Horror in Huntsville II: Turf Wars and Sham Peer Review

Here is part one of the story.

In 2003, Dr. Stephen Taylor had been a sixteen year veteran with staff privileges at Huntsville Hospital. When he first arrived at Huntsville Hospital in 1987, he was an idealistic new surgeon that always spoke his mind about ways to improve patient care. His confrontational style likely rubbed a lot of people the wrong way, and Dr. Taylor told me that he is also convinced that it lead to the wrong image, and ultimately what happened next. At the time in question in the beginning of 2003, there was a fracturing of the vascular surgery group. For about a year, he was working as part of a corporation, the Huntsville Heart Center Corporation. There were three vascular surgeons like Dr. Taylor part of the Heart Center, Dr. Fred Stucky and Dr. Ronny Johnson.

A hospital will given a doctor privileges. This means that said doctor can work as part of the staff of said hospital. The hospital itself, which gives them privileges is NOT their employer necessarily. In this case, Dr. Taylor was employed by the Huntsville Heart Center. Vascular surgery took second fiddle within the Heart Center to Cardiology. At the time, cardiologists, of which there were 24, were making an average of around one million Dollars yearly. At the same time, vascular surgeons, of which there were only three, made on average about three quarters of a million Dollars yearly at the Heart Center. After a dispute over money, the Vascular Surgery team split up, and Dr. Taylor formed his own corporation and continued to work as a privileged doctor at the Huntsville Hospital. (He also had privileges at a much smaller hospital, Crestwood Hospital)

At the time, there was a "chic" fairly new procedure that every doctor working on the heart was vying to be able to do, Carotid Stenting. This was a procedure that both Vascular Surgeons and Cardiologists were capable of doing, and it presented an enormous potential new income stream. At the time in question, no specialty had yet been approved to this procedure at Huntsville Hospital.

In April of 2004, Dr. Taylor was performing Carotid Endarterectomy. He needed to get at a valve deep within the vascular system and he needed to make a decision quickly in the middle of this procedure. He concluded that the easiest way to accomplish his goal was by using a Carotid Stent. The difference between the procedure, Carotid Stenting, and the technique that he used gets into all sorts medical technicalities. In this case, Dr. Taylor was making a decision which technique to use as part of a larger procedure. He was after the expert, as the Vascular Surgeon, and the procedure, Carotid Endarterectomy, was being done by him. He felt that the Carotid Stent was the easiest way to accomplish his goal.

This is exactly what he did. Unfortunately, the patient wound up later on having a seizure and eventually dying, though, Dr. Taylor told me that the seizure was in another part of th heart and not where he operated. As soon as he finished the Carotid Endarterectomy, Dr. Taylor informed the Chief Medical Officer, Dr. Robert Chappell, of what he did. Nothing seemed out of the ordinary about the conversation and Dr. Taylor went on his way. Unfortunately, the patient ended up dying days later. In the immediate aftermath of the death, Dr. Taylor was NOT cited and was not disciplined.

Then, in September of 2003, he was informed that his privileges at Huntsville Hospital would be suspended. By October of 2003, his privileges were revoked entirely. He was eventually cited as a "disruptive doctor" and for performing an "unprivileged procedure". . He was cited by a committee of non Vascular Surgeons who deemed his action an "unprivileged procedure". Dr. Taylor attempted to argue that he was performing the technique of a Carotid Stent in a procedure he did have privileges for. Had he not fractured from the rest of the Vascular Surgeons, one of them might have testified on his behalf. As it was, Dr. Taylor was facing the entire weight of the Huntsville Hospital apparatus on his own. His privileges were never restored.

Furthermore, because of HCQIA, his citation eventually as a "disruptive doctor" is now found in every central databank. As such, whenever Dr. Taylor looks for work, his potential employer sees that Huntsville Hospital cited him as a "disruptive doctor". At the time of the incident, he was making $750,000 yearly. He now struggles to make $50,000 yearly. He has since filed for a divorce from his wife.

Furthermore, in 2005, he filed a law suit in Federal Court in Birmingham, Alabama. His attorney filed for a motion for summary judgment in 2006 with Federal Judge Virginia Patterson. That summary judgment has sat idle for over two years with no decision in sight. In 1997, Huntsville Hospital hired the Greeley Company, a hospital consulting firm. Greeley lists among its specialties, identifing and dealing with "disruptive physicians".

Huntsville Hospital is a force in Alabama. It is one of the five biggest employers in the state. Huntsville Health Corporation is a mysterious being. It is technically a part of the government of Huntsville, Alabama. While its board must be approved, but not nominated, by the City Council of Huntsville, that appears to be the only clear relationship between the two. It's unclear just how much the hospital makes, though nine digits yearly is a good guess, and it's even more unclear just who the profits go to. It is clear that being a member of the board is a powerful and lucrative position. Often times, members of the board are local business persons and power brokers, and it isn't clear just how much background any of these folks have in running a hospital.

Also, please check out other such stories like a doctor in South Carolina that was targeted for reporting on a serial killer nurse, a doctor in Texas targeted by Blue Cross/Blue Shield, the Texas Medical Board's systematic targeting of doctors, and of course the one that started it all the tragic case of obscene corruption at Atlanta's Grady Hospital. Please read them all and demand that action be taken so that the scourge of sham peer review ends.