Famous Hospital Traverses Some Rocky Terrain

Loma Linda University Medical Center stands as one of the brightest marquees of the Seventh-day Adventist Church.

Hundreds of infants have been saved by heart transplants pioneered by Loma Linda doctors. The separation of Siamese twins in 1996--and the birth of another set this year--have stirred the hearts of parents everywhere.

A high-tech cancer treatment center has reduced the debilitating side effects of radiation on patients. Personal-health research at the medical center has promoted smarter lifestyle decisions.

And the gallant--albeit controversial--effort to save newborn Baby Fae with the heart of a baboon in 1984 showed the world that Loma Linda dared to make a difference.

But like the church itself, the hospital in the town of Loma Linda, 60 miles east of Los Angeles, has been beset by internal controversy over its style of management.

Dozens of physicians have left the 880-bed medical center alleging everything from religious favoritism and blatant nepotism to the firing of outspoken doctors as a warning to others.

“One of the real difficulties with Adventism is that the leadership feels they’re doing God’s work, so you can’t argue with them,” said Dr. Alan Jacobson, an Adventist who quit Loma Linda about seven years ago.

Some Say Anxieties Linger

Officials of the medical center and its affiliated Loma Linda University, a health sciences institution, acknowledge that there have been some rocky years but say relations at the Adventist-owned hospital have steadied since the departure of a number of disaffected doctors.

“Certainly, Loma Linda is not a perfect place,” said Loma Linda University President Dr. L. Lyn Behrens. “But the spirit of Loma Linda is positive, is productive, and we have the ability to solve problems in a way that is professional and appropriate.”

Although Loma Linda veterans agree that much of the open bitterness has eased, some contend that anxieties linger below the surface.

Physicians who practice at the hospital work for private doctor-operated medical groups, generally organized according to specialty, and must teach at the university as part of their employment.

“There are physicians here who are apprehensive about speaking out too strongly on issues because their employment might be at stake,” said Dr. Keith Colburn, chairman of the Clinical Sciences Faculty Advisory Council.

“I can’t say whether those fears are realistic,” he said. “But in any system where there is top-down management without a strong faculty organization, one always has to be concerned about jeopardizing his job security.”

Those concerns stem largely from a series of tumultuous events that began in the early 1990s when two doctors formerly at the medical center sued Loma Linda officials for allegedly stealing their potentially lucrative research--a charge the school denied.

Three prominent doctors who were outspoken in support of their colleagues eventually were fired, prompting more outcries. Two-thirds of the doctors in the School of Medicine called for their reinstatement.

A letter of protest signed by 20 doctors concluded that “the church has long been known for integrity and honesty, and for preaching the Gospel--love the Lord thy God with all thy heart and thy neighbor as thyself. We believe that the manner in which this administration has dealt with many [employees] is in stark contrast to our motto to ‘Make Man Whole.’ ”

The American Assn. of University Professors weighed in too, censuring Loma Linda in 1992 for the firings--a censure that remains in place today, one of 55 from the group that are currently in effect nationwide.

Loma Linda administrators dismiss the association as little more than a biased labor union and say its chief complaints about the handling of faculty grievances have been addressed.

Although the doctors who alleged that their research was stolen have settled their cases out of court for undisclosed sums, wrongful-discharge lawsuits filed by two of the fired physicians are heading toward trial.

Meanwhile, last summer the hospital’s neurosurgery residency program was placed on probation by a national accreditation team. The group’s report concluded that the department’s leadership suffered from “long-standing instability” and that “faculty do not get along or collaborate effectively in the training of residents,” jeopardizing their morale.

Loma Linda officials say the problems are being addressed. Another accreditation review is scheduled for next year.

Another physician, vascular surgeon Alan Koslow, is suing the hospital, alleging that after an argument with a supervisor led to his 1993 departure, he was deemed incompetent by a Loma Linda physicians panel that secretly reviewed his work. Koslow, who had earlier received numerous accolades from Loma Linda, said the review--posted on a nationwide physicians databank--cost him a new job.

A subsequent independent study cleared Koslow, concluding that “from the nature of the strictness with which his work was judged, there was something else afoot that does not really appear herein.”

After the pejorative information was removed from the databank, a lower court judge dismissed Koslow’s suit for financial damages--a ruling the physician is appealing. Citing the ongoing litigation, Loma Linda officials declined comment.

Probe of Contract Urged

In another episode, a former president of the worldwide Seventh-day Adventist Church told The Times that there should be a review of whether the awarding of a lucrative contract was unduly influenced by family connections.

Neal Wilson, now a Loma Linda trustee, said the contract could spark “views of nepotism, that there’s a family tie-in here, a kind of royal succession. . . . I think there is an ethical question, definitely.”

The contract--to maintain the hospital’s proton beam accelerator, a state-of-the-art device for radiation treatment--was awarded to the son of the chairman of the radiation medicine department. The contract also gave the son’s company exclusive rights to build and market proton accelerators internationally, using technology acquired by and further developed at Loma Linda--a deal potentially worth millions of dollars. Both the father and son have denied any wrongdoing.

Wilson, the church’s president from 1979 to 1990, has earned a reputation for speaking his mind. But he saves his sharpest words for those who would challenge the medical center’s administration--a philosophy that seems embedded in the Seventh-day Adventist Church itself.

Wilson said unequivocally that the medical center will not tolerate “a dissident type of mind” that “sows the seeds of discontent.”

“If the situation demands it,” he said, “the best way [to deal with it] is just to relieve people [of their jobs] . . . and wish them well.”