The Medical Center of South Arkansas will begin its relationship with a new staffing agency early next month, and a lawyer representing several doctors at the hospital said at least four physicians have yet to be offered the opportunity to continue in their jobs there.
On Aug. 9, former MCSA Chief Executive Officer Scott Street announced to MCSA staff that the hospital would be ending its years-long relationship with Shumacher Clinical Partners (SCP Health), a hospital staffing agency. On Sept. 1, he said MCSA's new vendor for hospitalist and ER physician services would be Emergency Staffing Solutions (ESS)/Hospital Care Consultants (HCC).
ESS/HCC's contract is scheduled to go into effect on Nov. 9.
In June, the general medical staff at MCSA voted "no confidence" in hospital leadership, specifically that of Street. Street eventually resigned from the hospital on Aug. 24.
On Aug. 12, during a staff meeting, 13 doctors out of 16 present voted to maintain MCSA's staffing contract with SCP Health; the three others abstained from voting, according to Vicki Gilliam, an attorney representing 11 physicians who voted "no confidence" in the hospital's leadership over the summer.
Doctors also held a second "no confidence" vote that day; 12 doctors out of 15 present voted no confidence, while three others abstained.
Gilliam said this week that on Oct. 13, MCSA Chief of Staff Dr. Ezinne Nwude; Emergency Department Medical Director Dr. Ugo Nwude; Hospitalist Dr. Greg Smart; and Emergency Physician and Hospitalist Dr. Abrar Khan were informed by ESS Chief Medical Officer Dr. Karl Wagenhauser and ESS Vice President of Business Development Jessica Williams that "they would not be offering contracts to them that would allow them to continue in their current positions at the hospital."
"Sadly, this is the very path that my clients had hoped that ESS would choose not to take, given that these doctors all gave truthful testimony to (a) CHS (Community Health Systems, the company that owns MCSA) investigative attorney about the quality of patient care and treatment of medical staff at MCSA while under the leadership of former Administrator Scott Street," Gilliam said in an email.
Hiring practices
Shonda Rupe, chief operating officer for ESS, said in an email Saturday that the company doesn't "comment on or provide information related to its decision-making criteria and processes as they deem that information confidential and proprietary to the business operations of ESS and HCC."
"In the case of Medical Center of South Arkansas, as with all their clients, ESS and HCC vetted several physicians, including physicians with whom ESS and HCC had existing contractual relationships," Rupe said. "ESS and HCC made physician contract decisions based on what they believed would best serve the emergency department and hospitalist programs of their healthcare facility client and the business needs of ESS and HCC."
Gilliam noted that when ESS/HCC was announced as MCSA's new vendor for staffing services, Street said all of the hospital's current doctors would have the opportunity to meet with representatives of the company to "learn more about their staffing plans and positions available."
"Although Street announced that all doctors would be given the opportunity to continue their contracts with MCSA, my clients report that no interviews were conducted with (them), leaving my clients with the impression that there was no realistic consideration of these four doctors for new contracts," she said. "According to these four doctors, no valid excuse was given, during the phone calls made this week, as to why these long-time, committed, local doctors were not asked to stay on in their roles at MCSA."
She said the Nwudes, Smart and Khan were not interviewed by ESS, nor were they offered continued employment in positions other than the ones they currently hold.
Cindy Grimmett, executive assistant to interim MCSA CEO Dwayne Blaylock, said on Friday that doctors employed at the hospital through SCP Health that have "not finalized their plans for the future" had been offered the opportunity to meet with hospital leadership "to explore opportunities to work together moving forward, even if that is not through employment with ESS."
"When hospitals contract with physician staffing services companies, those companies determine which physicians to hire based on their staffing models, job criteria, and the interviews they conduct with candidates," Grimmett said. "Medical Center of South Arkansas and CHS were not involved in any way in the selection of provider candidates, interview and screening process or hiring decisions made by EES/HCC regarding staffing for MCSA. Any suggestion otherwise is absolutely false."
However, Gilliam said the four physicians who haven't been offered new contracts through ESS/HCC hadn't been notified of the opportunity to speak with hospital leadership.
"(My clients) feel this was, apparently, a decision made in an effort to choose a new company who, on information and belief, was apparently willing to commit to not offer contracts to the most outspoken of the doctors in the battle with CHS to bring attention to the state of and events occurring which, in the medical staff's opinion, gave them 'no confidence' in the Administration led by Scott Street," she said.
Rupe said ESS/HCC prides itself on its work with doctors in rural communities.
"Both ESS and HCC pride themselves on their decades of experience serving the needs of rural healthcare facilities in Arkansas and throughout the United States. ESS and HCC contract with hundreds of physicians throughout the United States and take great care in the process of identifying and developing contractual relationships with physicians that serve the rural healthcare facility clients of ESS and HCC," she said.
Grimmett said MCSA executives are excited about the hospital's new relationship with ESS/HCC.
"We are excited about ESS beginning services at MCSA. ESS is an experienced company with a more than 20-year track record of serving hospitals just like ours, including some others in Arkansas. They have a reputation for working very well with their physicians and for working closely with their hospital clients to improve quality of care and patient experience," she said.
Whistle blowing
Over the summer, Nwude said problems at the hospital affected quality of care and staff morale.
Several nurses and MCSA ancillary employees spoke to the News-Times over the summer and alleged issues at MCSA including understaffing, COVID spread among patients, supply shortages, low wages and a toxic work environment.
An investigation into the general medical staff's allegations -- which were forwarded to CHS in several letters -- followed the first vote of no confidence. The investigation's findings were presented to the MCSA Board of Trustees in July; they subsequently voted to ask CHS for a "new administrative structure."
In the email announcing the end of MCSA's relationship with SCP Health, Street also announced the immediate resignation of Chief Nursing Officer Amy Triplet; the promotion of Chief Quality Officer Danna Taylor to the role of "associate administrator;" and that Director of Respiratory Therapy Mark Allman would be taking on "some operational responsibilities."
Subsequent to Street's resignation, Dwayne Blaylock was announced as interim CEO of MCSA.
All four of the physicians who haven't been offered jobs at MCSA are employed there currently through SCP Health. Gilliam noted that the hospital's contract with SCP Health wasn't set to end any time soon.
Former MCSA Executive Director of Business Development Alexandria Bennett said in August that the change in staffing agencies had been in the works since the beginning of the year.
Gilliam noted that the doctors who haven't been offered jobs at the hospital have deep ties to the community.
"Dr. Greg Smart has been a physician in El Dorado for forty years, and he was not asked to stay on. Dr. Smart had been passionate and emotional about his whistleblowing as to Street's and former DON (Director of Nursing) Amy Triplet's policies and management which were causing issues of quality of patient care and treatment," she said. "Dr. Ezinne Nwude, as Chief of Staff, fulfilled the duty of that position and brought light to the same issues with passion and commitment to making a change."
Dr. Ezinne Nwude was recognized last December by SCP Health with its Excellence in Leadership Award, which she was chosen for over 419 other physicians that contract with the agency. She has worked at MCSA for over seven years.
"Now, it appears that they made the ultimate sacrifice for (whistle blowing)... losing their jobs at a hospital in the community of patients for which they fought so vehemently to protect," Gilliam continued. "My clients can only surmise, sadly, that this was a retaliatory move against the good doctors who defended the safety of their patients and opposed the pattern of treatment to the medical staff."
"Effective November 10th, all four physicians will no longer be working at this facility as Hospitalists or ER physicians," Gilliam said.