Running a hospital is a balancing act: Doctors and other medical professionals try to keep patients healthy, while administrators must monitor the hospital’s vital signs. Asheville-based Mission Hospital and Health System is trying to regain its equilibrium as the five-year tenure of CEO Joe Damore comes to a close.
His resignation, effective Jan. 31, came after months of rising anger among staff physicians and those who send patients to Mission Hospital. Many accused him of heavy-handed management. Damore declined comment through a hospital spokeswoman, but doctors haven’t been shy about airing their views. In August, about 150 signed a letter to the hospital board complaining of “control and domination“ and bullying by administrators. “That led to some obvious conflicts that created a lot of stress and tension that sometimes got out of hand,” says Alan Baumgarten, chief of the hospital’s medical staff and a family physician at Asheville Family Health Center.
Doctors were disappointed when Mission Health System failed to strike a management agreement with MedWest Health System, a joint operating company for WestCare Health Corp., based in Sylva, and financially troubled Haywood Regional Medical Center in Clyde (“How a Hospital Had to Heal Itself,” March 2009). Instead of aligning with Mission, MedWest agreed to be managed by Charlotte-based Carolinas HealthCare System. Doctors say that gives Carolinas a competitive toehold on the health system’s turf and could mean MedWest patients who need advanced care are sent to Charlotte instead of Mission Hospital.
Doctors also say the health system stalled on building a cancer center and medical office building and failed to adequately equip and staff the hospital’s trauma center, leading to the resignation of well-regarded trauma specialist Michael Buechler. Baumgarten calls the mounting complaints “a perfect-storm kind of thing.”
Some health-care experts see the conflict as a manifestation of the angst of excellence. They say Mission Hospital consistently rates among the best in North Carolina and the nation, particularly in heart care, orthopedics, critical care and vascular procedures. It is the only hospital operating under a cost-control agreement with the state, and Damore has said it charges about 25% less than Charlotte hospitals. The health system has annual revenue of more than $1 billion, 40,000 patients a year and more than 6,000 employees.
Now, board members need to find a replacement who can mend the painful fractures while positioning the system for health-care reform. They’ve hired a search firm and are likely to appoint an interim administrator in the six months it might take to find the right person. “Hopefully, there’s a spot where the two can come together — financial responsibility and excellence of care,” Chairman George Renfro says.