Centegra Administration Trying to Cut Doctors Power

Centegra Hospital in McHenry.

Centegra Hospital in McHenry.

Centegra Hospital is doing its best to change its by-laws to conform with a policy change that directs patients admitted with doctors to hospital employees for future care.

For most of its history, the hospital has allowed physicians to be on-call to treat emergency room patients a couple of times a month.

That allowed younger doctors to build their practices.

In an interview with Dr. Bill Dam, McHenry County Blog learned some of the details.

Centegra’s administration thought it had prepared the way to change the by-laws concerning the exclusivity clause that would direct patients without docs to hospital staff physicians.

But when Dam entered the room where the Joint Medical Staffs of both the Woodstock and McHenry hospitals, he was approached by two former Chiefs of the Medical staff who had already signed off on the change and asked to help them out.

Dam, who has reformed two scandal-scarred local governments (Fox Lake and the Fox Waterway Agency) knows his way around politics.

Sitting next to President and Chief Operating Officer Jason Sciaro, he revealed that he has been asked to make a motion of no confidence in the administration.  He did not make the motion.

At the next quarterly meeting of the physicians on Centegra’s staff, in March,Dam was again asked by several members of the medical staff, including four previous Chiefs of Staff to argue against  a motion to approve the newly drafted bylaws favored by the administration.

The main objection to the new bylaws was an “exclusivity” section allowing the hospital to dismiss doctors from the staff with a sixty day notice to be replaced by doctors hired by the hospital, giving hospital employee doctors exclusive privileges to practice that specialty.

Centegra Woodstock Hospital from front

Centegra Hospital in Woodstock.

The two current Chiefs of Staff  “argued passionately” that the bylaw changes be accepted, Dam said.

But, the necessary extraordinary majority was not achieved.  Both Memorial and NIMC doctors rejected the proposal.

Then meetings between Dam and Sciaro resulted in agreement for  people having been present in person to vote on by-laws (a prohibition on email voting) and 20% needed to advance a write-in candidate became 10%, and one-third of the members being required for a quorum.

The question of funneling patients to hospitalists (doctors employed by the hospital)  and eliminating the rotating emergency room call schedule for private doctors was not resolved.

Meanwhile, a group of Centegra physicians are contemplating a suit.

Dam, who has been a member of the Centegra Health Systems Membership Board, which officially governs Centegra’s not-for-profit corporation, for about thirty years, then started seeking an up-to-date list of its members. He had one six years ago.

“We do not give out the Board member’s contact information,” read the email Dam received in reply to his request. He was directed to the Board Chair.

He did not achieve success until getting a former Executive Board President, an attorney, to make the request. As a Board member, the attorney advised, Dam had “an absolute right” to the list.

The attorney was asked by two administrative team members whey he wanted the information.

“What difference does it make?” the attorney responded.

Dam got the list last week, but it did not include addresses, as it had in the past.

He has compared it to the 2006 membership.

108 new members have been added since then.

He now wants to know how people get removed from the Board and how they get on.

He observes that many relatives of hospital employees have appeared on the list.

“The process should be transparent. I want the community to take back their board, choosing the officers in an open forum,” Dam said.


Centegra Administration Trying to Cut Doctors Power — 9 Comments

  1. An expose’ should be written regarding Centegra’s unreasonable refusal to grant hospital privileges to qualified Mercy Health Care physicians.

    For example, many Woodstock residents are patients of doctors at Mercy Woodstock Medical Center. The nearest hospital for Woodstock residents is, of course, Centegra-Woodstock.

    Yet my fully-qualified physician is not permitted to continue to care for me, if I enter Centegra’s hospitals in Woodstock or McHenry.

    This seems to me to be a good reason for a hospital to be independent of the clutches of one major medical group or another.

  2. Many physicians have privileges at multiple hospitals, even Centegra docs.

    At least they do according to my health plan.

    I am disappointed to see that even healthcare is subject to politics (Mercy v. Centegra aside).

    Poor leadership is going to sully the reputation of quality administrators and other good people, just because they are afraid of the light that transparency brings.

  3. How did Centegra get the contract for the Crisis Line?

    County employees being directed to use their health insurance for tests at Centegra? who, or what, is the link?

  4. With healthcare reform, hospitals are required to meet quality measures in order to get paid by insurance and medicare.

    This policy of Centegra’s is only going to improve the quality of care for patients at all hospitals.

    If Centegra isn’t letting all physicians take care of patients in the hospital, it’s probably because their quality is below standards.

    Doctors shouldn’t have to build their practice by waiting around for calls from the E.R.

    If they’re good, they’ll get referrals from friends, other physicians and their own patients.

  5. Just for the sake of clarity: the hospital alleges that hospitalist physicians who are paid by Centegra provide higher “quality” care.

    Whether true or not, the patients are finding out on their own. Centegra hired a large number of hospitalists 6 months ago, and the experiment is ongoing.

    Since hiring so many new internists costs a lot of money, to help defray those costs the hospital now keeps “unassigned patients” for its own hired physicians’ practices.

    There is a huge problem with this new system: when you show up with a problem, the hospital now will have a strong financial incentive to not find out who your regular doctor is, if that doctor is not an employee of Centegra. If you have a doctor that takes good care of you, odds are now higher that your doctor will be sidelined.

    Over the long term, this will concentrate power at the hands of business school types, away from the community’s physicians and patients.

    At a more basic level, the issue is that the hospital has bylaws, a constitution of sorts, that has governed the institution for years and years. The hospital and the ER there has served the community well, and so the current arrangements should not be changed at the whim of one executive or another.

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