Jason Sandford
Jason Sandford is a reporter, writer, blogger and photographer interested in all things Asheville.
Thanks for the comment. Here it is:
It seems to have taken the resignation of Dr. Mike Beuchler to cause this long-simmering controversy to finally boil over. And there’s a tragic story leading to that tortured, last-resort decision. The treatment of the Trauma Surgery Dept. is a microcosm of the entire way administration has treated the employed physicians — a combination of incompetence and arrogance.
MB is one of the least arrogant, most humble and self-effacing doc you will ever meet. Here’s a doc whose life work has been to improve patient outcomes. He built the trauma service into one of the best in the country and the second or third busiest in the state. Where other trauma centers with their volume would have 8 or more docs, a host of PAs, and several levels of residents, Mission had to do with 5 docs and 2 PAs.
That meant docs working 28-day shifts, half days / half nights. That meant absolutely nothing to Administration. MB pleaded and pleaded for additional help for the service, but was repeatedly rebuffed. Administration just didn’t see where the “numbers justified it.”
This was 100% inconsistent with the findings of the administration-hired consulants who came in to assess the hospital docs in preparation for contract negotiations and establishment of the governance structure (another story entirely).
MB and other trauma docs were warned to stop complaining about the need for additional help and the risk to patient care or they would be fired. They were warned that if they spoke to the Board they would be fired. MB was also told they could hire another doc for the service, but only if he quit.
At one point, a potential candidate (board-certified) came in and interviewed for a job and was told by Administration something like “Why should we pay to hire a board-certified doc like you when we can get a cheaper general surgeon right out of residency?” This is our emergency department!
Does Mission want to provide the best-quality care for people with an emergency in the region, or do they want a MASH unit that provides the bare minimum and have patients choppered to Charlotte, where the delay in treatment can mean the difference between life and death?
One final point: Throughout all this, Administration never once met with the trauma group as a whole, insisting on individual meetings where they shamefully, and not very discretely, tried to turn some of the docs against the others. They would say one thing to one doc, then deny saying it to the other docs.
This is our management team.
In reference to weknow and saddened, i have been a NTICU RN for many years, under both administrations and prior to the arrival of our wonderful and caring trauma surgeons, Drs. Buechler and Shillinglaw. After their arrival morale skyrocketed, patient outcomes vastly improved while length of stay decreased, (the statistics are available) very different than the sometimes negligent care we saw by physicians who were not trained in trauma. While it is true we are expected to perform at a higher standard we are happy to do so as we work as a team, every member being heard. I also have seen many doctors and nurses loose their temper–always related to patient care. If you are negligent or lazy in your care of a patient their should be repercussions, dealing with human emotion is a much smaller price to pay than losing your license. Because I work in other units at times I understand that RN’s are not treated with the same level of respect as we are accustomed to in NTICU. Yes MB is a fine surgeon, but I like to think of him more as an intellectual giant who has left an indelible mark on the landscape we call Mission and the thousands of lives he has touched.
As a mission employee, I started hearing the gossip about ashevegas a week ago. Today is the first time I had the time to read this. I am so embarrassed. I am an RN of many years experience in a variety of settings. I have lived in this city for 10 years employed at Mission Health Systems the entire time. Several years ago I made peace with the narrow-minded self absorption inherent in this community because I love nursing and serving and these mountains are like no place else I have ever been. This rhetoric is harming my practice. Mr. Damore entered a "Good-old boy" system that I am sure was daunting. Perhaps he did try to hire his own "team". The financial end of this new process has been very difficult on a daily basis. This stress of trying to deal with budget cuts is ever present. In my many years of practice, I have seen this before…"More with less". Until this time I have always seen Nursing rise up and deal with it….speaking honestly and truly. If you are a nurse speaking on this blog please remember that you are here to serve and protect. Our salaries are a lot better than many in the area and I see many families sustained from this. WE ARE RNs. Please don’t get caught up in this power struggle between 2 opposing forces. Do you honestly think your interests are being served here? If you really want to serve your practice and your patients, step back, separate yourself and think about what we really need. Dr Buechler is a fine surgeon and I wish him well…but I have seen him loose his temper, lash out and leave…never to apologise to the people left in his wake. Nursing is a force to be reckoned with. We don’t need a union as much as we need self respect…
as an employee of MH for several years I am seeing the crap so to speak come from the top. Dr. Mike buechler is an asset to the hospital sysytem. Shame on you JOE Damore and your leadership team. You screw your employees royally yopu dont give us a raise when we are still the lowest paid in the region? You treat docs like buechler who sitll care and do great things in our community with little respect… come on….. keep it up, you will reap what you sew
The problem is, and always has been, that healthcare is run by buisnessmen, who have exorbitant salaries and very little personal risk, thanks to "golden parachutes" and other undisclosed financial agreements . This is great if one is manufacturing cogs and shippping them to all the Wamarts of the world. However, medicine is not such a simple buisness model. There is much more at stake. When Mission posts their administrative framework, it resembles that if a pyrimid-with Joe Damore at the top, and everyone else beneath, supporting and working toward his vision of a profitable buisness. In healthcare this framework should inverted – the most important relationship, that being between the careproviders and the patient and families, at the top. My only hope for enlightenment for this man is that someday he persanally has to experience an overburdened and underfunded Healthcare team. Nah…nevermind- he’ll just sue.
As an employee at the hospital now going on 15 years, I can tell you there is a lot more to the story than what people are writing here. The doctors at Mission did the same thing to our previous CEO (who was loved and did so much for us) and they drove him off, and now they are after our current CEO and team. The doctors talk a good game, but their actions are something different. Just asked some of the nurses how doctors treat them. It wont be pretty. As i read some of the comments, it seems like to me that some of the posters on here are actually doctors on here with their own agenda. Their voice and words echo loudly. You know who you are and you should be ashamed Dr. Buechler and Shillinglaw.
Thank you to the "interested physician!" And you can bet that the employees of Mission are NOT going to let this just blow over! We don’t care how many suck up emails JD sends out via the hospital email system we see through his B.S. now! Nothing will change his inherent character flaws which got us in this mess! If it takes a Union to come in here then so be it! The board will have no one to blame but themselves. Clean up the mess that has been made and let us, the real health care professionals, get back to caring for this community!
I see in the ACT the Board and health care professionals (doctors) are "working together" to improve relationships.The current administration problem goes far beyond the tension between the Adm.and MDs–it gos to the very core of the health care professionals–nurses,volunteers,–everyone.Morale is terrible,trust is zilch and this is not going to be corrected by a bandaide of "working together"It will be business as usual as soon as this blows over.The problem is so deep that a clean slate of administrators is needed.The Board,made up of competent people as it is,is for the most part not fully aware of the inner workings of the medical profession including all health care professionals,not just the docs.These professionals are a team which has to trust each other,feel as if the hospital and board support them or bad things can happen as far as patient care which is what the whole deal is about anyhow.This administration has been a mistake,starting over is the best way to correct this situation.
Does the publication of Nancy Bompey’s article in the Citizen-Times mean media coverage of the problems at Mission is over? Many readers are still unclear what’s really at stake here? What’s really going on? Will Mountain Express do any real investigative journalism on this ?
Ref. ctdurham above, going back to last year, several things were not shared with the board (facts on JD’s history and a letter of indignation from a highly qualified trauma surgeon that had been interviewed for a position and praised the docs but was highly critical of the administration), so what else is new? That’s why it’s so imperative to come clean, and for the docs to stand firm. The only way to beat Damore is to stick together and force into the open the lies and manipulations of the past. If that doesn’t happen, the board will cave and the battle will be lost…and CMC will walk away with the remnants.
None of what is happening should be unexpected. It was clear from the time Damore was hired that he didn’t "fit" the culture that existed at Mission or the community. What made Mission a great hospital: outstanding physicians and 6000 employees that are very good at what they do.
Damore came in trusting no one – physicians or staff. Over time his lack of trust and insecurity led him to recruit people that he could control. He moved all decision making away from the people who knew what was needed and how to best get it done – he has a tremendous need to control all decisions. He never trusted physicans and slowly has eroded what was avery fuctional and sucessful relationship between the physicians and the hospital. Let’s not forget about the region. For years Mission was a national example of how a tertiary hospital could work with other providers in the region to achive common goals. JD had to control that too – he couldn’t trust them either.
So what has happened has really been very predictable. It was common knowledge for anyone who did a reference check on JD to know they were getting.
The good news is those outstanding physicians and staff are still around. What they need is a leadership that will allow them the opportunity to be great again.
Thank you to our asute local news media for being persistent enough to broadcast what many of us at Mission Hospital have known and endured for some time now.
I have been an employee at MH for over 15 years and have worked with Dr. Mike Buechler for over 11 years. As others have mentioned on various blogs, he was truly a gift to WNC. Our community has suffered an extraordinary loss of quality medical service and will not be the same without his tireless committment to each trauma patient/family and without his regional trauma service leadership. He is undoubtedly one of the most talented physicians in our community, and he epitomizes the rare combination of expertise, leadership, and compassion. He is also a teacher and quietly taught all of us by example the true definitions of quality and MERIT. We can also say the same of his colleagues, the remaining 4 trauma surgeons. Of pertinent importance is that the "second in line", Dr. Bill Shillinglaw, is doubled boarded in trauma surgery and critical care medicine. He also has a Masters in Public Health degree from UNC-Chapel Hill. Those of us who work in trauma would like for him to become the new Director of Trauma Surgery. Bill would also like to take on this position. However, he is being told by the administration that he will not be given an opportunity. The bottom line is that the current administration (the Joe and Brian team) doesn’t like Bill because they perceive him as being a threat. The "Joe and Brian team" has lied to and threatened all five trauma surgeons at different times. They were told that they were not allowed to talk to MH Board Members. They were also told that they could be ‘replaced tomorrow" and that they would "ensure that they aren’t hired anywhere else."
Classic leadership training from Covey and Maxwell and others is that people will work for you and follow your example if you are a positive role model. What has happened at MH?
Thank you so much for this opportunity to air some of the dirty laundry which has been piling up for some time now. Many of us who work for Mission have been extremely frustrated and angry because we did not have a forum. How can you talk with your supervisor or HR when they are under the thumb of THE DICTATOR and his immediate underlings? The dirt just continues down the line of command because we all need our jobs. This puts us in an ethical delimma. We know the Emperor and cohorts are stark naked, but shouting out the truth will lead to our demise.This is a well known and proven fact. Come on Board of Directors, take off your blinders and look closely at the staff satisfaction survey. (before it gets shredded.) Our wonderful healthcare here in Asheville is sliding down a very slippery slope. You have the power to turn things around.
I have read the letter from the prospective trauma surgeon to the then chair of the MMH Board (which was not shared with the board at the time).The administrations behavior towards him was reprehensible.The communication between the now departed to MMH was also read by me.The MD that developed the trauma service was treated extremely poor,threats,lies and innuendos.The current administration has made enemies of the remaining hospitals in the area–ie-Carolinas Medical Center moving into our back yard.The Board at MMH was advised not to let this happen.The moral of staff at MMH is the lowest in history which has been going on since the current administration took over.The currrent Board of Directors needs to make the right decision for the Asheville and WNC area and soon.A problem seems to besome of the current members are responsible for the administration arriving here in the first place.Its time for the board to put that behind them for the salvation of one of the best hospitals and health care community in the southeast.Its almost too late.
Deplorable. It’s about MONEY MONEY MONEY MONEY and patient care be damned.
Keep it up, Mission. Carolina Medical would love to expand.