survey intended to gauge the level of support or opposition of the corporate leadership of eight-hospital Beaumont Health is being circulated among the 5,000 physicians of the Southfield, Mich.-based health system by presidents of the hospitals' medical staffs.
Last week, Crain's reported that a "no confidence" petition was circulating among doctors on CEO John Fox and Chief Medical Officer Dr. David Wood.
The new survey — which the medical staff presidents plan to present to the 16-member Beaumont board of trustees as soon as possible — asks five questions designed to judge the relative confidence in the system's top executives and whether the proposed merger with Chicago-based Advocate Aurora Health would enhance patient care.
Several physician sources, who asked for confidentiality out of fear of management retaliation, told Crain's Thursday morning that leaders of the new survey say they plan to present the results to the Beaumont board along with yet unspecified requests for action on Fox, Wood and Chief Operating Officer Carolyn Wilson.
"This survey, developed and managed by medical staff leaders, is being sent to physicians at each hospital in an effort to help resolve the ongoing and increasingly public controversy involving Beaumont Health. A secure platform is being utilized, guaranteeing anonymity," according to the cover letter sent out by the medical staff presidents and the presidents' council.
Beaumont said in a statement that a survey is a good way to receive feedback. Top executives also are meeting with the medical staff presidents to listen to their concerns "and work with them on a path forward," the statement said.
Two Beaumont physicians said more than 1,000 doctors so far have responded to the survey, which was emailed to many of the 5,000 members of Beaumont's medical staffs on Wednesday. Two doctors told Crain's they hadn't seen the new survey as of late Thursday morning.
The physician survey is intended to replace the no-confidence petition, said the physician author of the petition. The petition asked the Beaumont board to immediately fire Fox and Wood because of a "rapid and progressive deterioration in every aspect of patient care at Beaumont Health" and loss of confidence in the "administration’s ability to provide a safe place for us to care for our patients."
Several dozen physicians signed the petition, but the physician author said some top doctors were unhappy with the wording of his petition and refused to endorse it because of the implication that Beaumont's quality of care has worsened.
"They want to go through official channels, using elected medical representatives," said physician author of the petition, who requested anonymity. "I am willing to comply as long as they really represent the medical staff. From what I can tell the pressure from the staff was so great that they had to agree to represent us. If they get afraid I will continue to push them. My involvement does not stop here."
In the end, the physician author said he agreed to hold his petition in favor of the medical staff presidents' more comprehensive survey of Beaumont doctors. He added that he still maintains the only solution is a change in management.
Phone messages seeking comment from several medical staff presidents and chiefs of staff were left by Crain's Thursday. One chief of staff said the survey results will be tabulated over the next several days.
"We thought it was an important way to capture medical staff sentiments for the board to consider," said the hospital chief of staff, who asked for anonymity. He said the presidents will present the board with action suggestions."We wish to address the board and have more input into strategic decisions regarding mergers, contracts and capital allocations," the chief said.
Each of the five questions in the survey have five choices: strongly agree, somewhat agree, neither agree nor disagree, somewhat disagree and strongly disagree. Doctors also have the ability at the end of the survey to add personal comments.
The five questions ask the following:
I have confidence in corporate leadership.
The proposed merger with Advocate Aurora Health is likely to enhance our capacity to provide compassionate, extraordinary care.
Corporate leaders are fostering a culture of excellence.
Corporate leadership is helping to make Beaumont the workplace of choice.
Corporate leadership appropriately prioritizes and allocates resources to support quality and patient safety.
During the past month, Crain's spoke with nearly two dozen doctors about the direction Beaumont has been headed the past five years since Fox was hired from Emory Health in Atlanta.
All doctors asked for anonymity and said they feared retribution if their names were known by Beaumont executives.
In a previous interview, Fox and Wood said they are taking complaints by physicians seriously, but that they need to understand more specifically what those complaints are.
Over the past week, Fox and other Beaumont executives have been holding Zoom teleconference meetings with doctors to hear their thoughts.
Two doctors told Crain's that Fox appears to be listening to concerns, but said Fox also used the opportunity in one Zoom meeting to criticize media reports on the controversies as overblown.
There have been ongoing reports for the last two years about various problems doctors have with Beaumont's leadership. In December 2017, United Physicians, one of the largest physician organizations in Southeast Michigan with nearly 2,000 doctors, began a running dispute with Beaumont over managed care contracts that led UP to sue Beaumont last year and withdraw from the system's provider network.
During the past year, top doctors have either resigned and left for other systems.
For example, two of Beaumont's top heart surgeons — Marc Sakwa and Jeffrey Altshuler — resigned and left late last year. They are now top surgeons and clinical leaders at the MemorialCare Heart and Vascular Institute in Los Angeles.
Others who have left for various reasons include David Walters, former senior vice president of Beaumont Health Physician Partners and an ER physician; Brian Berman, chair of pediatrics; Leslie Rocher, senior vice president and former chief medical officer at Beaumont Hospital Royal Oak; Matthew Zimmie, M.D., vice president and system chief medical informatics; and Paul LaCasse, executive vice president of post-acute care and diversified business operations and former Botsford Hospital president.
There are two major controversies that cut across Beaumont hospital medical staffs.
The first is a new employed physician compensation plan, called CARTS 2.0., that Beaumont has been rolling out by specialty for the 1,300 employed doctors in the Beaumont Medical Group.
Several doctors told Crain's the new compensation plan would drastically cut their compensation, some up to 50 percent, even though their production is high.
Fox has said that some doctors will be paid less, but he said some underpaid doctors will receive pay boosts. "We aren't saving money. We are reallocating money," he said.
The second major issue, which some doctors told Crain's was the tipping point that caused them to sign petitions and object to Beaumont's executive leaders, is the proposed merger between Beaumont and Advocate Aurora Health.
In mid-June, Beaumont signed a letter of intent to merge with Advocate Aurora Health, a 28-hospital system in Illinois and Wisconsin with $12 billion in revenue. Sources, all of whom asked for anonymity, tell Crain's that the Beaumont board is nearing a decision to approve the merger.
Last week, the independent members of the Beaumont Health board of trustees issued a statement of support for the proposed merger and for Fox and his management team.
Fox has advocated for the merger on the grounds that a larger, multistate Beaumont will give the system a better credit rating for issuing tax-exempt bonds, allowing more capital spending for buildings and equipment and greater negotiating clout with payers. He also said Advocate's expertise in population health management will give it a competitive advantage in Michigan.
But many doctors said they believe the loss of autonomy and local control over Beaumont outweighs any merger advantages.