Physicians Reject New Policies in Hospital Dispute

Times Staff Writer

While executives at Community Memorial Hospital met to discuss reconciliation with rebellious doctors Tuesday evening, about 130 members of the medical staff overwhelmingly voted to reject controversial new policies imposed by the administration last week.

Meanwhile, Dr. John Hill, elected by doctors as chief of staff at the hospital for 2004, said Wednesday that he is moving his lucrative surgical practice from the Ventura hospital to rival St. John's Regional Medical Center in Oxnard.

"I don't want to work in this hospital environment. And I'm very concerned they might terminate my privileges," said Hill, who chaired the Tuesday evening physicians' meeting. "So after nearly 31 years at [Community Memorial], I'm moving my surgical practice to St. John's."

Community Memorial has been embroiled in an internal fight for about a year, as the 242-bed hospital has tightened controls over its medical staff and physicians have bristled at what they see as an erosion of their rights as a self-governing branch of the hospital.

The dispute boiled over last week after an apparently productive mediation session between the parties was followed by distribution of an anonymous "Ventura Physician Newsletter" critical of the administration.

In response, hospital executives implemented a controversial medical staff code of conduct that banned "harmful or disruptive behavior." They also imposed a conflict-of-interest policy that forbids any doctor with a financial interest that competes with Community Memorial from voting as a staff member or serving as a staff officer -- a maneuver apparently aimed at Hill and a second member of the new physician leadership.

Then, Tuesday evening, in simultaneous meetings on different sides of town, the administration's newly formed Medical Advisory Committee brainstormed how to end the conflict, while nearly all of the rebellious physicians approved a series of resolutions critical of recent hospital actions.

"It was quite gratifying," Hill said. "And in contrast to what [administrators] said, we do not represent a small splinter faction of the medical staff. This is a major portion of it."

Dr. Richard Reisman, hospital medical director, said Wednesday that Community Memorial is seeking detente with all its doctors, including the roughly one-third of the staff that the dissident physicians represent.

"I don't want to be in this grenade-lobbing again," Reisman said. "I want it to go beyond this name-calling and fighting to a resolution of the issue in a gentlemanly and proper fashion."

Indeed, one of the issues discussed by the new Medical Advisory Committee -- two trustees, two administrators and eight doctors -- was whether the hospital might reconsider some of its recent actions that many physicians have found so onerous, Reisman said.

"I certainly sensed from the members of the board of trustees that their hope for reconciliation was real," said committee member Dr. John Keats, medical director at Buenaventura Medical Group, which has 40 doctors who practice at Community Memorial.

"Personally, my hope would be that it be quickly resolved," Keats said, "because it certainly seems to be interfering with the orderly functioning of the hospital."

Dr. Stanley Frochtzwajg, who attended the physicians' meeting, said the rebellious doctors want an end to the discord too.

"The medical staff really welcomes genuine reconciliation," he said. "But so far we have not seen any signs of that. The tone has become very strident from the administration with the anti-competition and code of conduct policies."

In addition, Frochtzwajg said doctors have been abruptly removed from staff committees and leadership positions.

For example, Hill's partner, Dr. Samuel Small, was removed as chief of the hospital's surgical department.

Two other Hill partners, Ray Nickel and Tom Horn, this week lost a block of their surgery time that had routinely been reserved for them at Community Memorial, Hill said.

Frochtzwajg, a family physician, was also recently stripped of a contract that allows Community Memorial employees to see him under their employee insurance plan.

Reisman said the moves affecting Frochtzwajg and Hill's partners had nothing to do with the current conflict.

"This was done in the best interest of patient care," Reisman said. "Unfortunately it was done in the midst of this controversy, so it's perceived the wrong way."

As for Hill's decision to leave for St. John's, Reisman said it would hurt the hospital financially, and if the doctor really cared about Community Memorial he would keep his practice there.

Hill said Community Memorial wants to strip him of his voting rights as a physician and hospital leader and criticize him for having a tiny ownership in a surgical center. But it also wants to keep the revenue stream of well over $1 million a year from his surgeries.

"They can't have it both ways," Hill said.

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