Horror in Huntsville I: The Introduction

Huntsville Hospital is a posh, well to do, full service hospital that is also a money machine. Its revenues appear to run into the nine digits (before the decimal point of course). I say appear because Huntsville Hospital is also structured in a manner that makes its earnings mysterious and difficult to track. Huntsville Hospital is a part of the Huntsville Healthcare Corporation which is embedded into the city of government of Huntsville, Alabama. That said, it is not technically a fully public hospital. Its structure is much more like JCAHO and Fannie Mae and also similar to how Grady Hospital is structured now. While the city council approves all nominated board members, it is unclear how much further that influence goes. As such, it is not very clear who the profits ultimately go to.

What is clear is that Huntsville Hospital is a very powerful force not only in the area but in the state in general. Huntsville Hospital is one of the five biggest employers in the entire state. A spot on the board of Huntsville Hospital is coveted and often goes to powerful members of the community. For instance, one of the board members, Jerry Larrison, is also owner of the prominent construction company LDF Construction. Often members of the board are powerful local business persons with great power in the community but little clear experience in running a hospital. Yet, the board of Huntsville Hospital is where the overwhelming majority of its power lies.

In 1986, Congress passed a law called the Health Care Quality Improvement Act (HCQIA) Among many other things, it allowed for greater protections to medical professionals that report on wrongdoing of other professionals. For instance, it provided what is known as qualified immunity for all accusers, meaning immunity from suit of monetary damages, as long as the accuser had a "reasonable belief that the action taken affected health care quality". Furthermore, HCQIA created a database for doctors that were merely accused of wrongdoing from medical peer review not strictly convicted. For instance, I chronicled the case of Dr. Blake Moore. He reported on a nurse that he believed was acting as an angel of mercy and killing off terminally ill patients. He became targeted and eventually hospital officials accused him of child abuse. Even though those charges were never proven, the charge continues to be stuck in the database and his career has been ruined.

The Greeley Company is a hospital consulting company. Among their many services is their consultation in "dealing with disruptive physicians". Here is how their division HC Marketplace describes the situation.

Disruptive physician behavior can harm patients, staff, and physicians themselves—and it is a top Joint Commission concern.

In July, The Joint Commission issued a Sentinel Event Alert that highlights the negative effect disruptive behavior has on patient safety, as well as how it can put the hospital at risk for litigation, cause staff morale to plummet, increase cost of care, and undermine performance improvement efforts.

Learn a non-punitive, constructive approach that can reduce behaviors that place both physicians and their patients at risk.

Of course, "disruptive physician" is a vague term and and when it is combined by a medical professional executing the equally vague " reasonable belief of health care quality", it can mean almost anything.

Finally, the specialties of vascular surgery and cardiology are both highly specialized and fruitful professions. At Huntsville Hospital, both professions could net either about a three quarters of a million Dollars yearly and many even made over a million Dollars yearly. The two specialties have lots of overlap like in the highly profitable carotid stenting procedure. Each specialty is in constant competition for highly profitable business. This creates all sorts of professional turf wars. Most wind up being cut throat professional tug of wars in which specialties jockey for position to make sure that their specialty is the one that maximizes the high ticket item. Sometimes though, these turf wars turn corrupt, and competition is eliminated using the corrupt practice of sham peer review.

This is the set up for Dr. Stephen Taylor. He was a vascular surgeon at Huntsville Hospital since 1988 in 2004 when he believes he became the victim of sham peer review as part of a turf war between the two specialties. As a result, the central medical database continues to list him as "disruptive physician" and he can't find any steady employment. His reputation has been ruined. He makes one tenth of what he used, and to top it off, a Federal Case he filed has been stuck for nearly two years. Of course, those details will come in part two of this tragic tale.

Here is part two of the story.