King/Drew Has a Void at the Top

Amid a massive turnaround effort, Martin Luther King Jr./Drew Medical Center conspicuously lacks helmsmen.

It has no permanent chief executive, no chief operating officer and no chief nursing officer.

Its affiliated medical school is hunting for a new president, dean and provost. Eight of 16 medical departments have fill-in chairmen.

About 200 other positions are unfilled, about 10% of the staff. Nearly 100 staffers -- 25 of them physicians -- have been fired since January 2004 amid mounting allegations of corruption and incompetence.

And the hospital continues to hemorrhage, losing an average of seven employees a month. Six were discharged in the first week of May alone.

The holes in King/Drew’s ranks have led some to question whether the troubled hospital, relying heavily for now on outside consultants and temporary staffing, will be able to attract the talent it needs for lasting reform.

The Los Angeles County Board of Supervisors, which oversees the hospital, has given health officials until August to determine whether reforms are likely to succeed or the hospital’s services should be reduced.

“If we can’t attract a [chief executive] candidate within the 90 days, I think it’s going to be hard to convince the supervisors we can turn the organization around,” said David Janssen, the county’s chief administrator.

Earlier this month, Janssen called the chief executives of county-owned Harbor-UCLA and Olive View medical centers to ask if they would be willing to temporarily fill in at King/Drew.

Their answer, Janssen told the supervisors, was, “Thanks, but no thanks.”

Supervisor Mike Antonovich’s suggestion that the offer be posed as “an opportunity ... for public service” and include a “five-signature scroll” was met with laughter.

“I tried all that,” Janssen replied.

Rotating lower-ranking employees from other county hospitals could yield better results, some in the health industry said.

“We need to get some of the physician pool replaced quickly, and using physicians from the other county hospitals is the way to do it,” said Jim Lott, a spokesman for the Hospital Assn. of Southern California.

Janssen said such rotations could lead to resistance, but Dr. Thomas Garthwaite, director of the county Department of Health Services, acknowledged that the county has not systematically sought volunteers.

Employees of other hospitals reacted cautiously.

“I don’t think that people would be upset about being asked to help out,” said Dr. Adam J. Jonas, chairman of the pediatrics department at Harbor-UCLA, near Torrance. But “if it’s forcible, some would have to reconsider whether they want to work for the county.”

“I wouldn’t consider it,” said Bethel Asres, a nurse at County-USC Medical Center in Boyle Heights.

Dr. Daryl Banta, a second-year resident at County-USC, is looking for a job for next year, but he said the challenges at King/Drew are not appealing.

“Dealing with patients in a county hospital is a challenge in itself,” he said. “I don’t know if I’d want to deal with the hospital’s other problems on top of that.”

The county has launched a broad recruitment effort for permanent staff, employing outside headhunters for the top leadership positions and offering a 10% salary bonus for rank-and-file nurses.

There are signs of progress: The hospital had a net gain of 27 employees in the first four months of the year and has received 11 qualified applicants for the top three posts.

A nursing job fair at the hospital this month attracted 66 applicants, six of whom accepted jobs.

Michael Henry, the county’s director of personnel, said his office had overcome obstacles before.

“There are people who for a variety of reasons will stand up to take on these challenges,” Henry said. “I’m optimistic.”

Others see a bleaker picture.

Several supervisors voiced skepticism about Garthwaite’s recent proposal to combine the hospital’s chief executive position with the presidency of Charles R. Drew University of Medicine and Science, whose faculty supervises physician trainees at the hospital.

The dual job may have been easier to fill, but would have tied the two troubled institutions together at a time when their future relationship is still being debated.

Antonovich has suggested severing the hospital’s ties to the university.

Some members of the King/Drew advisory board, formed by the county supervisors, are now questioning whether it will be possible to attract permanent leadership until reforms -- such as weeding out problem employees -- have taken hold.

“The administrator doesn’t have any direct control or input over what the doctors do,” said Lott, a member of the advisory board.

“Until those changes are made,” he said, “any administrator that walks into that hospital will fail.”