Another doctor group out at Summa, no-confidence vote in leadership possible, sources say

2017-01-06 | Akron Beacon Journal

Jan. 06--Another independent physician group has been ousted from Summa Health System, whose leadership is under pressure after it replaced its longtime emergency room doctors with another group with ties to a Summa senior leader.

An emergency meeting has been called for staff physicians at Akron City Hospital and Barberton Hospital was called for 5:45 p.m. tonight with sources saying that there could be a no-confidence vote taken in Summa President and CEO Thomas Malone and other leadership.

The three-year contract for Respiratory, Critical Care, Sleep Associates (RCSA), a member of Unity Health Network, based in Cuyahoga Falls, expired today and has not been renewed, RCSA managing physician director Dr. Charles Fuenning, confirmed on Thursday. Fuenning said it is his understanding that 11 physicians have been replaced with nurse practitioners to work with hospital-employed physicians.

"To my knowledge, no one has brought up quality issues. Myself and many of my physicians have been listed as top docs in Akron and Cleveland magazines," he said.

The non-renewal of his group's contract means his 11 physicians will no longer have privileges on critical care-floors, including as medical and surgical intensive care units at Akron City Hospital.

"It does not allow us to practice our full spectrum of respiratory medicine," he said.

Fuenning said he has worked with many nurse practitioners and physician assistants and "love them and they are very competent."

But, he said, "a nurse practitioner is not the same as a seasoned, board-certified critical-care physician."

Summa spokesman Mike Bernstein confirmed on Thursday afternoon that the contract with RCSA for critical care medicine staffing services will not be renewed.

"Dr. Fuenning is one of two RCSA physicians who were notified during an in-person meeting with members of Summa's leadership team on June 29, 2016, and subsequently via certified mail, of the decision. During the June 29 in-person meeting with Dr. Fuenning, it was confirmed that a several month transition plan would be put into place to ensure no interruption to patient care. Critical care medicine staffing services will now be provided by Summa Health Medical Group physicians," Bernstein said.

"The Summa Health System-Akron Campus will be staffed at all times by critical care physicians and nurse practitioners," he said. "The Summa Health System-Barberton Campus also will be staffed by critical care physicians and nurse practitioners with the exception of the midnight shift. During the midnight shift, Barberton will be staffed by nurse practitioners with a critical care physician on-call via telemedicine."

Bernstein did not answer several other questions regarding the non-renewal of the contract, including the reason and whether this was an indication that Summa was moving toward an employee-staffed model instead of working with independently contracted physician groups.

Fuenning, who said he is the longest-serving critical care specialist in Akron, has been practicing at Summa facilities since 1986.

Fuenning said he reached out to Summa leadership in May to ask whether they could start negotiations for a new contract. Fuenning said he was met with silence for several weeks, followed by a quick meeting to be told their contract would not be renewed.

"They offered no reason for their decision," he said.

Subsequently, he found out that Summa would staff its critical care units exclusively with Summa-employed medical personnel.

Fuenning said he and his colleagues are disappointed in the non-renewal.

"Many of my physicians I work with are graduates of that hospital residency program. They came back to this community to be here. We liked that hospital, so it's very disappointing," he said.

Fuenning said he and his colleagues would never tell a patient where to go for medical care, but they will be notifying patients that his practice is no longer able to see patients on critical-care units at City Hospital. They will continue to have privileges on non-critical care units, but if patients' conditions decline and they are moved to an ICU, the doctors could not see them, he said.

The doctors will instead be practicing at other hospitals, Western Reserve Hospital, University Hospital Portage Medical Center (formerly Robinson Memorial Hospital) and Mercy Medical Center in Canton.

Fuenning is also an investor in Western Reserve Hospital, which has been in an extended legal battle with Summa. Fuenning said he was not in a position to say whether the non-renewal was personal, "but it certainly could be."

News of RCSA's contract not being renewed comes on the heels of the firestorm last week when it was revealed that Summa Emergency Associates (SEA) ­-- an independent physician corporation that's separate from Summa -- was being replaced with four day's notice to staff its five emergency rooms with a group of doctors paid by Canton-based US Acute Care Solutions (USACS) on New Year's Day.

The changeover surfaced publicly late last week and affected staffing at Akron City Hospital and Summa facilities in Barberton, Green, Medina and Wadsworth.

USACS works with hospitals across the country to provide similar groups of physician services. The company's chief executive officer, Dr. Dominic Bagnoli, is the husband of Dr. Vivian von Gruenigen, Summa's chief medical officer, one of the most powerful administrative positions at the health system.

Summa officials said on Friday that von Gruenigen was not involved in the selection process and that she would not affect the relationship between Summa and USACS.

Fuenning, who has served as a division chief in the pulmonary department and has served on the hospital's board of trustees, said he and his partners have been receiving support from other doctors upset with Summa's decision to terminate the contract with his group and SEA.

"There's now two episodes here. It makes someone pause and think," he said.

But a dozen Summa department chairs signed a letter that was posted on an internal Summa blog on Wednesday urging medical staff to support the system.

In the letter, they said "the rapid series of events" surrounding the ER change "have stirred a variety of emotions and promoted misinformation that does little to serve our patients or promote a positive working or learning environment.

"We accept that this happened due to a negotiating process that went awry and forced a difficult decision to change Emergency Department providers."

The leaders said it was in the best interest to move forward with the decision.

"While we realize there are powerful emotional responses to this situation, we, the Chairs, want to place the focus on our patients and on supporting the Emergency Medical Department to serve those patients," the letter said.

Betty Lin-Fisher can be reached at 330-996-3724 or Follow her @blinfisherABJ on Twitter or and see all her stories at